Module 1

INTRODUCTION TO CAREGIVING
Module I: Introduction to Caregiving
Lesson I
Module Objectives:

 Understanding the role and responsibilities of a caregiver.

 Developing effective communication skills to interact with care recipients and their
families.
 Learning about the importance of maintaining privacy and confidentiality in caregiving
 To identify the responsibilities of members of the health care team.

What is caregiving?

 Caregiving is the act of providing help and comfort to another person. It can involve
many different activities such as helpinghelp with dressing, toileting or providing
emotional support to another person while they navigate a physical, emotional, or
health challenge.
 Caregiving can be a short-term role, or it can be something that lasts a very long time
depending on the needs of the care recipient, as well as your needs and abilities to
provide care. Although some people may have multiple health conditions contributing
to their need for care, the term CAREGIVING in this resource will refer to activities
associated with the act of providing care for someone.

Caregiver Responsibilities:

 Respect the patient's privacy and individuality.

 Cultivate the patient’s trust.
 Be objective in dealing with the patient. Never show pity.
 Approach the patient with an open mind. Never antagonize.
 Be organized in the process of caregiving.
 Have a good hygiene.
 Perform the different caregiver skills adequately.

Caregiver characteristics:

Personality traits of a caregiver

 1. Patience – people who need care often take longer to complete simple tasks.
They may ask the same questions over and over. Good caregivers need patience
to deal with anything from patient memory lapses to angry outbursts. They
practice staying calm and avoiding frustration.
2. Compassion- empathy and understanding are necessary. Even when caring for
an abusive person, caregivers try to remain empathetic and understanding.
3. Humor- finding something to laugh about can make a tough situation bearable. A
sense of humor keeps a caregiver emotionally strong and is a great stress buster.
4. Detail-oriented- good caregivers are good managers. They create schedules, plan
for emergencies, and organize information so they don’t have to scramble.
5. Being able to accept help- asking for help is not a sign of weakness. A good
caregiver realizes they can’t do it alone. They line up with family and
professionals to step in when they need a break.
6. Willing to set boundaries-a caregiver should respect their limits and say no to
demands when necessary.
7. Cooperative- a good caregiver is a part of a care team that may include doctors,
family, and friends. Being understanding and flexible goes a long way toward
being a successful team player.
8. Assertive-good caregiver advocate for their loved ones. They ask questions and
expect answers. Good caregivers learn about their patient's condition, and they
make sure their loved one gets the care they need.

Physical traits of a good caregiver

1. Physically fit- caregiver may make many trips up and down stairs every day.
Others need to help their patient move from the to the chair. Helping with
this transfer can lead to injuries. Being physically fit can make things easier,
but it isn’t always enough to avoid getting hurt. Caregivers need to learn how
to manage these chores safely, or know when to get help.
2. In good health- staying healthy might be the most important quality of a
good caregiver. It’s important to eat well, get well, get enough sleep, and
exercise regularly. And a good caregiver finds time to do things they enjoy. A
person can’t take care of others well if they don’t take care of themselves.

Basic communication skills in caregiving

 Effective communication is crucial in caregiving as it allows caregivers to understand the
needs of their patient, express concerns to healthcare professionals, and ask for help from
others. However, communication can become more challenging when individuals are tired, in
pain, frustrated, or depressed. Here are some basic communication skills that can help
caregivers improve their interaction:

1. Active listening: caregiver should practice active listening, which involves fully focusing
on and understanding what the other person is saying. This helps build trust and shows
empathy.
2. Nonverbal communication: nonverbal cues, such as facial expression, body language,
and tone of voice, can convey emotions and intentions. Caregivers should pay attention
to their own nonverbal cues and be mindful of the nonverbal cues of their patient.
3. Empathy: showing empathy involves understanding and sharing of feeling of another
person. Caregivers can demonstrate empathy by acknowledging and validating the
emotions and experiences of their patient.
4. Clear and concise communication: caregivers should strive to communicate clearly and
concisely to avoid misunderstanding. Using simple language, avoiding jargon, and asking
for clarification when needed can help ensure effective communication.
5. Respectful communication: caregivers should communicate with respect and dignity,
treating their patients as equal partners in caregiving process. This includes using polite
language, actively involving them in decision making, and honoring their preferences.
6. Patience: caregivers should practice patience when communicating, especially specially
when their patient may take longer to express themselves or understand information.
Allowing sufficient time for communication can help reduce frustration and improve
understanding.
7. Problem-solving: effective communication involves problem-solving. Caregivers should
work collaboratively with their patient and healthcare professionals to identify and
address any communication barriers or challenges that may arise.

Remember, effective communication is a skill that can be developed and improved over
time. By practicing these basic communication skills, caregivers can enhance their
interactions and provide better care for their patients.
THE HEALTH CARE TEAM
Compose of variety of workers whose skills and knowledge are directed to the total care
of the client.
Health team members work together to meet the needs of the clients.

Physician Pharmacist
Nurse Physical therapist
Social worker Occupational therapist
Nursing assistant Medical technologist
Radiologist Personal support worker
Psychologist Dietician/nutritionist
Chaplain Enterostomal therapist

FUNCTIONS OF THE HEALTH CARE MEMBERS

Physician
The role of a physician may vary from agency to agency.
Physician are responsible for doctor’s order in all settings.
In addition to medical orders, the physician is responsible for the plan of care in home care
settings.
Some physicians are very involved in the client’s plan of care whereas others rely heavily on the
nurses within the agency. Either way, the physician must approve the plan of care.
Nurse
The nurse plays a vital role as a member of the health care team and is often the professional
who has the most contact with the client, alongside nursing assistant and caregivers.
The addition of new team members to the client’s health care team is often the result of needs
and problems identified by the nurse.
Frequently, the nurse is the case manager for the client and thus coordinates the client’s care,
including scheduling team meetings.
Social worker
A social worker focuses on the psychosocial adjustments of the client and the family to illness
and can assess the home for the safety and appropriateness of various types of home care.
The social worker develops a plan of care with the client and family after an assessment has
been completed. An essential part of this plan is teaching coping skills through counseling to
help them maintain equilibrium during illness.
The social worker also functions as an advocate, a mediator, and a collaborator.
A referral for the services of the social worker, in home care, must be prescribed by a physician
and included in the physician’s plan of care.
Nursing assistant
The function and responsibilities of a nursing assistant vary among health care facility.
Nursing assistant perform functions and procedures relating to the personal hygiene, nutrition,
exercise and elimination needs of clients.
Related functions include lifting and moving patients, observing the patient’s physical comfort,
and collecting specimens.
May assist with the admission and discharge of patients, as well as taking and recording vital
signs.
Performs simple and basic nursing procedures under the direction and supervision of a
registered nurse.
Radiologist
Performs radiologic studies as prescribed by the prescribed by the physician like X-rays, CT-Scan
and other diagnostic exams.
Psychologist
Assess the psychological adjustments of the clients and the family towards the illness.
Focuses on the coping mechanism of the clients and family and makes necessary
recommendations for maladaptive adjustments.
Pharmacist
Prepare sand dispenses the right amount of medication as prescribed by the physician.
Physical therapist
A licensed rehabilitation specialist who focuses on physical fitness and mobility.
The purpose of PT is to promote optimal health and functional independence in people with
health problems resulting from disease or injury
The goal of the physical therapist is to alleviate acute and chronic movement dysfunction, pain
or physical disability. This is accomplished by assessing function limitations, impairments and
disability through examination.
Occupational therapist
A license rehabilitation specialist who focuses on the practice of activities of daily living such as
eating, playing, working, self-care, and caring for others and immediate environment.
Its goal is development and maintenance of the capacity to perform roles and tasks essential to
productive living to the satisfaction of self and others.
The occupation therapist evaluates and treats problem that reduce client’s ability to cope with
the tasks of everyday living. It can be either be developmental, physical, emotional, or social in
nature.
The interventions of the occupational therapist increase performance capacity and facilitate of
the development of adaptive skills.
Medical technologist
A license health care practitioner who handles specimens for various laboratory studies as
requested by the physician.
Personal support worker
The functions and responsibilities of a personal support worker/caregiver vary among health
care facilities.
Caregivers perform functions and procedures relating to the personal hygiene, safety, nutrition,
exercise and eliminating needs lifting
Related functions include lifting and moving patients, observing the patient’s physical comfort,
and collecting specimens.
May assist with the admission and discharge of patients, as well as taking and recording of vital
signs.
Perform simple and basic nursing procedures under the direction and supervision of a
registered nurse.
Dietician/nutritionist
The goal of the dietician is the promotion of health through proper diet and is responsible for
the therapeutic use of diet in treatment.
Enterostomal therapist
An enterostomal therapist specializes in skin and wound care associated with the
presence of an enterostomy.
An ET assesses and stablishes a plan of care manage ostomies, skin problem, complex
wounds and fistulas. These interventions include the fitting of prosthetic equipment for
ostomies, giving emotional support to clients and families, and educating staff, clients, and
caregivers about issues related to skin care.
Chaplain
They play an integral role in alleviating spiritual distress related to illness or disability.
However, their services are based purely on referral system.
Lesson II
Objectives:

 To know the legal implications of health care provisions.

 To be familiar with ethics in working as a health care provider.
 To be familiar with the various health care organization.

ETHICS AND VALUES

ETHICS
-the branch of philosophy that concerns the distinction between right and wrong on the
basis of a body of knowledge, not just on the basis of opinion.
Morality
-behavior in accordance with customs or traditions, usually reflecting personal or
religious beliefs.
Teleology
-ethical theory states that the value of a situation is determined by its consequences.
-principle of utility states that the act must result in the greatest amount of good for the
greatest number of people involved in the situation.
Deontology
-ethical theory that considers the intrinsic significance of the act itself as criterion for
the determination of good.
Values
-beliefs and attitudes that may influence behavior and the process of decision-making.
Values clarification
-process of analyzing one’s own values to better understand what is truly important.

Code of ethics
 -provide broad principles for determining and evaluation client care.
-are not legally binding, but institutions have the authority to reprimand any
practitioner for unprofessional conduct that results from violation of the code of ethics.

PSW CODE OF ETHICS

- Shall establish and maintain the highest moral principle with care, commitment, and
service, paramount to the delivery of service.
- Shall be commited to the benefit of the individual client in care, with respect, love,
and compassion, a gaol towards maximizing good.
- Shall value health and well being, and will assist persons to achieve their optimum
level of living in situations of normal health, illness, injury, or in process of dying.
- Shall respect and promote the autonomy of clients and help express their health
needs and values.
- Shall value and advocate the dignity and respect of human beings.
- Shall apply and promote principles of equity and fairness to assist clients.
- Shall practice environment conducive to safe, competent, and ethical care, and shall
safeguard the trust of clients in the information learned in the context of a
professional relationship is shared outside the healthcare team only with the client’s
permission, or as legally required.
- Shall act in manner consistrnt with their professional responsibilities and the
National Standards of Care Practices.
ETHICAL DILEMMA
- Occurs when there is a conflict between two or more ethicl principles.
- There is no correct decision.
- The health care practitioner must make a choice between two alternatives that are
equally unsatisfactory.
- Ethical reasoning is the process of thinking through what one ought to do in an
orderly and systemic manner to provide justification for actions on basis of
principles.
- Ethical committees are established to develop policies and procedures for the
prevention and resolution of dilemmas.

Types of Ethical Dilemmas

1. Intrapersonal- conflict arises within (involves just one person)

2. Interpersonal- conflict arises involving more than one person

ETHICAL PRINCIPES
PRINCIPLE DEFINITION EXAMPLE BEHAVIOR
Authonomy Execise of free choice Collaborates with clients in establishing
client-centered goals.
Respects client’s wishes to refuses care.
Non maleficence To do harm Assist in following medication procedure
meticulously.
Reports colleague’s incompetence
appropriately.
Beneficence To do good Interacts emphatically with clients.
Spends time reminiscing with elderly clients.
Justice Fair distribution of Plans daily schedule to assure that the most
resources vulnerable clients are given adequate care.
Participates in professional efforts to provide
health care to the homeless.
Fidelity faithfullness Returns to spend time to a client after
promising to do so.
Support colleague who is working to improve
standareds of care.
Confidentiality Protection on private, Refuses to discuss hospitalized colleague’s
 personal information conditon with non-heaalth providers.
Refuses to discuss clients information to
people who are not involved in his care.
Veracity Truthfulness Reports and records accurately.
Admits own errors immediately.

EMPLOYEE GUIDELINES
1. Respondent Superior- employer wil be held liable for negligent acts of employee acts of
employee occurred during the employment relationship and was within the scope of the
employee’s responsibilities.
2. Contract- employees are responsible to carry out terms of contractual agreement with
the employer and the client. Establish employee handbook and client care policies and
procedures that create obligations, rights, and duties, between those parties concerned,
govern the employee-employer relationship.
3. Institutional Policies- written policies and procedures of the employing institution that
detail how health care practitioner are to perform their duties. Policies and procedures
are usually specific and are located in minimals in most health care facilities. Although
policies are not laws, courts generally rule against health care practitioners violating the
policies. If the health care practitioner practices procedures in accordance with the
client care policies and procedures established by the employer, functions within the job
responsibility, and provides care consistently in a non negligent manner, the potential or
risk for the liability can be avoided or minimized.
4. Staffing- nurses, nursing assistant and caregivers should walk out when staffing is
inadequate, because charges of abandonment can be made. Short staffing situations
necessitates an immediate report to the nursing administration.
5. Floating- an acceptable, legalpractie used by the hospitals to solve their understaffing
problems. Employees in an floating situation must not assume responsibility beyond
their level of experience in caring for the type of clients who may be assigned to
him/her. Employees should request and be given orientation to the new unit.
6. Diciplinary Action- corrective measures applied to erring employees.
Causes of disciplinary action maybe:
*unprofessional conduct
*conduct that could adversely affect the health and welfare of the public
*breach of client’s confidentiality
*failure to use sufficient knowledge, skills, or judgement
*physically or verbally abusing the client
*failure to accurately maintain a record for each client
*falsifying a client’s records
 *leaving an assignment or obligation without properly notifying appropriate
personel

LEGAL LIABILITIES

1. LAWS
 Healthcare providers are govern by civil and criminal law in roles as providers of
services, employees of institutions, and as a private citizens.
 A healthcare provider has a personal and legal obligation provided a standard of
client care expected af a reasonably competent healthcare.

2. TYPES OF LAWS
LAW DEFINITION
Contract Law Concerned with the enforcement of agreement among
private individuals
Civil Law Concerned with relationship among people and the
protection of a person’s rights.
Violation may cause harm to an individual or property, but
no grave threat to society exists.
Criminal Law Concerned with relationships among individuals and
governments and with act that threaten society and its
order; a crime is an offense against society that violates a law
and is defined as a misdemeanor (less serious nature) or
felony (serious nature)
Tort Law Civil wrong, other than a breach on contact, in which the law
allows an injured person to seek damages from the person
who caused the injury.

3. Types of Tort

TORT SAMPLE DESCRIPTION OF OFFENSE

Fraud Misrepresentation of credentials; falsification of client’s
records
Invasion of Privacy Sharing of confidential information; refusing to allow use of
personal clothing when it would not interfere with the
procedures; demonstrating a procedure on a client without
permission.
 Slander (defamation Making a false verbal statement about a client having a
of character orally) socially unacceptable disease like AIDS, to another health
professional.
Libel (defamation of Making a false statement about a client in writing or making
character through such statement to a mass media (press, television)
writing)
Assault Threatening or appearing to threaten to provid treatment
without consent.
Battery Treating a client without consent.
False Imprispnment Restraining a client inappropriately; detaining a client in a
treatment facility against his or her will.
Negligence Negligence is tort – but with licensed providers, it is called
malpractice.
Malpractice Failure to maintain expected standards of care.

4. Negligence and Malpractice

 Conduct that falls below the standard of care.
 Can include acts of commission as well as acts of omission.
 If healthcare practitioner gives care foes not meet appropriate standards, he or
she may be held liable for Negligence.
 Malpractice is negligence on the part of the health care practitioner.
 Malpractice is determined of the health care practitioner owed a duty too the
client and did not carry out that duty, and the client was injured because of the
failure to the duty.
 there must be an established proof of liability:
a) Duty: At the time of injury, a duty existed between the plaintiff and
the defendant.
b) Breach of duty: The defendant breached duty of care to the plaintiff.
c) Proximate Caue: the breach of duty was the legal cause of injury to
the client.
d) Damage of injury: The plaintiff experienced injury or damages or both
can be compensated by Law
[e)] .
5. Good Samaritan Law (US Setting)
 This was enacted to encourage health care providers to assist strangers in emergency
situations without risk of criminal and civil liability.
 Guidelines are as follows:
a) Make a decision quickly as to whether you will stay and help. Remember
that there is no common law duty to stop and render aid. Once you begin to
provide care, you incur the legal duty to maintain a standard of reasonably
emergency care.
 b) Ask the injured person or family members for permission to help. Do not
force your services if refused.
c) Care for the injured party where you can do safely. This includes in the
vehicle or the exact site where the victim is found. Move the injured party
only if you must do so, without causing further harm and as needed to
prevent further harm (ex: incident happened along the highway).
d) Apply the rules of first aid: assess for and prevent bleeding, assess for the
need to initiate CPR, cover the injured part with a blanket or coat, and so
forth.
e) Continuously assess and reassess the person for additional injuries, and
communicate findings of our assessment to the person or family members.
f) Have someone call or go for additional help while you stay with the injured
part.
g) Stay with the person until equally or more qualified or more qualified help
arrives. Prevent unskilled persons from treating or moving the injured party.
h) Give as complete a description as possible for the care that you have
rendered to the police and emergency medical personnel so that continuity
of care exists. Give family member or police any personal items such as
dentures, eyeglasses, and the like.
i) Do not accept any compensation (money or gifts) offered by the injured
party or family members. Acceptance of compensation may change your
care into a fee-for-service situation and cause you to lose your Good
Samaritan protection.
j) Should you choose not to stop and render aid, stop at the nearest phone
and report the accident to proper authorities so that the injured party
maybe aided.
k) Review legislative actions periodically for any changers in your States’s Good
Samaritan Law. Know the Good Samaritan Law in other state before
providing assistance.
6. Consents
 Is the legal client’s approval to have his or her body touched by a specific individual.
 Legally, the client must be mentally competent to give consent for procedures.
 Prior to granting a consent, the client must be fully informed regarding treatment,
surgery tests, and so on, and must understand both the intended outcome and the
potentially harmful results.
 Consent must be obtained by the physician surgeon, or other medical practitioner
performing the treatment or procedure.
 Nurses, CNAs or Caregivers, when involved in the consent process, acts only as
witnesses.
 If a client is determined by court to be unable to make decisions, or is declared
incompetent or under a legal disability, a personal guardian is appointed by the court to
make decisions.
 Parental or guardian consent must be obtained before treatment is initiated for a minor
except in an emergency, in situations in which the consent of the minor is sufficient,
 such as treatment of a sexually transmitted disease, or if a court or other legal
authorization has been obtained.
 Kinds of consent includes:
 Informed Consent – notifying the patient of specific procedures and the options
involved in their care.
 Simple Consent – denotes that a patient has no knowledge about the procedure
that will be performed an that verbal consent should be obtained.
 Implied Consent – refers to consent being given by another person in an
emergency situation because the client is unable to make a decision.
 Expressed Consent – involved when a client wants a procedure to be performed
although they may not have given verbal or written approval.
7. Confidentiality Agreement
 Confidentiality and Security are important organization and individual goals when
interacting with clients. It is important to establish confidentiality guidelines and to take
them seriously. Problems can be created with families, individuals or other health care
providers if you do not practice the legal ethical standards of Confidentiality. The
security of information is protected under law.
 Below is an example of Confidentiality Agreement:

Confidentiality Agreement

As an employee of
__________________________________________________ I hereby certify that I
understand and am bound by the Freedom of Information and Protection of Privacy
Act. I promise to protect the privacy of individuals in the administration of Company
duties. I will have access to limited personal information and confidential information,
including, but not limited to, client lists, financial statements and tax return, which I
covenant, agree, and promise to keep confidential and not to disclose to any person,
not use in any manner outside of my employment with the Company, and for the
soles benefit of the Company, and the performance of duties in administration unless
authorized to do so in advance writing by an officer of the Company or by the court.
This agreement survives Employee termination with the Company and is
beyond employment with the Company.
Date: ___________________
Employee: _________________

Company Seal

Legal Safeguards

i) Risk management
 A planned method to identify, analyze, and evaluate risks followed by a plan for
reducing the frequency of accidents and injuries.
  Programs are based on a systematic reporting system for incidents or unusual
occurrences.
ii) Incident Reports
 A tool used as a means of identifying and improving client care.
 Follow specific documentation guidelines.
 Fill out completely, accurately, and factually.
 The report form should not be copied or placed in the client’s records.
 No reference should be made to the report form in the client’s record.
 Not a substitute for a complete entry in the client’s record regarding the incident.
iii) Documentation
 Legally required by all institutions/agencies although implementation may vary from
one agency to another.

Guidelines for Documentation

 Narrative:
a) Use black pen.
b) Date and time entries.
c) Provide objective, factual, and complete documentation.
d) Document care, medications, treatments, and procedures as soon as possible after
completed.
e) Document client responses to interventions.
f) Document consent for or refusal of treatments.
g) Document calls made to other health care providers.
h) Do not document for others or change documentation for other individuals.
i) Sign and title each entry.
j) Use quotes as appropriate for subjective data.
k) Use correct spelling, grammar, and punctuation.
l) Avoid unacceptable abbreviations. Use only those accepted by your institution.
m) Avoid judgmental or evaluative statements, such as “uncooperative client”.
n) Do not leave blank spaces on documentation forms.
o) Follow agency policies when an error is made (draw one line through the error, initial and
date. Never use correction fluid to correct entries.)
p) Follow agency policies regarding late entries.
 Computerized:
a) Use only the user identification (ID) code, name, or password.
b) Never lend access ID to another.
c) Maintain privacy and confidentiality of documented information printed from the computer.

Legal Documents for Decision-Making

A. Will
 Some agencies have specific policies that prohibit health care providers from signing as
witness to this legal document for a client.
 If healthcare provider witnesses a legal document, he or she must document the event
and the factual circumstance surrounding the signing in the medical record.
  Documentation should include who was present, any significant comment by the client,
and the healthcare provider’s observations of the client’s conduct during the signing
process.
B. Advance Directive
 Written document recognized by law that provides directions concerning the provision
of care when a person is unable to make his or her own treatment choices.
 Must be made part of the medical record.
C. Power of Attorney
 Also called healthcare proxy.
 An authorization that enables any competent individual to name someone to exercise
decision-making authority on the individual’s behalf under specific circumstances.
D. Living Will
 Document prepared by a competent adult that provides direction regarding medical
care in the event of the person’s incapacitation or otherwise becoming unable to make
decisions personally.

Resident’s Bill of Rights

 For the residents of Licensed Nursing Homes and Approved Charitable Municipal Homes for the
Aged.
 These facilities are primarily the home of their residents. A such they are to be operated in such
a way that the psychological, social, cultural, and spiritual needs of teach client are met.
Furthermore, each resident should be given the opportunity to contribute, in accordance with
his or her ability, to the physical, psychological, social, cultural, and spiritual needs of others. The
following rights of residents are to be fully respected and promoted.

 Every resident has the right to be treated with courtesy and respected and in a way
that fully recognizes the resident’s dignity and individuality and to be free from
mental and physical abuse.
 Every resident has the right to be properly sheltered, fed, clothed, groomed, and
cared for in a manner consistent his or her needs.
 Every resident has the right to be told who is responsible for and who is providing the
resident’s direct care.
 Every resident has the right to be afforded privacy in treatment and in caring for his
or her personal needs.
 Every resident has the right to keep his or her room and display personal possessions,
pictures, and furnishings in keeping with safety requirements and other resident’s
rights.