CHCPAL003 Student Assessment Booklet V1.2

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STUDENT
ASSESSMENT BOOKLET
CHCPAL003 DELIVER CARE SERVICES USING A PALLIATIVE APPROACH
ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

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Table of Contents
Assessment Overview........................................................................................................................................... 5
Assessment Task Summary........................................................................................................................ 5
Assessment Documents........................................................................................................................................ 5
Required Additional Documents.................................................................................................................. 5
Assessment Task Cover Sheet.................................................................................................................... 5
The Assessment Process and Your Rights........................................................................................................... 6
Submitting your Assessment Tasks............................................................................................................. 6
Assessment Attempts and Resubmissions.................................................................................................. 6
Assessment Outcomes................................................................................................................................ 6
Assessment Outcome Summary................................................................................................................. 6
Plagiarism, Cheating and Collusion............................................................................................................. 7
Assessment Appeals................................................................................................................................... 7
Reasonable Adjustment............................................................................................................................... 7
Information about Assessment.............................................................................................................................. 8
Dimensions of Competency......................................................................................................................... 8
Principles of Assessment and Rules of Evidence........................................................................................ 8
Principles of Assessment............................................................................................................................. 8
Rules of Evidence........................................................................................................................................ 9
Glossary of Instructional Task Words.......................................................................................................... 9
Assessment Plan................................................................................................................................................. 10
Assessment Task Cover Sheet – Assessment Task 1........................................................................................11
Assessment Task 1: Knowledge Questions........................................................................................................ 13
Assessment Checklist: Assessment Task 1....................................................................................24
Assessment Task 2: Advance Care Plan............................................................................................................ 29
Assessment Task 3: Pain Management.............................................................................................................. 37
Verbal Questions – Assessment Task 3..........................................................................................43
Assessment Task 4: End of Life Care................................................................................................................. 49
Verbal Questions – Assessment Task 4..........................................................................................52
Assessment Outcome Summary......................................................................................................................... 55
Assessment Outcome Summary Table: CHCPAL003 Deliver care services using a palliative approach...........56

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Assessment Overview
This Student Assessment Booklet includes all your assessment tasks for CHCPAL003 Deliver care services
using a palliative approach.
Assessment Task Summary

This unit requires you to complete four assessment tasks. You must satisfactorily complete all tasks to
achieve competency for this unit.
Assessment Task Assessment Method Task Summary
Assessment Task 1: Written questions Students must answer 12 knowledge questions in an

Knowledge Questioning open book written assessment.
Assessment Task 2: Role play Students must undertake a role play to assist a client
Advance Care Plan who has recently ceased to have chemotherapy, by
referring to their Advance Care Plan and completing
a Daily Progress Report.
Assessment Task 3: Role play and verbal Students must undertake a role play to discuss pain
Pain Management questions management for a client in the late stages of stomach
cancer.
Assessment Task 4: Role play and verbal Students must undertake a role play to care for a
End of Life Care questions person at end-of-life. This includes providing support
to the family during a difficult time in their lives.
Assessment Documents
Required Additional Documents

The following additional documents support this Student Assessment Booklet and form part of the
assessment tool for this unit. You will require them to complete the assessments for this unit.
 Advance Care Plan – James McDougal
 Daily Progress Report Template
 Banksia Care supporting documents (available on the Banksia Care website):
– AP SD7 Pain and Symptom Management Plan
– DC SD1 Code of Ethics
– DC3 Privacy and Confidentiality Policy and Procedure
– PC5 Palliative Care Management Policy and Procedure.
Assessment Task Cover Sheet

At the beginning of each task in this booklet, you will find an Assessment Task Cover Sheet. Please fill it in
for each task where you need to submit items for assessment, making sure you sign the student declaration.

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Your assessor will give you feedback about how well you went in each task and will write this on the back of
the Task Cover Sheet.

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The Assessment Process and Your Rights
Submitting your Assessment Tasks

When you have completed your assessment tasks, you will need to submit them, according to the
instructions provided to you by your assessor or RTO.
If you are provided with a due date, you must make sure you submit your tasks in accordance with it. You
may be required to apply for an extension if you require extra time, according to your RTO’s policies and
procedures.
Instructions about submission can be found at the beginning of each assessment task.
Make sure you keep a copy of your tasks before you submit them. Your RTO will need to keep them as
evidence and may not be able to return them to you.
Assessment Attempts and Resubmissions

You have up to three attempts to complete each assessment tasks satisfactorily. If after the third attempt,
you have not completed a task satisfactorily, your assessor will make alternative arrangements for
assessment, which may involve additional training and time to consolidate your skills and knowledge. When
you are required to resubmit, you may be required to:
 Resubmit incorrect answers to questions (such as written tasks and case studies)
 Resubmit part or all of a project, depending on how the error impacts on the total outcome of the task
 Redo a role play after being provided with appropriate feedback about your original performance
 Being observed a second (or third time) undertaking any tasks/activities that were not satisfactorily
completed the first time, after being provided with appropriate feedback
When you are required to resubmit, you’ll be given a due date for your resubmission. For example, you may:
 Be given 30 days in which to resubmit incorrect responses to written tasks, projects and so on
 Be provided with feedback about your performance in a role play and then being required to complete
the role play again at a future meeting with your assessor
 Need to complete workplace-based tasks again during the same workplace visit or additional workplace
observations may need to be scheduled (as applicable)
All re-submissions will be conducted in accordance with the RTO’s policies and procedures.
Assessment Outcomes
Each assessment task will be given an outcome of either Satisfactory (S) or Not Satisfactory (NS). You must
complete all tasks satisfactorily to achieve an overall outcome of Competent (C) for a unit. If one or more of
tasks are assessed as Not Satisfactory, you will be given an outcome for the unit of Not Yet Competent
(NYC).
You will be given a total of three attempts to complete each task and achieve a Satisfactory outcome. In the
case of resubmission, you will be given a date by which you will need to resubmit, and you’ll be given
feedback about what needs to be addressed in your resubmission.
Assessment Outcome Summary

The Assessment Outcome Summary records the task and overall unit results for the unit of competency
named herein. The results for each attempt at each task must be recorded in the Assessment Outcome
Summary.

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Once you have attempted all assessment tasks, you assessor must enter a result for the unit in the Unit
Results box. You must achieve a Satisfactory outcome for all assessment tasks that are relevant to a unit to
be marked as Competent for the unit. Where you have attempted all tasks, but one or more tasks have an
outcome of Not Satisfactory, you assessor must record a result of Not Yet Competent in the Unit Results
box.
Plagiarism, Cheating and Collusion

Plagiarism, cheating and collusion on assessments is not acceptable. Any incidence of this is considered
academic misconduct. The definitions of each of these are below.
 Cheating – seeking to obtain an unfair advantage in the assessment of any piece of work.
 Plagiarism – to take and use the ideas and/or expressions and/or wording of another person or
organisation and passing them off as your own by failing to give appropriate acknowledgement. This
includes material from any sources such as staff, students, texts, resources and the internet, whether
published or unpublished.
 Collusion – unauthorised collaboration between students.
Where your assessor believes there has been an incident of academic misconduct involving plagiarism,
cheating, and/or collusion, this will be addressed in line with the RTO’s policies and procedures which may
ultimately lead to your withdrawal or you needing to complete the whole unit again.
Assessment Appeals
If you don’t agree with an assessment decision made, you have the right to appeal it. You may need to lodge
your request for an appeal within a certain amount of time from the original decision being made. You will
need to make your appeal in writing and follow your RTO’s process for appeals. Refer to your Student
Handbook for more information about our appeals process.
Reasonable Adjustment
A legislative and regulatory framework underpins and supports the delivery of vocational education and
training across Australia. Under this framework, providers of vocational education and training must take
steps to ensure that students with recognised disabilities have the same learning opportunities and same
opportunities to perform and complete assessments as students without disabilities. Sometimes reasonable
adjustments are made to the learning environment, training delivery, learning resources and/or assessment
tasks to accommodate the particular needs of a student with a disability. An adjustment is reasonable if it can
accommodate the student’s particular needs while also taking into account factors such as:
 The views of the student
 The potential effect of the adjustment on the student and others
 The costs and benefits of making the adjustment
RTOs are obliged by law to provide reasonable adjustments where required to ensure maximum participation
of students with a disability.
Making reasonable adjustments requires the RTO to balance the need for change with the expense or effort
involved in making this change. If an adjustment requires a disproportionately high expenditure or disruption
it is not likely to be reasonable.[1]
Please discuss with your assessor if you believe a reasonable adjustment to an assessment task, method or
process needs to be made on the basis of disability.
[1][1]
Source: Innovation & Business Skills Australia. (2015). BSB business services training package: implementation guide. Retrieved from
https://vetnet.gov.au/Public%20Documents/BSBv1.2%20Business%20Services%20Implementation%20Guide.pdf.

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Information about Assessment
Dimensions of Competency
To be competent, you must show your ability to perform effectively in a broad capacity. The dimensions of
competency ensure the person being assessed has the skills to perform competently in a variety of different
circumstances. To be competent, you must demonstrate the following:
 Task Skills: The skills needed to perform a task at an acceptable level. They include knowledge and
practical skills, and these are usually described in the performance criteria.
 Task Management Skills: These are skills in organising and coordinating, which are needed to be able to
work competently while managing a number of tasks or activities within a job.
 Contingency Skills: The skills needed to respond and react appropriately to unexpected problems,
changes in routine and breakdowns while also performing competently.
 Job Role/Environment Skills: The skills needed to perform as expected in a particular job, position,
location and with others. These skills may be described in the range of variables and underpinning skills
and knowledge.
Principles of Assessment and Rules of Evidence

Assessment must be conducted in accordance with the rules of evidence and principles of assessment
(definitions from the Users’ Guide: Standards for Registered Training Organisations (RTOs) 2015).
The following are the definitions of the Principles of Assessment and Rules of Evidence.
Principles of Assessment
 Validity
‘An assessment decision of the RTO is justified, based on the evidence of performance of the individual
learner.’
Validity requires:
– Assessment against the unit/s of competency and the associated assessment requirements covers
the broad range of skills and knowledge that are essential to competent performance
– Assessment of knowledge and skills is integrated with their practical application
– Assessment to be based on evidence that demonstrates that a learner could demonstrate these
skills and knowledge in other similar situations; and
– Judgement of competence is based on evidence of learner performance that is aligned to the unit/s
of competency and associated assessment requirements.
 Reliability
‘Evidence presented for assessment is consistently interpreted and assessment results are comparable
irrespective of the assessor conducting the assessment.’
 Flexibility
‘Assessment is flexible to the individual learner by:
– Reflecting the learner’s needs
– Assessing competencies held by the learner no matter how or where they have been acquired
– Drawing from a range of assessment methods and using those that are appropriate to the context,
the unit of competency and associated assessment requirements, and the individual.’
 Fairness

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‘The individual learner’s needs are considered in the assessment process.

‘Where appropriate, reasonable adjustments are applied by the RTO to take into account the individual
learner’s needs.
‘The RTO informs the learner about the assessment process and provides the learner with the
opportunity to challenge the result of the assessment and be reassessed if necessary.’
Rules of Evidence
 Validity
‘The assessor is assured that the learner has the skills, knowledge and attributes as described in the
module or unit of competency and associated assessment requirements.’
 Sufficiency
‘The assessor is assured that the quality, quantity and relevance of the assessment evidence enables a
judgement to be made of a learner’s competency.’
 Currency
‘The assessor is assured that the assessment evidence demonstrates current competency. This requires
the assessment evidence to be from the present or the very recent past.’
 Authenticity
‘The assessor is assured that the evidence presented for assessment is the learner’s own work.’
Glossary of Instructional Task Words

Your assessment tasks use a range of instructional words throughout them – such as ‘compare’ and ‘list.
These words will guide you as to the level of detail you must provide in your answers. Some questions will
also tell you how many answers you need to give – for example, ‘Describe three strategies…’. Use the
below glossary to guide you on interpreting the words in the tasks.
 Describe – This means you should outline the most noticeable qualities or features of an idea, topic or
the focus of the question.
 Discuss – This means you must point out the important issues or features, key points, possible
interpretations, and debate through argument. You should provide reasons for and against.
 Explain – This means you need to make something clear or show your understanding by describing it or
providing information about it. You will need to make clear how or why something happened or is the
way it is.
 Identify – You must recognise something and indicate who or what the required information is. The
length of the answer should be guided by what you are being asked to identify.
 List – You must record short pieces of information in a list form – with one or two words, or sentences on
each line.
 Outline – You must give a brief description of the main facts or sequence of events about something.
The length of the response should be guided by what you are required to outline. As long as you include
the main facts or points, then that’s enough.
 Summarise – You must express the most important facts or points about something in short and concise
form.

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Assessment Plan
The following outlines the assessment requirements for this unit. You are required to complete all
assessment requirements outlined below to achieve competency for this unit.
Your assessor will provide you with the due dates for each assessment task. Write them in the table below.
Assessment Tasks Due Date
1. Assessment Task 1: Knowledge Questioning
2. Assessment Task 2: Advance Care Plan
3. Assessment Task 3: Pain Management
4. Assessment Task 4: End of Life Care
AGREEMENT BY THE STUDENT
Read through the assessments in this booklet before you fill out and sign the agreement below. Make sure
you sign this before you start any of your assessments.
Have you read and understood what is required of you in terms of assessment?  Yes  No
Have you read and understood the RTO’s policies and procedures related to  Yes  No
reassessment?
Do you understand the requirements of this assessment?  Yes  No
Do you agree to the way in which you are being assessed?  Yes  No
Do you have any special needs or considerations that must be made in preparation  Yes  No
for this assessment? If yes, what are they?
__________________________________________________________________
Do you understand your rights to appeal the decisions regarding assessment?  Yes  No
Student Name: __________________________________________________
Student Signature: _______________________________________________ Date: _______________
Assessor Name: _________________________________________________
Assessor Signature: ______________________________________________ Date: _______________

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Assessment Task Cover Sheet – Assessment Task 1
Students: Please fill out this cover sheet clearly and accurately. Make sure you have kept a copy of your
work.
Name:
Date of submission:
Unit: CHCPAL003 Deliver care services using a palliative approach
No. of pages in
submission:
Assessor to complete
Is this a
Satisfactory/ reassessment?
Assessment Task Number and Title Not satisfactory Date Y/N
Assessment Task 1: Knowledge Questions
STUDENT DECLARATION
I __________________________________________________ declare that these tasks are my own work.
þ None of this work has been completed by any other person.
þ I have not cheated or plagiarised the work or colluded with any other student/s in the completion of this
work.
þ I have correctly referenced all resources and reference texts throughout these assessment tasks.
þ I understand that if I am found to be in breach of the RTO’s policies, disciplinary action may be taken
against me.

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ASSESSOR FEEDBACK
Assessors: Please return this cover sheet to the student with assessment results and feedback.
A copy must be supplied to the office and kept in the student’s file with the evidence.
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Assessor Signature: _____________________________________________________________________
Assessor Name: ________________________________________________________________________
Date: _______________

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The following assessment tasks use a simulated aged care facility called Banksia Care.
To complete the assessment tasks, students will need to access information,
templates, policies and procedures associated with Banksia. These documents can be
accessed on Banksia’s intranet (accessible via the website). To access, head to
http://banksia.eduworks.com.au/, navigate to the staff intranet and enter your RTO’s
username and password prior to completing your assessment tasks.
In this task, you will demonstrate your knowledge by answering a series of

questions that relate to this unit of competency.
You must answer all questions correctly to achieve a satisfactory outcome for this
TASK SUMMARY task.
RESOURCES AND
EQUIPMENT  Access to a computer.
REQUIRED  You may use your learning materials as a reference if required.
WHERE AND
WHEN THIS TASK  You must complete this task in your own time or at a time allocated by your
WILL BE trainer/assessor.
COMPLETED  Your assessor will provide you with the due date for this assessment task.
You need to answer all questions correctly to be marked Satisfactory for this task. If
WHAT HAPPENS IF
you answer any questions incorrectly you will need to resubmit your answers to
YOU GET those questions again. Your assessor will provide you with a due date by which you
SOMETHING must resubmit your new responses. You have up to three attempts to achieve a
WRONG? Satisfactory outcome.
SUBMISSION
REQUIREMENTS  Your answers for each question.

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 Answer all questions below by indicating your response to each question in the
space provided.
 You may use your learning materials as reference if required.
TASK  You must answer all questions and their parts correctly to achieve a
INSTRUCTIONS Satisfactory outcome for this task.
QUESTION 1
a) What is palliative care?
b) What are the aims of palliative care?
c) What are three of the principles of palliative care?

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d) What is the difference between a ‘curative’ and a ‘palliative’ approach?
QUESTION 2
a) Working in palliative care can be very stressful. List three emotions that workers would feel while caring
for terminally ill clients.

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b) What are four things that you can do to help your colleagues deal with their emotions?
QUESTION 3
a) List three types of nutrition and hydration advice you would give to a client and their family during the
early stages of palliative care.
b) In the final stages of life, appetite and thirst may decrease significantly. Family members may feel that
they should try to feed the person. What would you advise the family members?

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QUESTION 4
a) List two common misconceptions about pain relief.
b) Choose one of the misconceptions from your answer in Q4(a). In one paragraph, describe why it is a
misconception and the truth around this statement.
QUESTION 5
Scenario
Shamus’s family come to talk to you about his care.
They want to speak to you because they trust you as someone who has worked very closely with Shamus
as a palliative care worker for the last two months.
They are very distressed about a report they have received from the doctor, who has told them that
Shamus has only days to live.
His family ask you to refer them to a different doctor – there must be something that can be done to
preserve his life. They aren’t ready to lose him yet!
Shamus has an advanced care directive. It states he does not want further medical treatment to keep him
alive.
His family are aware of this directive.

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a) You feel that people have the right to get a second opinion. Should you refer Shamus’s family to a good
doctor that you know? Explain your answer.
b) What other action could you take to support Shamus’s family?
QUESTION 6
Scenario
Shamus has died.
His wife, Katherine, comes to see you and thanks you for looking after him so well.
She gives you a hug, and you both feel a bit sad.
Katherine tells you that she seems to be living in a daze. She can’t even remember what she did this
morning. She is usually so well organised but just can’t seem to concentrate at the minute. What if
something goes wrong at the funeral because she forgets to do something?
‘I haven’t even cried yet!’ she exclaims.
a) Why is Katherine experiencing this type of reaction so soon after her husband’s death?

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b) What would you say to Katherine to reduce her fear of something going wrong at the funeral?
c) What are the five stages of grief according to the Kübler-Ross Grief Cycle?
QUESTION 7
Constipation is a common problem in palliative care clients. The doctor may prescribe laxatives to assist with
this. What two supports can a personal care worker give to a client suffering from constipation besides
medication?

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QUESTION 8
Scenario
A client’s family is looking for some information on palliative care. They have received the information the
Banksia Care team provided but are looking for more.
Research the Internet and find a reputable source of information that they can access to find out more. Name
the source of this information (i.e., the website address).

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QUESTION 9
a) Describe three legal issues that may arise with advanced care directives and suggest how to deal with
these.
b) Describe three ethical issues that may arise with advanced care directives and suggest how to deal with
these.

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QUESTION 10
Scenario
Betty has severe dementia.
Before she got dementia, she had written out an advanced care directive that said that she wanted to be
resuscitated by CPR if she collapsed under any circumstances.
As far as Betty was concerned, life was more important than anything else – even if she wouldn’t be able
to make her own decisions as her dementia progressed.
Betty’s son has not been to visit her for months. One day he appears at Betty’s side. ‘I’m the only next of
kin,’ he says. ‘Mum isn’t here anymore; she’s just a vegetable now. I don’t want her to be resuscitated if
she collapses again. Just let the old lady die.’
You are aware that Betty is a very rich woman. From the look of her son, he could do with some money.
a) What ethical issues are involved in this scenario, and what action should the care worker take?

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b) Outline what is ‘unconscious bias’ is and how it could impact providing the correct care in this situation.
Betty’s son begins to ask a lot of questions about his mother:

 ‘What is the matter with her?’
 ‘How sick is she?’
 ‘Does she know who anyone is anymore?’
 ‘Where is all her bank paperwork?’
Betty’s son assures you that he has a power of attorney for Betty but does not show you a copy.
c) Betty’s last surviving relative is her son. Considering he says he has power of attorney, do you think you
can give him any of the information he has asked for? Explain your answer.

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QUESTION 11
a) Palliative care also includes care of the deceased person’s body and meeting their documented
preferences. Outline what information would be included with regards to preferences in an Advance Care
Directive.
b) Outline the formal process for documenting death and who may be responsible for this.

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c) Outline the infection control process you are required to follow to handle a dead body.
d) After a person has passed, what are you to do with their personal effects and belongings?

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QUESTION 12
In Australia, the laws that relate to Voluntary Assisted Dying are changing and vary between the states and
territories. Name the legislation that applies in your state and the date from when this legislation came into
effect.
ASSESSMENT CHECKLIST: ASSESSMENT TASK 1 Attempt 1 Attempt 2 Attempt 3
Did the student demonstrate the Date: Date: Date:
required level of competence for

Yes No Yes No Yes No
each of the following points? Comments
Did the student answer all written

questions correctly in line with the
decision-making rules provided in the
Marking Guide?
If ‘no’ to the above, have arrangements

been made for re-assessment?
Where any items above are marked ‘No’, outline the gaps below. Ensure feedback is provided to the student on their
Assessment Task Cover Sheet. Note actions that will be taken to correct the gaps.
Comments: What did you observe? Are there any gaps? What did the student do to demonstrate competence?

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Please outline any reasonable adjustments made for this task here.
Assessment Task 1 Outcomes
Attempt Date Outcome Assessor Name Assessor Signature
Attempt 1  Satisfactory
 Not Satisfactory

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work.
Name:
Date of observation/
submission:
No. of pages in
submission:
Is this a
Assessment Task 2: Advance Care Plan
STUDENT DECLARATION
work.
against me.

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ASSESSOR FEEDBACK
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Assessor Name: ________________________________________________________________________
Date: _______________

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For this task, you will be observed participating in a role play to confirm you can
perform to industry standards and expectations.
You are to undertake a role play to support a client who has recently ceased to have
chemotherapy, refer to their Advance Care Plan and complete a daily progress
TASK SUMMARY report.
 Banksia Care simulated workplace environment:

– a bed or chair
– table and chairs
RESOURCES AND – pens.
EQUIPMENT
 A fellow student or a colleague to play the role of the patient, Jim.
REQUIRED
 A fellow student or a colleague to play the role of Jim’s wife, Thelma.
 Your assessor to play the role of your Palliative Care team supervisor.
 Supporting document:
– Advance Care Plan – James McDougal
– Daily Progress Report Template
– Banksia Care supporting documents (available on the Banksia Care
website):
– PC5 Palliative Care Management Policy and Procedure
– DC SD1 Code of Ethics.
 You will complete this task with your assessor observing you in the classroom
or online if specified by your assessor.
 Your assessor will advise you of the date on which you will be required to
WHERE AND complete the role play.
WHEN THIS TASK  If your assessor is unable to directly observe you at the time of the assessment,
WILL BE arrangements will be made for you to video record yourself performing the tasks
COMPLETED required and submit it to your assessor online.
If your performance in the role play is deemed Not Satisfactory (N/S) or your
assessor is unable to see all required observable items, your assessor will make
arrangements to observe your performance again on another occasion. Your
WHAT HAPPENS IF assessor will only need to see the items that were not able to be observed at the
YOU GET original assessment or that were Not Satisfactory.
SOMETHING For items that are Not Satisfactory, your assessor will provide you with feedback.
WRONG? You have up to three attempts to achieve Satisfactory performance.

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 Completed Daily Progress Report Template.

SUBMISSION If your assessor is unable to observe you during the role play, video evidence must
REQUIREMENTS be submitted.
To prepare for this role play task, you must first read the provided scenario and
review the Advance Care Plan Form.
 You are playing the role of Jim’s carer.
TASK  A fellow student or a colleague is to play the part of Jim.

INSTRUCTIONS  A fellow student or a colleague is to play the part of Thelma.
 Your assessor is to play the part of your Palliative care team supervisor.
Working in line with the Banksia Care policies and procedures, you will need to use
the Advance Care Plan to guide your discussion. You will need to show that you
can communicate appropriately with Jim and Thelma to support them as they work
with you to reflect on the Advance Care Plan. You then need to complete the Daily
Progress Report Template.
 Following your discussions with Jim and Thelma, the assessor will play the role
of the supervisor in Jim’s care team. Provide an accurate account of your
observations during your discussions with Jim and Thelma.
 The role play should take approximately 10 minutes.
Scenario
You are a care worker who is working in a palliative care unit.
Jim is a 50-year-old man with Stage 4 Pancreatic cancer.
Jim has had chemotherapy, which initially looked like it would be successful, but the oncologist told Jim
last week that the chemo was no longer effective.
Jim and his wife, Thelma, talked it over, and they both decided that they would like Jim to remain at home
for as long as possible – hopefully being able to die peacefully and with dignity in his home.
Jim has been referred to the community palliative care team.
You work with this team and are meeting with Jim and Thelma today to reflect on the Advance Care Plan
and complete a Daily Progress Report.
During the role play, your assessor will be looking to see that you can:
 communicate with Jim and Thelma appropriately
 respect Thelma’s role as an integral part of Jim’s care team
 support Jim and Thelma in talking about their physical, cultural and spiritual needs
 identify that Jim’s needs will vary from now until his death
 identify any needs and issues that may be outside of your own boundaries and refer to the appropriate
person for advice
 respect Jim’s dignity of risk, even if you have different ideals from Jim and/or Thelma
 accurately record information in the Daily Progress Report Template, showing empathy and providing

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emotional support to both Jim and his wife, Thelma

 report your observations to the supervisor of Jim’s Palliative Care team.

each of the following points? Comments Yes No Yes No Yes No
 Communicate with both Jim and

Thelma appropriately, adjusting as
necessary.
 Respect Thelma’s role as an

integral part of Jim’s care team.
 Support both Jim and Thelma in

discussing their physical, cultural
and spiritual needs.
 Identify that Jim’s needs will vary

from now until his death.

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Comments Yes No Yes No Yes No
each of the following points?
 Identify any needs and issues
outside their boundaries and refer
to the appropriate person for
advice.
 Respect Jim’s dignity of risk. (Even

if they have different ideals to Jim
and/or Thelma.)
 Accurately record information in

the Daily Progress Template,
showing empathy and providing
emotional support to both Jim and
his wife, Thelma.
 Report their observations to Jim’s

Palliative care team supervisor.
Report their observations to Jim’s Palliative care team supervisor.

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work.
Name:
submission:
No. of pages in
submission:
Is this a
Assessment Task 3: Pain Management
STUDENT DECLARATION
work.
against me.

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ASSESSOR FEEDBACK
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Assessor Name: ________________________________________________________________________
Date: _______________

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For this task, you will be observed participating in a role play to confirm you can
You are to undertake a role play about pain management for a client in the late
stages of stomach cancer. After the role play, you will be asked a set of verbal
TASK SUMMARY questions

– a bed or chair with a blanket
– a jug of water and a glass
RESOURCES AND – a fellow student or a colleague to play the role of John
EQUIPMENT
– your assessor to play the role of your supervisor.
REQUIRED
 Supporting documents:
– John’s Palliative Care Management and Client Plan (provided below)
– Supporting documents (available via the Banksia Care website):
– AP SD7 Pain and Symptom Management
 Your assessor will advise you the date on which you will be required to
SOMETHING For items that were Not Satisfactory, your assessor will provide you with feedback.

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 Completed AP SD7 Pain and Symptom Management Plan for John.

SUBMISSION If your assessor is unable to observe you during the role play, video evidence must
REQUIREMENTS be submitted.
To prepare for this role play task, you must first read the provided scenario and
John’s Palliative Care Management and Client Plan:
 You are playing the role of John’s carer.
TASK  A fellow student or a colleague is to play the part of John.

INSTRUCTIONS  Your assessor is to play the part of the supervisor of John’s care team.
Working in line with the Banksia Care policies and procedures, you must show that
you can communicate with and respond to John’s needs and support him by
providing appropriate care:
 As a part of John’s patient file, you must document your observations on the AP
SD7 Pain and Symptom Management Plan (available via the Banksia Care
website).
 You will need to discuss your observations of John with your supervisor.
 The role play component of the task should take approximately 10 minutes.
 At the completion of the role play, your assessor will also ask you a set of verbal
questions about John and his care.
Scenario
You are a care worker who is working with a client called John. He has terminal stomach cancer and is
receiving care at the palliative care unit where you are working.
John’s care plan provides you with the following information:
 He is in the late stages of stomach cancer.
 Pain medication is morphine taken orally. It has been successful in reducing pain and discomfort.
 John needs to be reminded to take regular sips of water to remain hydrated.
 Today John received his morphine as usual – his last dose was one hour ago.
During the role play, your assessor will be looking to see that you can:
 follow John’s Palliative Care Plan
 observe John and ask him to identify his pain or any other symptoms
 document John’s pain and other symptoms using the AP SD7 Pain and Symptom Management Plan
(available via the Banksia Care website)
 communicate appropriately concerning John’s quality of life, pain, comfort and wishes
 create an emotionally supportive environment where John can share information about his condition
and current symptoms
 use strategies to manage John’s pain and make him more comfortable
 show that you respect and support John’s end-of-life wishes

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 review and document if John’s pain management has been effective

 accurately report your observations to the supervisor of John’s care team.

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JOHN’S PALLIATIVE CARE MANAGEMENT AND CLIENT PLAN
Palliative Care Management Plan
Name: Date:
John Smith 12/05/2015
DOB: Address:
01/07/1942 286 High Street, Kerrytown VIC 3878
Diagnosis of illness:
Terminal stomach cancer
Current medical treatment:

Morphine 10mg 4 hourly
Laxative as required (currently twice daily)
Liquid food only
Client’s prognosis:
John has advanced-stage stomach cancer.
He has had surgery and one round of both chemotherapy and radiotherapy. However, the cancer has
spread to the bowel region.
John has made the decision to refuse any further surgery or chemo/radio therapy and is now receiving
palliative care.
John’s condition is terminal – John’s doctor has indicated that he may have 3–5 months left.
Palliative care planning
Physical needs: Emotional/psychological:

 Needs assistance for all activities of daily living  John has accepted his condition
 Pain is severe but well controlled with  John has a very supportive family who visits
medication often
 Requires assistance with feeding (liquid diet)  He may sometimes be teary but is generally in
and drinking good spirits
 Can walk short distances with support
 Requires laxatives for constipation
Family: Spiritual/religious:
 John’s wife, Catherine, is next of kin. Catherine  John is Catholic (non-practising)
is supportive and has accepted his condition;
however, she feels helpless to care for him.
 Catherine and John have agreed that he will
remain at the hospice until he is in the last
stages, and then he will return home to
Catherine’s care.
 John has two sons, Jeremy and Peter.

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Future care needs: Communication:

 Palliative care only – no further surgery,  John can communicate himself with no trouble.
chemotherapy or radiation therapy at John’s
request.
 Maintain pain control.
 Maintain hydration.
 Feed liquids orally only – no feeding tubes at
John’s request.
Client Care Plan
Symptoms Objectives Intervention
Pain Reduce pain to a manageable Morphine orally 10mg every 4

level hours
Nutrition Prevent malnutrition; enjoy food Liquid food only by mouth – no

feeding tubes
Prevent choking, nausea
Hydration Maintain an adequate level of Provide sips of water frequently

hydration
Prevent dry mouth and mouth
conditions
Temperature maintenance Provide adequate body and Monitor body temperature

ambient temperature
Provide blankets and warm
drinks if cold
Control ambient room
temperature
Nausea To prevent distressing symptoms Maxolon as required

 Follow the correct procedure to

commence working with John as
per his Palliative Care Plan.

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 Observe John and ask John to
identify his pain or any other
symptoms.
 Document John’s pain and other

symptoms using the Pain and
Symptom Management Plan.
 Communicate appropriately in
relation to John’s quality of life,
pain, comfort and wishes, and
adjust as necessary.
 Create an emotionally supportive

environment where John can share
information about his condition and
current symptoms.
 Use strategies to manage John’s

pain and make him more
comfortable.

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 Show that they respect and
support John’s end-of-life wishes.
 Review and document whether

John’s pain management was
effective.
 Accurately report their

observations to the supervisor of
John’s care team.
Assessment Task Cover Sheet. Document the actions that must be taken by the student to address the gaps.

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VERBAL QUESTIONS – ASSESSMENT TASK 3
Your assessor will ask you the following verbal questions and may make notes documenting how your response
demonstrates competency.
Questions Additional Comments/Notes
1. Comparing John’s condition today against

his care plan, what do you think is
significant about your observations?
2. What action will you take?
3. What will you do about John’s request to

talk to someone about his end-of-life
wishes?
4. A family member approaches you and

says, ‘Why does John have so much
morphine? The morphine will kill him
before the stomach cancer does!’ How
would you respond to them?
5. What other resources could you use to

make John comfortable besides those
available in this role play? If you
discovered any of these were successful,
how would you document your findings?
6. Consider the role play. What was the limit

of your responsibilities? What
responsibilities must be referred?
7. How do you feel about John wanting to go

home to die? He won’t be able to receive
the professional help he gets in the facility,
which will be a big strain on his family.

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8. How do you feel about working with

people who are ageing and dying? How
will you look after your own emotional
needs?
9. Working in palliative care is a team

approach. How would you make sure you
worked effectively in the team?
10. How do you think you went with your

communication techniques? Do you think
you gave John the best support that you
could? Is there anything you would do
differently if you were to do the role play
again?
11. What would you do if you were unsure

about the procedure for changing end-of-
life wishes?
Where further verbal questioning is required or additional prompts are required that do not interfere with reliability of
assessment process, please document the questions asked in the space provided below and the responses provided
by the student.

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work.
Name:
submission:
No. of pages in
submission:
Is this a
Assessment Task 4: End of Life Care
STUDENT DECLARATION
work.
against me.

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ASSESSOR FEEDBACK
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Assessor Name: ________________________________________________________________________
Date: _______________

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For this task, you will be observed participating in a Role Play to confirm you can
You are to undertake a role play to care for a person at the end of life. This includes
providing support to the family during a difficult time in their lives. During the role
TASK SUMMARY play, you will be asked a series of verbal questions.

– a bed with a pillow and blanket
– additional chairs around the bed
RESOURCES AND – 2–3 fellow students or colleagues to play the role of Barry and his family
EQUIPMENT
– your assessor to play the role of your supervisor.
REQUIRED
 Supporting documents (available on the Banksia Care website):
 Your assessor will advise you of the date on which you will be required to
SOMETHING For items that were Not Satisfactory, your assessor will provide you with feedback.
If your assessor is unable to observe you during the role play, video evidence must
SUBMISSION be submitted.
REQUIREMENTS You must give responses to verbal questions throughout the role play.

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You must first read the provided scenario to prepare for this role play task:
 You are playing the role of Barry’s carer.
 Your assessor will play the part of the lead supervisor of Barry’s care team.
TASK  The parts of Barry and his family will be played by 2–3 fellow students or
INSTRUCTIONS colleagues.
Working in line with the Banksia Care policies and procedures, you must show that
you can apply your knowledge of end-of-life procedures by providing appropriate
support to Barry and his family and required care as he passes away:
 You will need to work closely with your assessor playing the role of supervisor
as you discuss end-of-life strategies and support. They will be asking you
questions throughout this role play.
 The role play should take approximately 15 minutes.
Scenario
Barry is British. He came to Australia in his 60s to be with his family.
Barry and his family are very private people. They tend to keep their feelings to themselves – perhaps this
is because of their British culture.
Barry has late stages of a terminal disease. He has made it clear in his advance care directive that he:
 does not wish to be resuscitated
 wants to be kept comfortable
 would like his immediate family to be with him when he dies (if possible)
 would like the Anglican priest to be called to perform the last rites.
Barry’s health has deteriorated significantly. He has been sleeping for the last 24 hours and has been very
restless today.
The doctor has told you that he is not expected to live more than a few hours.
It is likely that he will die on your shift.
As this is your first time experiencing end-of-life, you, with the support of your supervisor, will both be
caring for Barry today.
During the role play, your assessor will be looking to see that you can both demonstrate and apply your
knowledge verbally regarding end-of-life care in the workplace, incorporating the following:
 check for and explain the signs of death and deterioration to the supervisor
 explain the importance of changes to individualised plans
 afford the family respect, privacy and support
 provide appropriate comfort and care, maintaining patient dignity
 discuss issues out of own scope of responsibility with the supervisor
 provide emotional support to the family after death has occurred
 explain the required care for a body after death to the supervisor.

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 Check for signs of deterioration.
 Afford the family respect, privacy

and support.
 Check for signs that Barry has

passed.
 Respect the family in their spiritual

beliefs, even if they are different to
their own.
 Provide emotional support to the

family after death has occurred.

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Assessment Task Cover Sheet. Document the actions that must be taken by the student to address the gaps.
Your assessor will ask you the following verbal questions and may make notes documenting how your response
demonstrates competency.
Questions Additional Comments/Notes
 You have been well aware of Barry’s end-

of-life wishes for some time. Is there any
need for you to check them again?
Explain your answer.
 What are the indicators that death is now

imminent for Barry?

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 Name four other common signs that

indicate death is imminent.
 Describe three types of care that we can

give Barry at this stage.
 What can you do to respect Barry’s dignity

at this time?
 If you are working on your own in a similar

situation to this one, who should you talk
to if you don’t know or remember what to
do during this end-of-life stage?
 Given his end-of-life wishes, who should

be contacted about Barry’s imminent
death?
 What support can you give right now to

Barry’s family?
 What can you do to support Barry and his

family’s cultural and spiritual needs?

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 You and I may have cultural practices and

religious beliefs that are very different to
those of Barry’s family. How should we
deal with this situation?
 What signs will you be checking to confirm

that Barry has died?
 If you are working on your own, in a

similar situation to this one, where would
you find guidance on how to care for a
body after death?
 Describe what we need to do to care for

Barry’s body after death. What are the
steps we need to take?
 You are a new personal care worker and

have not previously prepared a body after
death. You may feel uneasy, but you are
prepared to follow protocol in getting
everything done.
What can you do to look after yourself –

now and during the next few days?
Where further verbal questioning is required or additional prompts are required that do not interfere with reliability of
assessment process, please document the questions asked in the space provided below and the responses provided
by the student.

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Assessment Outcome Summary
This section records the outcome of each task so that the final assessment outcome can be determined.
The Assessment Outcome Summary Table shows all the assessment tasks required for this unit.
Task Outcomes
For each attempt at each task, fill in the Task Outcome, either Satisfactory or Not Satisfactory, insert the date
of the decision and your initials. Fill in the task outcome for each attempt.
Students must receive a Satisfactory outcome for each task that relates to a unit, to be marked Competent
for the unit.
Unit Assessment Results
When a student has attempted all tasks, but one or more tasks are marked as Not Satisfactory, a Not Yet
Competent unit result must be entered in the Unit Assessment Results section.
Once the student has satisfactorily completed all tasks, enter a unit result of ‘Competent’.

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Assessment Outcome Summary Table: CHCPAL003 Deliver care services

using a palliative approach
Task Outcomes
Satisfactory (S)
Not satisfactory Assessor
Assessment Tasks (NS) Date initials
Unit Result Assessor

Unit Assessment Results (C/NYC) Date initials
CHCPAL003 Deliver care services using a palliative

approach
Assessor Name:
Assessor Signature: Date:

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ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

© 2023 Eduworks Resources

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Assessment Task Summary

Assessment Task Assessment Method Task Summary

Assessment Task 1: Written questions Students must answer 12 knowledge questions in an

Required Additional Documents

Assessment Task Cover Sheet

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

The Assessment Process and Your Rights

Submitting your Assessment Tasks

Assessment Attempts and Resubmissions

Assessment Outcome Summary

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Plagiarism, Cheating and Collusion

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Information about Assessment

Principles of Assessment and Rules of Evidence

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

‘The individual learner’s needs are considered in the assessment process.

Glossary of Instructional Task Words

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Assessment Tasks Due Date

1. Assessment Task 1: Knowledge Questioning

2. Assessment Task 2: Advance Care Plan

3. Assessment Task 3: Pain Management

4. Assessment Task 4: End of Life Care

AGREEMENT BY THE STUDENT

Do you understand the requirements of this assessment?  Yes  No

Student Name: __________________________________________________

Student Signature: _______________________________________________ Date: _______________

Assessor Name: _________________________________________________

Assessor Signature: ______________________________________________ Date: _______________

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Assessment Task Cover Sheet – Assessment Task 1

Unit: CHCPAL003 Deliver care services using a palliative approach

Assessment Task 1: Knowledge Questions

Student Signature: _______________________________________________ Date: _______________

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Assessor Signature: _____________________________________________________________________

Assessor Name: ________________________________________________________________________

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Assessment Task 1: Knowledge Questions

In this task, you will demonstrate your knowledge by answering a series of

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

b) What are the aims of palliative care?

c) What are three of the principles of palliative care?

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

d) What is the difference between a ‘curative’ and a ‘palliative’ approach?

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

b) What other action could you take to support Shamus’s family?

ILOZ_CHCPAL003 Student Assessment Booklet V1.2_Jan 2024

Student Signature: _________________________________ Date: _

Assessor Signature: ________________________________ Date: _

Student Signature: _________________________________ Date: _

Student Signature: _________________________________ Date: _

Student Signature: _________________________________ Date: _