Personal Care and Assistance
Course Description
This practical course offers students the opportunity to acquire personal care and assistance skills within the parameters of the HCA role. The course comprises class and supervised laboratory experiences, which assist the student to integrate theory from other courses to develop caregiver skills that maintain and promote the comfort, safety, and independence of clients in community and facility contexts.
Minimum course hours: 120
Learning Outcomes
- Perform personal care skills in an organized manner ensuring the comfort and appropriate independence of the client:
- 1.1 Organize and implement care according to client needs.
- 1.2 Encourage independence of the client as much as possible.
- 1.3 Encourage client communication and engagement during personal care.
- 1.4 Maintain client privacy and dignity.
- 1.5 Assist the client with personal hygiene and grooming.
- 1.6 Assist the client with movement and ambulation.
- 1.7 Use aids to promote comfort, relaxation, and sleep.
- 1.8 Take and record vital signs accurately (temperature, pulse, respirations).
- 1.9 Assist the client with eating and drinking.
- 1.10 Assist the client with medication as per the client’s care plan. (HCAs are not permitted to administer medication by any method without regulated health professional authorization).
- 1.11 Provide specialized, sensitive care for the dying client in line with palliative care principles.
- Apply an informed problem-solving process to the provision of care and assistance:
- 2.1 Observe the client and situation.
- 2.2 Observe for changes in the client’s health status.
- 2.3 Identify priorities for care within the care plan.
- 2.4 Use appropriate health care team members as resources to augment one’s own problem-solving and decision-making.
- 2.5 Follow the care plan for each client.
- 2.6 Conduct caregiving or assisting activities.
- 2.7 Reflect on and evaluate effectiveness of care or assistance.
- 2.8 Carry out recording requirements.
- 2.9 Use creativity and flexibility when required to adapt care and assistance to a variety of contexts.
- Provide personal care and assistance within the parameters of the HCA role:
- 3.1 Comply with the legal parameters of practice for the HCA role.
- 3.2 Collaborate with other members of the health care team.
- 3.3 Use appropriate lines of communication.
- 3.4 Demonstrate dependability, reliability, honesty, and integrity.
- 3.5 Adhere to the client’s activities of daily living (ADL) and care plan.
- Provide care and assistance in ways that maintain safety for self and others in a variety of contexts:
- 4.1 Wear safe and appropriate clothing, including identification.
- 4.2 Observe the environment prior to commencing care.
- 4.3 Adjust the environment, as appropriate, to ensure safety and promote efficiency.
- 4.4 Organize time and equipment for safety and efficiency.
- 4.5 Adhere to the principles of body mechanics.
- 4.6 Adhere to the principles of medical asepsis and infection-control practices.
- 4.7 Recognize and make wise choices in situations of potential risk to self or others.
- 4.8 Exhibit flexible and adaptable behaviour in a variety of contexts.
- 4.9 Recognize and respond appropriately to emergency situations.
Care Contexts
All skills are taught in such a way that recognizes all care contexts (complex care, community care, and acute care). To recognize acute care settings, consider using simulations to have students practise skills needed for working with clients who have IVs, drainage (or other) tubes, wounds or surgical incisions, or dressings. Consider incorporating scenarios involving clients with higher acuity and increased possibility of acute changes in condition while the HCA provides care. These scenarios could include appropriate communication with team members, reporting, and recording.
Other aspects of the acute care environment could also be simulated where possible. These may include an environment with higher levels of activity, more interactions with health care team members, and increased use of call bells, transmission-based isolation precautions, and emergency codes.
Course Content
Problem-Solving When Carrying Out Caregiving Procedures
- Planning and implementing care based on the client’s needs, the established care plan, and agency policies.
- Observing the client and the situation prior to commencing care.
- Identifying unsafe environments or situations.
- Establishing priorities for care with consideration to client acuity.
- Seeking assistance, if necessary, to maintain the safety of the client and the care provider.
- Organizing equipment and supplies to efficiently complete care activities.
- Checking equipment for safety and functionality.
- Reporting equipment malfunction.
- Performing the procedure(s).
- Maintaining client privacy and dignity.
- Encouraging independence and self-care as much as possible.
- Cleaning equipment after use and returning to appropriate place.
- Tidying the client’s environment.
- Evaluating effectiveness of the procedure and care.
- Reporting and recording actions, results, and observations.
- Responding appropriately to emergency situations.
Care Activities
The care activities in the skills list below include both tasks and restricted activities.
Tasks: care activities that HCAs are educated and trained to perform as part of their assigned HCA role.
Restricted activities: higher-risk care activities outlined in health professional regulations that an HCA cannot perform without authorization by a regulated health professional (such as a registered nurse). This process requires client-specific delegation and is limited by the boundaries permitted by legislation and the regulated health professional’s regulatory college.
Asepsis and Prevention of Infection
- Microorganisms and the spread of infection.
- Principles and practice of medical asepsis.
- Routine practices.
- Hand washing.
- Gloving.
- Isolation precautions.
- Doffing and donning personal protective equipment (PPE).
Promoting Comfort and Rest
- Admitting a client to a facility.
- Promoting comfort, rest, and sleep.
Promoting Personal Hygiene
- Oral hygiene.
- Bathing — bed bath, tub baths, and showers.
- Providing perineal care.
- Assisting with grooming and dressing (e.g., hair care, shaving, changing clothing).
- Morning and evening care.
- Back massage and skin care.
- Using pressure relieving devices.
Moving, Positioning, and Transferring a Client
- Body mechanics.
- Turning and moving a client in a hospital or regular bed.
- Using positioning devices.
- Transferring a client to a stretcher.
- Moving a client to the side of a bed and assisting them to sit.
- Transferring a client from a bed to a chair or wheelchair and back.
- Transferring a client from a wheelchair to a bath chair or toilet.
- Using mechanical lifts including ceiling lifts.
- Cleaning of equipment.
Bedmaking
- Making a closed bed.
- Making an open bed.
- Making an occupied bed.
Promoting Exercise and Activity
- Bed rest.
- Assisting with ambulation.
- Assisting with walking devices, especially safe use of walkers with resting seats.
- Assisting with wheelchairs.
- Dealing with falls.
Assisting with Dietary Intake
- Serving meals in ways that encourage normalizing interactions.
- Assisting clients with eating and drinking.
- Using appropriate techniques and strategies to safely assist individuals experiencing difficulty biting, chewing, or swallowing.
- Using adaptive utensils.
- Observing and recording intake and output.
Promoting Urinary and Bowel Elimination
- Using bedpans and urinals.
- Toileting techniques.
- Using commodes.
- Assisting the client with urinary and bowel incontinence.
- Using urinary incontinence products.
- Assisting the client with condom catheter drainage.
- Assisting the client with an established catheter (must have client-specific delegation from a regulated health professional to perform any restricted activities).
- Emptying drainage bags.
- Collecting urine specimens.
- Factors affecting bowel elimination.
- Assisting with bowel training.
- Administering enemas and suppositories (must have client-specific delegation from a regulated health professional to perform any restricted activities).
- Assisting the client with an established ostomy (must have client-specific delegation from a regulated health professional to perform any restricted activities).
- Collecting stool specimens.
Hand and Foot Care
- After assessment of the client by a regulated health professional, HCAs may assist with hand and foot care tasks limited to:
- Observing for any changes and reporting to the supervisor.
- Nail clipping for clients without chronic diseases like diabetes without swollen feet, without compromised skin, or without compromised nail integrity.
- Soaking, massaging, and applying lotion to hands and feet as per the care plan.
Compression Stockings
- After assessment of the client by a regulated health professional, HCAs may apply and remove compression stockings as per the care plan.
- Wash and dry stockings as per care plan.
Measuring Vital Signs
- Measuring height and weight.
- Measuring body temperature.
- Monitoring pulse and respirations.
- Being familiar with differing types of equipment.
- Reporting and recording vital signs.
Heat and Cold Applications
- Knowing policies and procedures of facility or agency.
- Theory of heat and cold applications.
- Safety considerations and checks.
Medications
General Information Regarding Medications
- Types of medications (capsules, tablets, ointments, suppositories, liquids, drops, inhalers).
- Common abbreviations used with medications.
- Critical “rights” of assisting with medications.
- Reading medication labels.
- Roles and responsibilities, legal implications of actions.
- Observing the client for unexpected effects (recognizing what is not normal for the client and reporting it).
- Individual’s right to refuse medication.
- Documentation as required by the care plan.
Medication Assistance
Medication assistance includes activities taught in the HCA curriculum that an HCA could perform if assigned by a regulated health professional, if the HCA is over the age of 19, and as indicated in the client’s health care plan for a client who is able to direct their own care. These include:
- Reminding the client to take their medication.
- Reading the medication label to the client.
- Providing the medication container to the client.
- Opening blister packs or dosettes.
- Loosening or removing container lids.
- Recapping the device or closing the medication container or bottle.
- Placing the medication in the client’s hand.
- Steadying the client’s hand while the client places medications in their mouth or administers their own eye drops, nasal sprays, or other medication.
- Using an enabler (such as a medicine cup, spoon, or oral syringe) to assist the client in getting the medication into their mouth.
- Supervising clients during self-administration.
- Providing the client with water or other fluids for rinsing the client’s mouth or to help them swallow medication.
Medication Administration
Medication administration includes restricted activities taught in the HCA curriculum that an HCA could only perform if delegated by a regulated health professional to perform for a specific client, if the HCA is over the age of 19, and as indicated in the client’s care plan. These include:
- Applying a transdermal patch.
- Administering prescription ear or eye drops.
- Inserting a rectal suppository or enema.
- Applying a prescription cream or ointment.
Dispensing, compounding, and administering medication are considered restricted activities in British Columbia. Restricted activities are performed by regulated health professionals, such as registered nurses and licensed practical nurses, who have the restricted activity outlined in their profession-specific regulation.
A regulated health professional (registered nurse) may in some circumstances, through delegation to a specific individual, authorize an HCA to perform medication administration for a specific client, within the boundaries permitted by legislation and the regulated health professional’s regulatory college, as well as the education, training, and competency of the individual HCA.
Assisting with Oxygen Needs
- General precautions for the safe use of oxygen.
- Application and removal of nasal prongs.
- Dealing with oxygen tubing.
- Recognizing oxygen concentrators, tanks (compressed oxygen), and liquid oxygen.
- Turning on and off the nebulizer.
Home Management
- Applying agency policies and procedures.
- Observing the home for safety risks (for client and caregiver).
- Fire hazards and safety precautions.
- Maintaining safety and medical asepsis in the home setting.
- Using common cleaning agents, following Workplace Hazardous Materials Information Systems (WHMIS) plan.
- Using body mechanics in a home environment.
- Dealing with emergencies in the home.
- Community resources and supports.