Training Modules


MODULE VII

 

When Clients are asked what qualities they value most in HHA they say:

  • Positive Attitude

  • Punctuality

  • Reliability

  • Responsiveness to Needs

  • Continuity

 

Physical Disabilities could be developmentally related or be caused by a disease or accident.  These clients must adjust physically and mentally to the situation. Rehabilitation helps them to do so.

Muscular Dystrophy (MD) Refers to a number of progressive diseases that cause a variety of physical disabilities due to the muscle weakness. MD is an inherited disease, it causes a gradual wasting away of muscle, weakness and deformity.  HHA will provide reassurance, Safety and assist with ADL's. 

 

Stroke  occurs when blood supply to to a part of the brain is blocked or blood vessel leaks or ruptures within the brain. Blood brings oxygen to cells, without it brain cells begin to die. 

Stroke can cause:

  • Hemiparesis Hemiplegia Expressive aphasia Receptive aphasia

  • After a stroke client with hemiplegia will have a strong and a weak side involved side will need the HHA’s assistance and protection due to loss of sensation and strength.

  • Always encourage independence and self-esteem, let the client do things for him/her whenever possible.

  • When dressing a client after a stroke, dress the involved side first and undress it last to prevent the limb from being stretched and twisted. Always place food in the unaffected side of the mouth to prevent choking.

Parkinson’s disease – look up in glossary

A person with Parkinson’s has a mask-like facial expression. Multiple sclerosis (MS) –look up in glossary

MS will eventually cause  blindness, contractures and loss  of  function.    HHA will provide safety by preventing injury and falls.

Spinal cord and head injuries caused by car accidents, falls, war or criminal violence. Those injuries can cause intellectual disabilities, personality changes, breathing problems, seizures, coma, and memory loss, loss of consciousness, paresis or paralysis.

Paraplegia and quadriplegia (look up words) caused by spinal injury

Care of those clients:

  • Provide emotional support and physical assistance

  • Provide safety by preventing falls and injury, due to paralysis PT will have no sensation

  • Be patient with self-care allow as much independence as possible with ADL’s

  • Perform careful skin care, it is essential to prevent pressure ulcers. Report any changes in skin integrity.

  • Assist clients to change positions at least every 2 hours, be gentle when re-positioning.

  • Perform range of motion exercises exactly as ordered to prevent contractures and atrophy.

  • Immobility leads to constipation. Provide plenty of fluids and high-fiber diet.

  • Lack of activity leads to poor circulation, special stockings may be ordered.

  • Difficulty coughing and shallow breathing can lead to pneumonia.

 

Hearing impaired clients usually speak loudly, lean forward when someone is speaking, cup the ear to hear better, respond inappropriately, ask the speaker to repeat what has been said and avoid social gatherings.

When working with hearing impaired clients:

  • Make sure the hearing aid is worn, it is clean, and it turned on.

  • Reduce or eliminate any background noises.

  • Speak clearly, slowly and in good lighting, directly face the person

  • Clients may read lips, so do not chew GUM or eat while speaking

  • Keep your hands away from your face

  • Use short sentences and simple words

 

Vision impairment can exist at birth or develop gradually.

Guidelines when working with vision impaired clients:

  • Identify yourself immediately when you enter the room. Do not  touch the client until you have said your name. Let the client know when you are leaving the room.

  • When you enter a new room with the client, orient him/her where things are, use the face of an imaginary clock as a guide.

  • Always tell the client what you are doing while caring for him/her.

  • Do not change the position of the furniture; put everything back where you found it.

  • Keep doors completely open or completely closed, never partly open

  • If the client has eyeglasses, make sure they are clean, and that he/she wears them. If the glasses are not in good condition, report it to your supervisor.

 

 

Paraplegia and Quadriplegia caused by spinal cord injury.

Care for those clients:

  • Provide emotional support and physical assistance

  • Provide safety by preventing falls and injury, due to paralysis PT will have no sensation.

  • Be patient with self-care allow as much independence as possible with ADL’s.

  • Perform careful skin care, it is essential to prevent pressure ulcers. Report any changes in skin integrity.

  • Assist clients to change positions at least every 2 hours, be gentle when re-positioning.

  • Perform range of motion exercise exactly as ordered to prevent contractures and atrophy.

  • Immobility leads to constipation. Provide plenty of fluids and high-fiber diet.

  • Lack of activity leads to poor circulation, special stockings may be ordered.

  • Difficulty coughing and shallow breathing can lead to pneumonia

 

After a stroke client with hemiplegia will have a strong and a weak side. Involved side will need the HHA’s assistance and protection due to loss of sensation and strength. Always encourage independence and self- esteem, let the client do things for him/her self whenever possible. When dressing a client after a stroke dress the involved side first and undress it last to prevent the limb from being stretched and twisted. Always place food in the unaffected side of the mouth to prevent choking.

Parkinson’s disease is a progressive incurable disease that causes a section of the brain to degenerate. Parkinson’s disease causes muscle stiffness; it causes stooped posture and shuffling gait. Tremors make it very difficult for a person to perform ADL’s. A person with Parkinson’s has a mask-like facial expression.

Multiple sclerosis (MS) progresses slowly and unpredictably. Symptoms may include blurred visions, tremor, poor balance and difficulty walking; also incontinence and behavior changes. MS will eventually causes blindness contractures and loss of function. HHA will provide safety by preventing injury and falls.

Spinal cord and Head injuries caused by car accident, falls, war or criminal violence. Those injuries can cause intellectual disabilities, personality changes breathing problems, seizures, coma, memory loss, loss of consciousness, paresis or paralysis

 

 


MODULE VIII

 

NUTRIENT – Look in glossary

WATER is the most essential nutrient for life. We need about 64oz. of water a day, without water a person can only live a few days. Water assists in the digestion and absorption of food, helps with waste elimination also through perspiration. Water helps maintain normal body temperature.

CARBOHYDRATES supply the body with energy and help the body use fat efficiently also provide fiber, which is necessary for bowel elimination.

PROTEINS are part of all body cells; they are essential for tissue growth and repair. EXCESS PROTEINS are excreted by the kidneys.

FATS help the body store energy. Body fat provides the body with insulation which protects the body organs. Fats add flavor to food and important for the absorption of vitamins.

VITAMINS are substances that are needed by the body to function, we cannot produce most vitamins they can only be obtained by eating certain foods.

MINERALS maintain body functions they provide energy and regulate body processes half of the plate must be fresh fruits and vegetables. Second half of plate are whole grains and proteins. Green vegetables are the healthiest. Fruits and vegetables are naturally low in fat, sodium, calories and have no cholesterol.

The sense of thirst can diminish as people age, remind elderly clients to drink fluids often. Some clients may have doctors order to force fluids or restrict fluids. Also  some clients may have NPO order, which stands for “nothing by mouth”. This means that a client is not allowed to have anything to eat or drink. Dehydration occurs  where a person does not have enough fluids in the body.

Report the following:

  • Dry mouth

  • Cracked lips

  • Sunken eyes

  • Dark urine

  • Strong- smelling urine

  • Weight loss

 

FLUID OVERLOAD – Look in glossary

Clients that are unable to eat orally may have a nasogastric tube or per-cutaneous endoscopic gastronomy (PEG)

 

 

HHA’s never insert tubes or feeding or irrigate the tubes. HHA’s may assemble equipment and supplies, may position the client in a sitting position for feeding. May discard or clean used equipment and supplies. Also, HHA’s will observe, report, and document any changes in the client.

REPORT WITH TUBE FEEDING:

  • Redness or drainage around the opening

  • Skin sores or bruises

  • Client complaints of pain or nausea

  • Choking or coughing

  • Vomiting or diarrhea

  • Swollen and tender abdomen

  • Tube falls out