SELF DIRECTED ATTENDANT CARE

TRAINING INFORMATION AND MATERIALS FOR THE MEMBER

INTRODUCTION

This section of the Self Directed Attendant Care (SDAC) Member Manual provides you with training materials to use when training your Attendant Care Worker (ACW).  You may use as little or as much of the information as you would like.  You can give your worker copies of certain pages or you can go over the information together.

Listed below is what is included in this section and a little bit about each topic.

•	Training and Orientation Schedule
This is an outline of how you might set up the training for your new worker. It includes suggestions for what topics to cover on what days.

•	Pre-employment Certifications
This is information about what training your ACW must complete before being able to work for you.

•	Required Training: Universal Precautions and HIPAA
These are the materials that you can use to train your ACW on Universal Precautions and HIPAA.  These are required trainings.  If you don’t want to train the worker yourself, call your case manager and he or she
will arrange for it to be done by an agency.

•	Required Training: Skilled Services
If you wish to have your ACW do skilled services for you as listed on your “What Do I Need?” Checklist, a registered nurse must visit you and the ACW before these services are provided so that the nurse can assess,
educate and train you both and make sure that the ACW demonstrates
the skill to perform these services for you.

•	Suggested Training
This  section  lists  other  trainings  that  you  or  your  ACW  might  be interested in.   You can give or show this list to your worker and talk
about which ones to do.  ALTCS will pay for these trainings, so be sure to let your case manager know so he or she can authorize them.

•	ACW Code of Conduct: Tells the ACW how to abide by moral and ethical standards, and how to be professional in their dress, behavior and the care they provide you.

•	Caregiver Burnout:   Caring  for  someone  can  be  difficult  and stressful. This information can help your caregivers, whether they are paid or not, avoid getting burned out and be able to continue to care for you.

•	Fraud, Abuse, Neglect and Exploitation:   This information is similar to the information in the first section, but it is important that your	ACWs   know   what   these   terms   mean   and   what   their responsibilities are if they suspect fraud or abuse.

•	Home and Fire Safety:  This section includes a lot of information about keeping your home safe and preventing fires.   It is very important that your worker knows what to do in an emergency and what you want done.  There is a form in the Forms section of this manual to help you develop your emergency plan.

•	Things to Know As An Attendant Care Worker:  This section contains much information about a variety of topics, which might be useful for your ACW to know. The topics include:

o Attendant Tips:  Provides guidance on how to be the best ACW
for you.

o Boundaries: Discusses the limits of where one person ends and another begins, such as personal space.

o Communication Skills:    Discusses  the  advantages  of  clear communication, including nonverbal communication and listening.

o Maintaining a Clean and Pleasant Environment:  Instructs the ACW on how to best maintain your residence and your possessions.

o Food Handling Guidelines:  Tells the ACW how to take care of your food so it does not make you ill.

o Proper Body Mechanics:  Tells the ACW how to properly use their body to lift heavy things and how to lift you without injuring themselves. If your ACW hurts themselves trying to lift, they may not be able to provide the care you need.

o Mobility,   Transferring   and   Ambulation:      This   section contains information about how to help you if you need help getting out of a chair, getting out of bed, getting around, etc.  It is important that your ACW know how to do these things safely so that you don’t get hurt and so that your worker doesn’t get hurt.

o Bathing and Providing a Bed Bath:  Discusses the benefits of regular bathing and how the ACW can assist you with bathing. You will have to tell your ACW how much, or how little, assistance you need with bathing.

o	Information   about   Diseases:       This   section   includes information about a large number of diseases. If you have any of these health problems, you might want to give your ACW the sheets that describe them so that he or she will understand more about your condition

o	Secondary Conditions:  These are physical, medical, cognitive, emotional,	or  psychosocial  outcomes  to  which  persons  with disabilities are more susceptible by virtue of an underlying condition.	They include such things as chronic pain, pressure sores, etc.

REQUIRED TRAINING

There  are  four  certification/training  requirements  for  an  Attendant  Care Worker (ACW) to obtain/receive. The first two listed below have to be in place before a potential ACW can be hired.   The second two must be completed within 30 days of starting as an ACW.

F Pre-employment Certifications:

There are two certifications that your ACW must have before ever being hired by you.  Those are CPR and First Aid.  A description of each can be found below.  It is important to remember that both types of certification have to be renewed every two years.  It will be your responsibility to make sure that your ACW renews his or her certification in a timely manner, as needed.   This training must be completed face-to-face with hands-on practice; certification from an on-line program will not be accepted.

•	Cardio-pulmonary Resuscitation (CPR):    This training will teach your ACW what to do if your heart stops beating or if you stop breathing. The ACW will need to show you and the FEA proof that he or she has finished this training.

•	First Aid:  This training will teach your ACW what to do when accidents or emergencies happen.  They will learn what to do if you choke, cut yourself and start bleeding, get a burn, have a seizure, and much more.

F REQUIRED TRAINING

The ACW should complete these training requirements during the first 30 days of employment.  For information about where the ACW can get the required training, look in the Additional Help and Information section (at the end of the GENERAL INFORMATION FOR MEMBERS AND ATTENDANT CARE WORKERS chapter) of this manual.

•	Universal Precautions:  This training will teach your ACW how to help you maintain a clean, sanitary environment to prevent the spread of germs.	In this way, you will be less likely to get infections.  You can teach your ACW these things yourself, using the materials in the training section of this handbook or you may have someone else train your ACW. If you want someone else to do the training, talk to your case manager, who will set it up for you.

•	HIPAA:     HIPAA  stands  for  the  Health  Insurance  Portability  and Accountability Act.  It promotes privacy and security of personal medical records.	The training will stress the importance of keeping personal information confidential and the consequences of not doing so.  You can teach your ACW these things yourself, using the materials in the training section of this handbook or you may have someone else train your ACW. If you want someone else to do the training, talk to your case manager, who will set it up for you.

•	Skilled Care:  If you wish to have your ACW do skilled services for you as listed on your “What Do I Need?” Checklist, a registered nurse must visit you and the ACW before these services are provided so that the nurse can assess, educate and train you both and make sure that the ACW demonstrates the skill to perform these services for you.

SUGGESTED TRAINING/OTHER TRAINING AVAILABLE

Even though it is not required, it is a good idea to train the ACW on certain other topics. These would include:

•	Your personal preferences about how you like things about your care done, what you like to eat, etc.
•	Transfers and mobility, if you need help in these areas.   It can help prevent injury to you and your ACW if he/she knows the correct way to do these things.
•	Boundaries and  Maintaining a  Professional Relationship between the
ACW and yourself
•	Caregiver Burnout
•	Home and Fire Safety
•	Communication
•	Abuse and Neglect
•	Organizing and Planning Daily Activities
•	Things to Know as an ACW
•	ACW Roles and Responsibilities
•	Disease Information and Secondary Conditions
•	Food Handling Guidelines

You can use the materials in the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER section of the manual if you want to do the training yourself.  If you want someone else to do the training, call your case manager.

TRAINING AND ORIENTATION
SCHEDULE

TRAINING SCHEDULE

F GENERAL INFORMATION

The following pages outline a suggested Training Schedule for you to use if you want to.  Even if you know your Attendant Care Worker (ACW) well, it is a good idea to have some formal training to make sure you are both clear on what you want him or her to do.

•	It usually takes a couple of weeks to get a good routine going with a new ACW. Be flexible and patient when providing information and directions.

•	Keeping the communication line open with your ACW is one sure way to cut down on employees quitting or doing a less than satisfactory job.

ORIENTATION:	DAY ONE

•	Introduce yourself again and ask your ACW to sit and make him/herself comfortable.

•	Have your employee start a time sheet, so they will start getting paid for training time.

•	Go  over  again  with  your  ACW  the  Self  Directed Attendant Care Member/Attendant Care Worker Work Agreement that you both signed which states (briefly) the job duties.  Even if your ACW is a friend or family member you will still sign this Work Agreement.

o You may also want to provide more details about the job duties and when they should be performed.   Refer to the “What Do I Need?” Checklist in the Forms section of this manual.

•	Take time to get to know each other; this will set up a good working relationship, that will allow you to talk openly about the job duties.

•	Show your ACW where things are around the house, so they will feel comfortable doing their job.

•	Review the Attendant Care Worker’s roles, rights and responsibilities at the beginning of the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER section of this manual.

•	Discuss the two  required training topics of Universal Precautions and HIPAA.  These are at the beginning of the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER section of this manual.

•	If you wish to have your ACW do skilled services for you, a registered nurse must visit you and the ACW before these services are provided so that the nurse can assess, educate and train you both and make sure

that the ACW demonstrates the skill to perform these services for you. Have your case manager schedule the registered nurse for you to complete this training requirement.

ORIENTATION:	DAY TWO

RULES

•	SET RULES for your ACW on using personal things such as eating your food or using the telephone. Refer to the Self Directed Attendant Care Member/Attendant	Care  Worker Work  Agreement you  both  signed earlier.

o When giving directions about what RULES will need to be followed, try to do it with a soft voice, but with direct eye contact.

o You may also want to give your ACW a copy of the Attendant Care Worker Code of Conduct. The Code outlines specific expectations of the ACW in maintaining a professional environment while working for you.   This Code of Conduct follows the HIPAA training in the TRAINING	MATERIALS   AND   OTHER   RESOURCES   FOR   THE ATTENDANT CARE WORKER section of this manual.

YOUR NEEDS

•	Go over your “What Do I Need?” Checklist with your ACW. Keep a copy of it handy for your ACW to refer back to as they do their job.

Be CLEAR and SPECIFIC about each area of need. Ask your ACW if you are explaining your needs in a way that they understand.

GIVE DETAILS!!   Everyone learns how to clean and cook differently, so be sure you take the time to explain your way of doing these tasks.

DO NOT take it for granted that your ACW will know how you like things done without telling them directly, even if you know your ACW.

Suggestion:    Have your ACW review the Caregiver Burnout information  in  the  Training  Materials  for  ACWs  section  of  this manual.

ORIENTATION:	DAY THREE

EMERGENCY PLAN

•	Go  over  emergency procedures and  create an  Emergency Plan.    A sample plan is found in the Forms section of this manual. Post your Emergency Plan in an easily accessible location (on the refrigerator or by the phone). Make sure you let your ACW know all the details.

•	Make sure you have an emergency evacuation plan in case of a fire. This is  an  area  where  you  and  your  Attendant  Care  Worker  can  work together. Allowing your ACW to give some suggestions will make the plan easier to remember.

Review the Home and Fire Safety section of the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER portion of this manual, which includes information on Fall Prevention, Fire Safety and Prevention.

There is also a Self Directed Attendant Care Reporting Form that follows the Emergency Plan in the Forms section of this manual. This form should be used by you or the ACW to report an injury, concern or summary of an incident to the case manager.

Suggestion:  Have your ACW review the Fraud, Abuse, Neglect and Exploitation information in the TRAINING MATERIALS AND OTHER RESOURCES FOR THE ATTENDANT CARE WORKER section of this manual.

ORIENTATION:	DAY FOUR

DISEASE INFORMATION AND SECONDARY CONDITIONS

•	Today you will start out with the information on Disease Information and Secondary Conditions.   Be sure to specifically cover any diseases and secondary conditions that apply directly to you.

•	Take a few minutes with your ACW to look at all the different types of diseases and secondary conditions listed in the manuals.

•	Pay  close  attention  to  your  disability  and  make  sure  to  include information that applies to your health condition. Be clear to your ACW about which areas concern you.

•	Ask your ACW to study the specific characteristics listed in the manual so they can help with recognizing them and help you with preventing them.

o For example: A pressure sore develops due to poor blood supply to an area of the body. To prevent this from occurring, your ACW should make sure you are not sitting or lying in one place for too long.

Remember: Secondary Conditions can be controlled with proper guidance and attention!

ORIENTATION:	DAY FIVE ONGOING

Keep your ACW updated on any information you want them to focus on. Make sure to provide feedback to your ACW on things they are doing well and things that need improvement.

Use the information in the remainder of the Training Materials for the ACW portion of this manual to provide additional training to your ACW. Any training you provide your ACW will help them provide better care to you.

Suggested Topics to Cover:

‡ Communication (located in the GENERAL INFORMATION FOR MEMBERS AND ATTENDANT CARE WORKERS section of the Member Information section of the manual). Includes Managing Emotions and Conflict Management.
‡ Stress Management (located in the GENERAL INFORMATION FOR MEMBERS AND ATTENDANT CARE WORKERS section of the Member Information section of the manual). Includes Relaxation Techniques.
‡ Attendant Tips
‡ Boundaries
‡ Communication Skills
‡ Maintaining a Clean and Pleasant Environment
‡ Food Handling Guidelines
‡ Proper Body Mechanics
‡ Mobility, Transferring and Ambulation
‡ Bathing and Providing a Bed Bath