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CHCCCS025

SUPPORT RELATIONSHIPS WITH CARERS AND


FAMILIES

LEARNER RESOURCE
CHCCCS025 Support relationships with carers
and families

TABLE OF CONTENTS
TABLE OF CONTENTS........................................................................................................................................ 2
UNIT INTRODUCTION ....................................................................................................................................... 4
ABOUT THIS RESOURCE ...................................................................................................................................... 4
ELEMENTS AND PERFORMANCE CRITERIA ....................................................................................................... 5
PERFORMANCE EVIDENCE AND KNOWLEDGE EVIDENCE ................................................................................. 6
PERFORMANCE EVIDENCE......................................................................................................................................... 6
KNOWLEDGE EVIDENCE ............................................................................................................................................ 6
ASSESSMENT CONDITIONS .............................................................................................................................. 8
TOPIC 1 – INCLUDE CARERS AND FAMILY MEMBERS AS PART OF THE SUPPORT TEAM ................................... 9
INTRODUCTION ....................................................................................................................................................... 9

ASSESS AND ACKNOWLEDGE THE ROLE AND IMPORTANCE OF CARERS AND FAMILY MEMBERS FOR THE
PERSON ......................................................................................................................................................... 10
WORK IN A MANNER THAT RECOGNISES AND SUPPORTS CARER’S RELATIONSHIP WITH, AND KNOWLEDGE
ABOUT, THE PERSON WITH SUPPORT NEEDS AND IDENTIFY THE KNOWLEDGE AND SKILLS OF THE CARER
THAT COMPLEMENT THE ROLE OF THE WORKER ........................................................................................... 11
RESPECT FOR THE CARER......................................................................................................................................... 12
NEEDS THAT IMPACT ON THE FAMILY MEMBERS .......................................................................................................... 12
PRIVACY AND CONFIDENTIALITY OF CARER .................................................................................................................. 13

INVOLVE CARERS AND FAMILIES IN THE DESIGN AND DELIVERY OF THE PERSON’S SUPPORT SERVICES ........ 14
PLANNING ACTIVITIES ............................................................................................................................................ 14
RESPECT AND INCLUDE THE CARER AS PART OF THE CARE TEAM ....................................................................................... 15
IDENTIFY CARER ISSUES........................................................................................................................................... 16
FIND SOLUTIONS TO ISSUES ..................................................................................................................................... 17
RECOGNISE AND SUPPORT THE CARER'S RELATIONSHIP WITH AND KNOWLEDGE ABOUT THE PERSON WITH SUPPORT NEEDS ......... 18
TYPES OF SERVICE DELIVERY APPROACHES .................................................................................................................. 18
RIGHTS-BASED APPROACH ...................................................................................................................................... 18
PERSON-CENTRED PRACTICE .................................................................................................................................... 19
STRENGTHS-BASED APPROACH................................................................................................................................. 19
ACCESS AND EQUITY............................................................................................................................................... 19

TOPIC 2 – ASSESS AND RESPOND TO CHANGES IN THE CARE RELATIONSHIP ................................................. 21


ASSESS POTENTIAL RISKS OF CHANGE TO THE CARE RELATIONSHIP INCLUDING ANY POTENTIAL PHYSICAL
AND PSYCHOLOGICAL HARM TO CARERS AND THE PERSON .......................................................................... 21
FINDING A SOLUTION ............................................................................................................................................. 21
IDENTIFY CHANGING RELATIONSHIPS ......................................................................................................................... 22
IDENTIFY KEY CHANGES THAT MAY INCLUDE RISK OF CARE RELATIONSHIP BREAKDOWN ........................................................ 23
SUPPORT THE PERSON, CARER AND FAMILY TO IDENTIFY AND USE STRATEGIES THAT MAXIMISE POSITIVE
ASPECTS OF CHANGE AND TRANSITION ......................................................................................................... 24
SUPPORT CARERS, FAMILIES AND FRIENDS TO MAXIMISE ONGOING SUPPORT AND INVOLVEMENT IN THE
LIFE OF THE PERSON ...................................................................................................................................... 26

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CHCCCS025 Support relationships with carers
and families

TOPIC 3 – MONITOR AND PROMOTE CARER RIGHTS, HEALTH AND WELL BEING ........................................... 28
RESPECT THE CONFIDENTIALITY AND PRIVACY OF THE CARER, AS WELL AS THE PERSON WITH SUPPORT
NEEDS ............................................................................................................................................................ 28
DUTY OF CARE REQUIREMENTS ................................................................................................................................. 28
ORGANISATIONAL CODE OF CONDUCT ........................................................................................................................ 29
ORGANISATIONAL REQUIREMENTS ............................................................................................................................ 29
PRIVACY .............................................................................................................................................................. 30
CONFIDENTIALITY .................................................................................................................................................. 30
PROVISION OF SERVICES ......................................................................................................................................... 31
CURRENT BEST PRACTICE APPROACHES FOR SERVICE DELIVERY ........................................................................................ 31
LEGAL AND ETHICAL CONSIDERATIONS ....................................................................................................................... 32
Discrimination ............................................................................................................................................. 32
Dignity of risk .............................................................................................................................................. 33
Duty of Care ................................................................................................................................................ 33
Human rights, including the United nations convention on the rights of persons with disabilities (UNCRPD)
.................................................................................................................................................................... 33
Mandatory reporting .................................................................................................................................. 33
Privacy, confidentiality and disclosure ........................................................................................................ 34
work health and safety................................................................................................................................ 34
Principles of empowerment ........................................................................................................................ 35
IDENTIFY AND RESPOND TO THE NEED FOR SERVICES REQUIRED BY THE CARER AND ISSUES THAT MAY
IMPACT ON THE PHYSICAL AND EMOTIONAL HEALTH AND WELL BEING OF THE CARER ................................ 35
PROVIDE CARERS AND FAMILIES WITH INFORMATION ABOUT CARER SUPPORT SERVICES ........................... 37
SUMMARY ..................................................................................................................................................... 39
REFERENCES................................................................................................................................................... 40

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CHCCCS025 Support relationships with carers
and families

UNIT INTRODUCTION
This resource covers the unit CHCCCS025 Support relationships with carers and
families.

This unit describes the skills and knowledge required to work positively with the carers
and families of people using the service based on an understanding of their support
needs.

This unit applies to workers across a range of community services contexts.

The skills in this unit must be applied in accordance with Commonwealth and
State/Territory legislation, Australian/New Zealand standards and industry codes of
practice.

ABOUT THIS RESOURCE

This resource brings together information to develop your knowledge about this unit.
The information is designed to reflect the requirements of the unit and uses headings to
makes it easier to follow.

Read through this resource to develop your knowledge in preparation for your
assessment. You will be required to complete the assessment tools that are included in
your program. At the back of the resource are a list of references you may find useful to
review.

As a student it is important to extend your learning and to search out text books,
internet sites, talk to people at work and read newspaper articles and journals which
can provide additional learning material.

Your trainer may include additional information and provide activities. Slide
presentations and assessments in class to support your learning.

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CHCCCS025 Support relationships with carers
and families

ELEMENTS AND PERFORMANCE


CRITERIA
1. Include carers and family 1.1 Assess and acknowledge the role and importance
members as part of the of carers and family members for the person
support team
1.2 Work in a manner that recognises and supports
carer’s relationship with, and knowledge about, the
person with support needs

1.3 Identify the knowledge and skills of the carer that


complement the role of the worker

1.4 Involve carers and families in the design and


delivery of the person’s support services

2. Assess and respond to 2.1 Assess potential risks of change to the care
changes in the care relationship including any potential physical and
relationship psychological harm to carers and the person

2.2 Support the person, carer and family to identify


and use strategies that maximise positive aspects of
change and transition

2.3 Support carers, families and friends to maximise


ongoing support and involvement in the life of the
person

3. Monitor and promote carer 3.1 Respect the confidentiality and privacy of the
rights, health and well being carer, as well as the person with support needs

3.2 Identify and respond to the need for services


required by the carer to support the care relationship
with the person

3.3 Identify and respond to issues that may impact on


the physical and emotional health and well being of
the carer

3.4 Provide carers and families with information


about carer support services

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CHCCCS025 Support relationships with carers
and families

PERFORMANCE EVIDENCE AND


KNOWLEDGE EVIDENCE
This describes the essential knowledge and skills and their level required for this unit.

PERFORMANCE EVIDENCE

The candidate must show evidence of the ability to complete tasks outlined in elements
and performance criteria of this unit, manage tasks and manage contingencies in the
context of the job role. There must be evidence that the candidate has:

 Assessed and responded to the needs of at least 3 different people and their
carers or family members
 Used strengths-based solutions to respond to both routine and unpredictable
problems related to care relationships

KNOWLEDGE EVIDENCE

The candidate must be able to demonstrate essential knowledge required to effectively


complete tasks outlined in elements and performance criteria of this unit, manage tasks
and manage contingencies in the context of the work role. This includes knowledge of:

 Context for caring in Australia:


o Carer demographics
o Carer support organisations and resources
o Attitudes, stereotypes, false beliefs and myths associated with caring
o Different pathways into service settings for the person and the
implications for carers, families and friends
 Rights, roles and responsibilities of different people in the care relationship
o The person
o Family members
o Friends
o Support worker
 Impact of the caring role on family, carers and friends
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CHCCCS025 Support relationships with carers
and families

 Different family patterns and structures and their impact on the person
 Life cycle transitions:
o Types of transitions
o Positive and negative impacts
 Current service delivery philosophy and models:
o Basic principles of person-centred practice, strengths-based practice
and active support
o Strategies to work positively with families, carers and friends
 Organisation policies and procedures in relation to carers and families
 Legal and ethical requirements for working with carers and families and how
these are applied in an organisation and individual practice, including:
o Discrimination
o Privacy, confidentiality and disclosure
o Work role boundaries – responsibilities and limitations

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CHCCCS025 Support relationships with carers
and families

ASSESSMENT CONDITIONS
Skills must have been demonstrated in the workplace or in a simulated environment
that reflects workplace conditions. The following conditions must have been met for this
unit:

 Use of suitable facilities, equipment and resources, including organisation


policy, protocols and procedures relevant to carers and families
 Modelling of industry operating conditions and contingencies, including
people, carers or family members with whom the candidate can interact

Assessors must satisfy the Standards for Registered Training Organisations (RTOs)
2015/AQTF mandatory competency requirements for assessors.

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CHCCCS025 Support relationships with carers
and families

TOPIC 1 – INCLUDE CARERS AND


FAMILY MEMBERS AS PART OF THE
SUPPORT TEAM
INTRODUCTION

The carer’s role in the assistance of people with disabilities, mental illness and those
people who are ageing is a vital part of the care process in Australia and without them
the health care for these people would be far greater. People who need care benefit
greatly from families and friends who care for them as they are more likely to be able to
remain in the home and more independent.

ABS surveys and other sources have shed some light on carers in Australia. By better
understanding carers' characteristics and demographics, we are better able to provide
advocacy and advice to support them.

Some quick statistics:

 2.7 million unpaid carers in Australia


 more than 770,000 carers are primary carers
 300,000 carers are under the age of 24
 150,000 carers are under the age of 18
 over 1.5 million carers are of working age (18-64)
 31,600 Indigenous carers are over the age of 15
 620,000 carers were born outside Australia
 366,700 carers were born in non-English speaking countries
 520,000 carers are over 65 years of age
 the estimated replacement value of unpaid care provided in 2015 is $60.3
billion - over $1 billion per week, or 3.8% of Gross Domestic Product
 It is estimated that carers will provide 1.9 billion hours of unpaid care in
2015

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CHCCCS025 Support relationships with carers
and families

 On average carers spend approximately 40 hours per week providing care. It


is estimated that carers of someone with a mental illness spend on average
104 hours per week in the caring role. 1

ASSESS AND ACKNOWLEDGE THE ROLE AND IMPORTANCE OF


CARERS AND FAMILY MEMBERS FOR THE PERSON

There are many challenges to being a primary carer for a family member or friend. In
very few instances do people go into a relationship expecting to be the one responsible
for the intimate care of another person. Many people embrace the challenge and set out
to learn as much useful information as possible to help them in their new role. Others
struggle with the challenge and may well be negatively impacted physically and
emotionally as their personal resources are drained. Many carers perform the role for a
large part of their life.

Parents are generally prepared to nurture their newborn offspring until the time they
become independent and are subsequently faced with a range of emotions when a child
is born that may require ongoing care for life. The emotions they will experience can
vary from grief and loss to sadness, resignation, anger and bitter disappointment that
life has dealt them such a blow.

For a person who has acquired a life changing injury the adjustment to being dependent
on another for care can be devastating. Combined with the change in their role in the
family, the situation can be very demanding for all involved. A formerly capable adult
may become dependent on a spouse or child to assist with their activities of daily living.
The new carer may be uncomfortable with their new role and the change in the family
dynamic.

For older people, providing care for a partner or adult child can be fraught with
challenges as the carer themselves age. The physical demands on an ageing body can
result in injuries to the carer and risk to the person they care for. The difficulties of
caring for a partner with dementia or who is dying are well documented. The emotional

1 http://www.carersaustralia.com.au/about-carers/statistics/
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CHCCCS025 Support relationships with carers
and families

reaction to watching someone you have spent a lifetime with slowly fade away can be
heart wrenching.

In your role, as a worker in any aspect of the care industry, it is vital to recognise the
contribution of the primary carer and the significance of their relationship to the person
they care for. In some instances they may also be the decision maker for your client.
Where the client is capable of making their own decisions then their relationship with
the primary carer needs to be clarified with you. You will need to know if the carer is to
be involved in decisions on a day to day basis or if there needs to be a consultation
process on aspects of the care provided. The client may establish goals and wishes but,
without the support and cooperation of the carer, these may never be achieved.

For some carers there is the dual responsibility of caring for older people while still
raising their own family.

In all your interactions you will need to recognise and respect the importance of the
relationship between the client, their family and their friends. All care situations need to
be handled with sensitivity as the wellbeing of the client can be directly impacted by the
relationships you develop with their significant others.

WORK IN A MANNER THAT RECOGNISES AND SUPPORTS


CARER’S RELATIONSHIP WITH, AND KNOWLEDGE ABOUT, THE
PERSON WITH SUPPORT NEEDS AND IDENTIFY THE
KNOWLEDGE AND SKILLS OF THE CARER THAT COMPLEMENT
THE ROLE OF THE WORKER

One of the greatest concerns facing people who take on the role of carer is the need to
suddenly develop new skills. This can be especially challenging for someone who has
never been called on to act in the role before. Shopping, housework, cooking and
performing personal care tasks may stretch the abilities of a person who has rarely
performed these tasks previously. The need to carry out duties formerly the province of
nurses, such as giving injections, administering medication, catheter care etc can be a
terrifying experience for a primary carer newly thrust into the role.

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CHCCCS025 Support relationships with carers
and families

Your role as a care worker is to support the carer in their role while recognising and
acknowledging the work that they do. It is important to develop a relationship of trust
and work together to achieve the best outcome for the client. You will also need to
ensure the carer has the support they need to continue in their role.

RESPECT FOR THE CARER

As a worker you may be asked to perform tasks outside your role and responsibilities.
You must be courteous in your refusal but recognise that the carer may require further
support from an external source. Always document such incidents and requests and
provide feedback to your supervisor in case further assistance needs to be offered to the
carer or the care plan modified to include additional tasks.

There is also the risk as a worker that you may be tempted to underestimate the
abilities of a carer. This is particularly apparent when a child or young person takes on
the role of primary carer. In nearly 400 000 instances in Australia care is provided by
children or young people where there are other factors that mean an adult is not
available. This can be due to family circumstances, financial difficulties, geographical
location or relationship breakdown. Take care in these instances that you respect what
the young person does and clarify with them your own role in providing care. Confirm
with your supervisor that the young carer has been included in discussions around the
development of the care plan and that you are both clear about the limits of your role.

NEEDS THAT IMPACT ON THE FAMILY MEMBERS

Increasingly the significant role of the carer is recognised by the government and the
community. It has now been identified that the health and wellbeing of the carer is a
primary factor in the provision of quality care to the client. To this end steps must be
taken to ensure the needs of the carer are met.

One of the needs most commonly expressed by carers is that for information and
education. In 2009 studies conducted in Australia showed that, particularly among
elderly carers, there was a generally dismissive attitude to their request for quality
information on aspects of their role. This is a particular problem where training is
required in aspects of technical care or medication administration. Your knowledge of
services available through your organisation or the resources in the local community
can be an invaluable support to your clients and their carers. A call to the Department of

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CHCCCS025 Support relationships with carers
and families

Human Services can often be a good start to accessing relevant information on payment
entitlements and services.

For some carers their role means an increasing restriction on their ability to socialise or
participate in the workforce due to their carer responsibilities. Short term respite in the
home, day activity centres or longer term respite in a care facility can help provide the
carer with the break they need while still providing for the needs of the client. This can
give the carer the opportunity to participate in employment or social opportunities.

PRIVACY AND CONFIDENTIALITY OF CARER

Your work in the care industry is governed by comprehensive legislation and


government policies that protect you and the people you work with. This includes the
primary carer.

Such legislation and guidelines may include:

 Anti-discrimination Act 1977 (NSW)- Carers' responsibilities amendment


 Carer Recognition Act 2004 (WA)
 Carer Recognition Policy 2003 (QLD)
 Carers Charter; Carer Recognition Legislation; State Carers Policy (SA)
 Caring for Carers in the ACT - A plan for Action 2004-2007
 Child protection legislation
 Department of Human Services Victoria 'Recognising and Supporting Care
Relationships Policy Framework 2006+ Action Plans for Aged care, mental
Health and Disability
 NSW Carers statement 1999 (NSW)
 The Aged Care Act 1977
 The Disability Discrimination Act 1992
 The Privacy Act 1988
 The Racial Discrimination Act 1975

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CHCCCS025 Support relationships with carers
and families

To review details and amendments of these and more visit the ComLaw website at
www.comlaw.gov.au

Remember, you are bound by law to comply with The Privacy Act 1988 and its subsequent
amendments, by maintaining the privacy and confidentiality of your client, their carer and
their information.

You can achieve this by:

 Not discussing the client's information with anyone you are not authorised to.
This includes relatives and friends of the client not identified in the care plan
 Taking care to secure any written information you have regarding the client
and their care as per your organisation's policies and procedures
 Checking with your supervisor and the client when you have concerns about
who to give information to
 Maintaining the carer's information with the same respect as that of the client
 Documenting any concerns or observations of the carer that could indicate they
may require more assistance

INVOLVE CARERS AND FAMILIES IN THE DESIGN AND DELIVERY


OF THE PERSON’S SUPPORT SERVICES

PLANNING ACTIVITIES

As a care worker your opinion will be sought when reviews are made to the client's care
plan. The client, their case manager and the primary carer will be involved in identifying
and establishing goals for the future and discussing what is working well and what areas
need to be adjusted to meet the needs of the client and their carer. Your recorded
observations and comments are an important part of this discussion. In the HACC
environment you are often the link between the family and your organisation and the
first person to identify when areas of concern may be developing.

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CHCCCS025 Support relationships with carers
and families

This 'team approach' to providing care is extended into all your interactions with the
client. When planning any activities with the client the involvement of the carer should
be identified and acknowledged by you. This will be influenced by the client's capacity to
make decisions on their own behalf and you will need to use your judgement when
determining this. Your ability to involve the carer as part of the care team is especially
important where you are working in the home. While it is your workplace it is the
personal space of the people you are working with and should be respected as such.

A discussion you should initiate with the client and their carer is regarding fire safety in
the home. As it is your workplace while you are with the client there needs to be a plan
in place to ensure your safety in the event of a fire. This is important also in terms of
evacuating the client, their carer and other family members whether you are there or
not. Your discussion should include:

 Behaviour that may contribute to the risk of fire injury or fatality


 Optimum placement of smoke alarms, types of alarms and making sure they
work
 Referral for installation and maintenance of smoke alarms
 Smoke alarm testing and cleaning
 Escape plan and assembly points for household members
 Ensuring access and egress points are clear
 Emergency numbers for local services

You may find your organisation has prepared information for you to give to the client
and their carer regarding safety in the home.

It is important to recognise that decisions made on any aspect of care by Aboriginal and
Torres Strait Islander clients can often involve consultation with extended family and
social networks. Respect should be shown for the decision making process and the
wishes of the client upheld in this regard.

RESPECT AND INCLUDE THE CARER AS PART OF THE CARE TEAM

As a professional care worker it is important that you treat the carer as a co-contributor
to the care of the client. When working with your client you may find that the carer is
unwilling to relinquish their role to you in any way. Others may stand back and wait to
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CHCCCS025 Support relationships with carers
and families

be invited to contribute. It is vital that you establish a good rapport with your client and
their carer to enable everyone involved to identify their role and be comfortable in this
important relationship.

Where the client does not want the carer involved in an aspect of their care then treat
the matter sensitively. An example may be an elderly person being showered by their
son or daughter. One or the other may feel embarrassed or uncomfortable with this
intimate aspect of their care and you will need to handle the situation with care and
respect.

Each situation will be different and this is one of the challenges of working in the care
industry. Your excellent communication skills and respectful manner will mean you will
quickly identify the levels of involvement that are comfortable for you, the carer and
most importantly, the client.

IDENTIFY CARER ISSUES

Carer issues may include:

 Emotional well being


 Exhaustion, lack of sleep
 Financial difficulties due to loss of income or expense of meeting care needs
 Feelings of grief and loss, resentment, depression
 Breakdown of other family relationships
 Physical health and well-being, the carer's own medical issues
 Withdrawal from social participation by choice or due to carer obligations
 Destructive behaviour such as drug or excessive alcohol consumption used to
address stress

As identified previously, the support the primary carer provides is vital in economic
terms for the government and to the wellbeing of the client. It is therefore critically
important to maintain the health and wellbeing of the primary carer.

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CHCCCS025 Support relationships with carers
and families

The support you offer in this regard cannot be understated. As the care worker you will
be in a unique position to identify when a carer is experiencing ill health, injury or stress
related to, or impacting on, their role as the primary carer for your client. It is important
to record your concerns and observations and report to your supervisor as soon as
practicable.

Carer burnout is a real concern in the support of those who are ageing or living with a
disability. There are many carer support groups and networks available to provide
information and assistance to carers at risk.

FIND SOLUTIONS TO ISSUES

Your well-developed communication skills, and the rapport you have developed with
them, will form a good basis to initiate conversations with the client and their carer on
aspects that may need to be discussed. What may seem an overwhelming issue initially
may be addressed quite simply with some modification to the care plan or by providing
helpful information.

Using a strengths-based approach may seem counter intuitive when the focus on most
of the care delivered appears to be on 'what's wrong' with the client or situation. By
taking a different approach and focusing on 'what's right' a more respectful,
empowering approach to problem solving can take place. This gives the people involved
the opportunity to control their lives in meaningful and sustainable ways.

For example, a client rejoining the workforce may simply need assistance with their
activities of daily living at a different time of day. If the primary carer is also the mother
of young children then this could place additional strain on the carer in the early
mornings. A solution to this might be an adjustment to the care plan with a care worker
allocated for the new time required. Be supportive and remind the client and carer they
are managing other aspects of their lives very well. A degree of flexibility is essential in
care planning to meet the changing needs of carers, clients and family.

A primary carer undergoing surgery may be able to access respite care for the client
while they recover post operatively. This will give the carer the time and rest they need
to recover and provide for the care needs of the client in the short term. Your
organisation will have information you can provide to the carer and client to help them
in the decision making process regarding options for respite care.

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CHCCCS025 Support relationships with carers
and families

It is important that you identify any concerns either the client or carer may have and
invite them to suggest solutions, or what strategies they would like to see put in place,
before offering your thoughts on the matter.

RECOGNISE AND SUPPORT THE CARER'S RELATIONSHIP WITH AND


KNOWLEDGE ABOUT THE PERSON WITH SUPPORT NEEDS

Respect in all dealings you have with the carer is significant in maintaining a good
relationship. Where they are the primary decision maker for the client you should
always defer to their wishes regarding client care providing there is no risk to you or the
client.

Seek the carer's guidance when delivering services to your client. The carer is most
likely to have a thorough understanding of the preferences and idiosyncrasies of how
the client 'likes things done'. They are also an excellent source of tips for encouraging a
client who may be having a bad day, is not well or is unwilling to cooperate.

The primary carer is usually the first to notice when the person they care for varies from
their normal behaviour or demeanour. Their observations and insights are an invaluable
source of information on what is happening with your client's overall health and
wellbeing.

TYPES OF SERVICE DELIVERY APPROACHES

It is essential that all of the service delivery options and responses to the client are
developed specifically for their individual needs and ensuring that all of their rights,
needs and preferences are met by the options.

RIGHTS-BASED APPROACH

Rights based approaches in community service are focused on ensuring that all of the
rights of all clients are upheld at all times. It is essential to ensure that all rights of the
client are known, explained to the client and then upheld at all times.

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PERSON-CENTRED PRACTICE

Person-centred approaches to community service delivery are focused directly to the


needs and desires of the specific individual, it has been determined that the most
effective type of community services responses are those that foster a person centred
approach.

STRENGTHS-BASED APPROACH

It is important for the community services worker to develop a relationship with the
client that allows them to understand what motivates and inspires the client and where
the clients develops their own feeling of strength and energy from. These positive
feelings and characteristics must be celebrated and harnessed in order to activate the
strength and energy that a client will require access to in order to be successful over a
long period of time and achieve their goals.

ACCESS AND EQUITY

Access and equity is the act of promoting fairness while distributing resources and
opportunities, particularly to those in need. While working in community development,
in order to adhere to the principles of access and equity, the following guidelines should
be considered:

 Ensuring that individuals from culturally and linguistically diverse


backgrounds are presented with information in manner which they can
understand
 Provide material in multiple languages and provide a translator when
possible
 No one should be excluded from taking part or being employed by the
organisation based on race, gender, sexual orientation, disability, or country
of birth
 Services should be designed and delivered on the basis of accessibility to all
who qualify to use them
 Holding meetings and services in locations that have access for handicapped
individuals

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 Encourage members from diverse backgrounds to seek employment or use of


services from the organisation.

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TOPIC 2 – ASSESS AND RESPOND TO


CHANGES IN THE CARE
RELATIONSHIP

ASSESS POTENTIAL RISKS OF CHANGE TO THE CARE


RELATIONSHIP INCLUDING ANY POTENTIAL PHYSICAL AND
PSYCHOLOGICAL HARM TO CARERS AND THE PERSON

While many carers cope well with their role and provide excellent care to their loved
one there are times when their own needs and preferences are in conflict with the
client's. Some of these have been previously discussed.

Other carer needs may include:

 Affirmation
 Choice about involvement in specific aspects of care
 Education
 Inclusion
 Information and referral
 Peer support
 Recognition

It is important that the carer be recognised for the role they play. Where the client is
unable or unwilling to pay tribute to the efforts of their carer your role in affirming their
worth will go a long way to lifting their morale and self-esteem. Ensuring the carer does
not become isolated in their role, that they are aware of support networks in their area
and that time is allocated for their self-care are practical steps you can address to
maintain their wellbeing and ensure their needs are being met.

FINDING A SOLUTION

Where a carer has expressed a need to become involved in an area outside of caring for
your client then reasonable steps should be taken to accommodate them. A desire to
enrol in further education, for example, may require an amendment to the times you

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have been allocated to be with the client. Where set hours for attending classes can be
established then your organisation will take steps to amend the personalised care plan
to see that a care worker will be there to provide the respite care required to enable the
carer to participate in the education opportunity.

When the primary carer is involved in raising children or caring for the elderly as well
as their primary care responsibilities to your client then you need to be aware of the
effect these competing demands can have. Allocating time for specific responsibilities
such as taking a parent to an appointment and out to lunch or taking a child to dance
class then out for an ice-cream, can greatly contribute to maintaining healthy
relationships and the overall happiness and wellbeing of the carer.

Provide the carer with the opportunity to discuss with you any areas of concern in their
own life that impact on their ongoing ability to fill the carer role effectively. By having a
thorough knowledge of the services and supports your organisation provides, or those
available in the community, you will be able to provide assistance to the carer when
they need it most. Liaise with your supervisor to identify what assistance can be offered.

Remember to show a positive, supportive attitude to addressing the needs and


preferences of the carer while acknowledging the important role they play.

IDENTIFY CHANGING RELATIONSHIPS

Over time the care relationship may change for a variety of reasons. The care may no
longer be required by the client as they mature, learn new skills, adapt to their disability
or deteriorate to the point where they require full time care in a facility or die. No
matter the situation, you, as a care worker, need to recognise the effect these changes
may have on the carer and support both them and the client in any decision making
process.

This can be particularly difficult for a parent who has cared for a child living with a
disability. While the autonomy of the child is the most important factor you should
recognise the internal struggle this might pose for the parent. Recognising that their
adult child may leave home as any person would; may not be something they had
thought about. It could require modification to an environment designed to support
them or financial independence the parent had not previously considered possible.

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Whatever the situation; there is bound to be a period of considerable adjustment for


both parties, as the nature of the relationship changes.

Where care is provided by an older person to their ageing spouse there is well
documented evidence of the emotional stages the carer may go through as they watch
their loved one deteriorate. Some close relationships are maintained throughout but
others are lost and the carer left with a feeling of resentment as the person they knew
and loved becomes increasingly consumed by ageing or disease.

Children and young people may feel increasingly constrained by their care
responsibilities as their need for social and emotional relationships changes over time.
While the client may be encouraging of these changes, the carer may feel guilty about
abandoning the client and the resulting tension can be reflected in a strained
relationship between them.

IDENTIFY KEY CHANGES THAT MAY INCLUDE RISK OF CARE RELATIONSHIP


BREAKDOWN

For many reasons a primary carer may not be able to continue in their role. Some
reasons may include:

 Conflict in relationships with family or service providers


 High intensity care
 High level of carer stress
 Loss of formal or informal supports
 Multiple competing role demands
 Worsening carer health
 Worsening health or behaviour of the person with support needs

As a child with a disability grows the carer may not be able to physically cope with the
manual handling aspects of continuous care. This is especially true as a carer ages and
experiences issues associated with their own ageing process.

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The worsening health or behaviour of a client may bring the care relationship to an end.
A tantrum in a two year old may be manageable but in a twenty year old living with an
intellectual disability a tantrum could pose a genuine risk to the safety of the carer and
others.

Older people with dementia deteriorate over time to the point where a carer may no
longer be able to provide the high level of support required to meet their needs. Given
that the primary carer in this instance is often the client's ageing spouse there is a very
real risk of harm to the carer through physical and emotional exhaustion.

Whatever the reason, it is vital that you recognise the impact on the relationship
between the carer and the client. This is particularly important where there is a health
risk to either party.

SUPPORT THE PERSON, CARER AND FAMILY TO IDENTIFY AND


USE STRATEGIES THAT MAXIMISE POSITIVE ASPECTS OF
CHANGE AND TRANSITION

Many people who care for their family members, whether ageing or disabled or those
who are dealing with mental health issues need support and care.

They can struggle with the changing relationships they experience as carers for
example;

 A child now becomes the carer for an ageing parent


 The parent now cares for a disabled or mentally ill child who has become an
adult

These relationships must be formed again in a different manner. Whilst the person they
are caring for is an adult, they are often unable to manage as an adult would, this can
sometime mean they are treated more as children and not adults.

Sometimes when a child becomes the carer for their ageing parent the relationship
begins as simply performing small tasks for them but as the parents health and abilities
deteriorate they can often begin doing things such as:
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 Assisting with toileting


 Showering
 All personal hygiene
 Cooking
 Cleaning
 Feeding
 Among other things

This can often affect the carer greatly and in this case the really need assistance to
managing this changing relationship.

Assistance may include things such as:

 Counselling
 Respite
 Home help
 Home care services
 Medical support

This assistance may also extend to the parent themselves. They may feel that they are a
burden on their child or they may feel as though they are useless and can become quite
depressed.

They may also need counselling or medical assistance but there are some things that
you can do to encourage both parties to begin to enjoy the changing relationship.

Try to get both parties to focus on the positive aspects of their lives. Things such as:

 The closeness they now share


 The time they can spend together
 The feeling that the child can now assist the parent rather than the other way
around

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They can also be encouraged to do things together outside the more personal caring role
such as:

 Enjoying a walk through the gardens


 Coffee at the local café
 Shopping trips
 Zoo outings

There are a millions things that they could do together that would enhance their
relationship that would not be a burden or concern. This would enhance relationships
and make both parties feel better about the caring role.

In all circumstances, if you believe there is a problem in relation to the mental health of
either the carer or the person being cared for you should report this to your supervisor
or refer them to a G.P. or counsellor.

SUPPORT CARERS, FAMILIES AND FRIENDS TO MAXIMISE


ONGOING SUPPORT AND INVOLVEMENT IN THE LIFE OF THE
PERSON

Caring for a disabled or elderly person can be a drain on any person and none so much
as the child of the person. The main thing is that they are encouraged to use the
supports that are available to them. Supports may include:

 Respite - Respite care can give the carer a well-earned break and the person
they care for variety and extra social opportunities.
 Counselling - counselling can provide all parties with a means to talk openly
about their feelings and can give everyone the release they need to just feel
free to talk without offending or burdening others.
 Home care - can offer services to assist with cleaning, cooking and shopping.
 Meals on wheels - provides daily meals for people in need when they are
unable to cook them for themselves.

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 Home nursing - can provide assistance with medications, wound


management, showing, personal care.

Each of these services provide a different support and can be utilised in order to give the
client, the families and friends a break from the day-to-day care of the person.

Many carers see themselves as a family member who looks after a person they love, not
as a carer. This means that they may not think to look for, or ask for help. There are a
wide range of services available to help them in their caring role. Whatever the service,
whether it’s short-term respite or counselling, it is designed to lend them the support
and assistance they may need. It’s things like having some extra help and support that
may mean they can stay in their caring role for longer.

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TOPIC 3 – MONITOR AND PROMOTE


CARER RIGHTS, HEALTH AND WELL
BEING

RESPECT THE CONFIDENTIALITY AND PRIVACY OF THE CARER,


AS WELL AS THE PERSON WITH SUPPORT NEEDS

When providing support and assistance to any person, it is imperative that you do so
according to the policies and procedures of your organisation. Policies aim to tell
workers and people being supported what the service values and how it goes about
putting those values into practice.

Most written policies are clear, concise sets of guidelines outlining how that service
operates. The policies tell you what management expects will happen in certain
situations to support the service’s mission/ philosophy (belief statement). The policies
state what practices should be implemented, so work is done efficiently and
consistently.

Organisational policies relating to the provision of services may encompass issues such
as:

 Duty of care requirements


 Organisational code of conduct
 Organisational requirements

DUTY OF CARE REQUIREMENTS

Organisational policies will incorporate the duty of care requirements, which serve to
guide the workers in the delivery of their care. This is to ensure that the client does not
incur any harm or injury, particularly as a result of the actions of the worker. Duty of
care policies will include ensuring that care and service plans are followed, case notes
are followed and acted on as appropriate, and that new entries in relation to the health
of the individuals are documented accordingly. Having knowledge of the requirements
of the duty of care is instrumental in ensuring that the person and their carer are
supported in the most effective way. It is the responsibility of the worker to be aware
and familiar with their requirements in relation to the duty of care.

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ORGANISATIONAL CODE OF CONDUCT

Every organisation will have its own code of conduct, which outlines the functions that
it intends to perform. Usually, there are statements about the mission, values and
commitments of the organisation along with how it is guided in the provision of
services. Organisations are guided by a charter of rights and responsibilities. These
reflect the legislation that the organisation must abide by, and the types of services that
are provided. Every type of work that occurs within the organisation will have its own
code of conduct specific to that type of work. In some instances, members of that group
will be accountable to an external professional body.

ORGANISATIONAL REQUIREMENTS

In addition to duty of care requirements, each organisation will have its own
organisational requirements. Tis may vary according to the services that it provides.
However, there will be similarities relation to the provision of those services to the
clients. Organisational requirements need to be known and understood by the workers
in order for them to be able to effectively perform their work.

Your service probably has a policy and procedures manual available to workers
containing policies on a range of subjects. Some organisations may refer to these as SOP
or Standard Operations and Procedures Manual.

Policies are developed to help you in several ways such as:

 Avoiding hurried or spur of the moment decisions


 Guiding your actions so you are aware of due process
 Ensuring consistency in the way things are done by everyone
 Ensuring consistency in duties is carried on even though someone from the
staff may leave
 Ensuring decisions can be made without consulting everyone else

Generally, policies can help the staff team by:

 Empowering individuals who are able to make decisions with confidence as


they are based on written documentation
 Protecting staff who make decisions and act on established policies
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 Helping teamwork and cooperation by collectively establishing common


goals, procedures, and understanding

When commencing work within the community services sector, all employees need to
be aware of the policies, protocols and procedures relating to the provision of services
within their organisation and follow them accordingly in the provision of their care of
the client.

PRIVACY

As with respect, the client and their carer’s should feel that their privacy is maintained
at all times. The worker should never divulge any information relating to the client or
their carer’s to neighbours or any others with respect to the services they are receiving
or any other personal matters. When working in the home, consideration should be
given to the fact that conversations can be easily heard by others in the vicinity, so
therefore you should limit the volume of your voice.

Tasks such as answering the phone or collecting and reading of the mail should be left to
the client or carer unless otherwise requested to do so.

CONFIDENTIALITY

When communicating personal information regarding clients or carers in the


community services sector, it is extremely important to ensure that caution is used at all
times to ensure the confidentiality of both carer and client matters. This is important
both during written and verbal communication of personal information that may
pertain to your colleagues or clients.

Your community services organisation will have policies and procedures in place for the
handling of confidential information, and it is important that you make yourself aware
of these and follow them at all time. The protection of the personal information of
clients and carer’s is also enforced by legislation that is applied in many sectors of
business including the community services sector.

Organisational policy on confidentiality may relate to:

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 Access to records
 Destruction of records
 Release of information
 Storage of records
 Verbal and written communication

As well as handling all personal information of client and carers within the correct
organisational policies, procedures, regulations and guidelines it is important that you
also conduct the handling of this information with respect and care. Simple steps such
as:

 Closing the door to have a private conversation


 Not leaving papers of a personal nature in plain view of others
 Ensuring that you take care when writing information so as not to release
information inadvertently
 Ensuring that you choose your words with care when communicating
verbally regarding the personal information of others

PROVISION OF SERVICES

It is essential that a collaborative approach is taken when working with the person with
a disability and their family in order to ensure that the most appropriate service
delivery option is able to be selected for that person.

It will be necessary to ensure that all service provisions meet the needs of the
individual’s aspirations, needs, rights and preferences at all times.

It will be necessary to take the following into consideration:

CURRENT BEST PRACTICE APPROACHES FOR SERVICE DELIVERY

According to accreditaion standards within the community services industry client have
the right to:

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 Services that meet the clients needs


 Transperancy in quality requirements and indicators
 Foster a culture of continous improvement
 Supported feedback

The accreditation standards are summarised as:

 Empowerment: People’s rights are promoted and upheld.


 Access and Engagement: People’s right to access transparent, equitable and
integrated services is promoted and upheld.
 Wellbeing: People’s right to wellbeing and safety is promoted and upheld.
 Participation: People’s right to choice, decision making and to actively
participate as a valued member of their chosen community is promoted and
upheld. 2

All policies and procedures within a community service organisation should uphold all
ofthese standards and community service workers should be aware of the standards
and how they are measured and take them into account at all times during work
activities.

LEGAL AND ETHICAL CONSIDERATIONS

DISCRIMINATION

It is essential to ensure that the person with a disability is not discriminated against and
receives the same level of care, choice and respect as any other person.

The disability discrimination Act must be adhered to at all times throughout service
delivery and contact with the client.

2 http://www.dhs.vic.gov.au/about-the-department/documents-and-resources/policies,-guidelines-and-
legislation/department-of-human-services-standards
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DIGNITY OF RISK

Dignity of risk is the legal requirement to ensure that all persons with a disability has
the legal right to choose their own medical treatments even if the professionals involved
feel that this is not the correct choice for them.

DUTY OF CARE

Duty of care is ones legal obligation to take reasonable care to prevent others from
being harmed. This means that if a worker identifies something that could reasonably be
considered to be a risk, than that employee must, in response take reasonable action to
eliminate that risk. This means that if a client is presenting with indicators of harm it is
important that these are responded to according to legal requirements and duty of care
needs.

All relevant risk assessments, observation tools and activities should be carried out
when any of these indicators are present. It is essential that when a client presents with
a need for a particular service they will in fact be referred on to that service.

Legal requirements and duty of care obligations include:

 Ethical referral
 Comply with state and territory legislation

HUMAN RIGHTS, INCLUDING THE UNITED NATIONS CONVENTION ON THE RIGHTS OF


PERSONS WITH DISABILITIES (UNCRPD)

It is essential to ensure that all of the person’s human rights are respected and upheld at
all times. All human rights legislation as well as the United Nations conventions on the
rights of persons with a disability is respected and upheld. These treaties provide
persons with a disability with a range of rights including, respect, dignity, self-
determination and the right to choose what happens to them in their lives.

MANDATORY REPORTING

In addition to the general level of duty of care and ensuring that adults risks are
minimised and managed it is important to keep in mind that in some instances such as
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when a child is presenting with indicators of harm, neglect, abuse or risk of harm that
appropriate legal and ethical factors are considered.

Child protection requires knowledge of relevant state mandatory reporting legislation


and its application. It will be necessary for all community services workers to ensure
that they both know and comply with the legislation related to the reporting of these
indicators in children for their jurisdiction.

PRIVACY, CONFIDENTIALITY AND DISCLOSURE

In regards to community service work is viewed to in legal terms as the protection of


personal information. In order for one to comply legally with regulations surrounding
confidentiality, an individual is not permitted to share a client’s personal information
with coworkers, third parties or even friends and family of the client. The legal
exception to this rule is when sharing the information could prevent harm being done to
the client or anyone in the greater community.

There are many ways to keep information confidential. The following are examples of
some of these methods:

 individual files are locked and secured


 support workers do not tell other people what is in a client’s file unless they
have permission from the client
 information about clients is not told to people who do not need to know
 clients’ medical details are not discussed without their consent
 Adult clients have the right to keep any information about themselves
confidential, which includes that information being kept from family and
friends

WORK HEALTH AND SAFETY

It is essential that all aspects of the work health and safety Act are upheld at all times
and that appropriate controls and steps are taken in order to effectively identify any
hazards in the environment and to take appropriate measures to minimise, manage and
report on them.

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PRINCIPLES OF EMPOWERMENT

Gaining independence is a very important aspect of empowerment for people living with
a disability and this is a very important aspect of working with people with a disability.
It is essential that a range of steps are taken that will assist in guiding and enabling
choice and self-determination in a positive and supportive manner for the client at all
times.

IDENTIFY AND RESPOND TO THE NEED FOR SERVICES


REQUIRED BY THE CARER AND ISSUES THAT MAY IMPACT ON
THE PHYSICAL AND EMOTIONAL HEALTH AND WELL BEING OF
THE CARER

Responding to the needs of carers is the most vital part of the relationship, you not only
need to identify you need to act in accordance with the need.

People who care for a family member or friend can experience many rewards:

 The opportunity for personal growth and the development of new skills
 Proving that they can meet new challenges
 The satisfaction of knowing they have helped someone who needs them and
done the best they could to improve their quality of life
 Strengthening the relationship with the person they care for and knowing
how much they appreciate the help
 Receiving the acknowledgement of family and friends

On the other hand they also can experience some quite difficult challenges:

 Financial hardship
o 50% of primary carers are on a low income and many find it hard to
cover living expenses, save money or build up superannuation
o The extra costs of caring can be enormous. Caring families often have
to find money for extra expenses like heating and laundry, medicines,
disability aids, health care and transport.

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 Health and wellbeing


o Caring can be emotionally taxing and physically draining. Carers have
the lowest wellbeing of any large group measured by the Australian
Unity Wellbeing index.
o Carers often ignore their own health and are 40% more likely to suffer
from a chronic health condition. Some health problems, like back
problems, anxiety and depression, can be directly linked to caring.
o Many carers are chronically tired and desperately need to refresh with
just one night of unbroken sleep, a day off or an extended period with
no caring responsibilities
 Social isolation and relationships
o Many carers feel isolated, missing the social opportunities associated
with work, recreation and leisure activities
o The demands of caring can leave little time for other family members
or friends
o Carers often have to deal with strong emotions, like anger, guilt, grief
and distress, that can spill into other relationships and cause conflict
and frustration.
 Disadvantage
o Many carers miss out on important life opportunities, particularly for
paid work, a career and education
o Caring can take the freedom and spontaneity out of life

If you identify any of these problems then you will need to respond by providing or
referring the carer to the appropriate service.

If you are unsure about who to send them to or how to assist them please ensure you
ask your supervisor or manager. It is not enough just to acknowledge there is a problem,
you will need to ensure you provide these support they need in their time of need. Never
let it wait until later. Act immediately!

Learner Resource CHCCCS025 Page 36/40


Version: 2.0 Last Updated: 30 June 2017
Responsibility: Director of Studies Developed by Enhance Your Future Pty Ltd
Melbourne City College Australia RTO No: 45140 CRICOS: 03592B ABN: 77 602 164 625
CHCCCS025 Support relationships with carers
and families

PROVIDE CARERS AND FAMILIES WITH INFORMATION ABOUT


CARER SUPPORT SERVICES

There are many support services located in your area for carers to assist them to
continue caring for their friend or family member. You will need to provide them with
the information on how to contact the services and what these services can do for them.

There are services such as:

 Counselling - Free counselling for carers throughout Victoria


 Policy & research - Improving recognition and support for caring families
 Respite & Support - Respite and support for carers throughout Australia
 Education & training - Carers Victoria offers carer workshops and educational
programs to help carers and health professionals enhance their knowledge
about the caring role, and how to support the health and wellbeing of carers
and the person they are caring for.
 Information & advice - For caring families across Victoria
 Young carers - The term ‘young carer’ is used to describe children and young
people up to 25 years of age, who provide unpaid care for a family member
who has a disability, mental illness or chronic illness, or who is frail aged.
 Ethnic family carers - They can provide advice, support and information if
English is not your preferred language.
 Aboriginal & Torres Strait Islander Carers - They provide services and
supports to caring families.
 Better Start - The Better Start program is an initiative that supports children
who have a diagnosis of Down Syndrome, Fragile X Syndrome, Cerebral Palsy,
Moderate or greater vision or hearing impairments, including deaf, blindness.
From 1 January 2013, Better Start has also been made available to children
who have a diagnosis of Prader-Willi, Williams, Angelman, Kabuki, CHARGE,
Cornelia de Lange or Cri du Chat syndromes or microcephaly. Rett Syndrome
was added to that list on 1 February 2014
 Lesbian, gay, bisexual, trans* and intersex (LGBTI) carers - they provide
information and support for LGBTI carers.
Learner Resource CHCCCS025 Page 37/40
Version: 2.0 Last Updated: 30 June 2017
Responsibility: Director of Studies Developed by Enhance Your Future Pty Ltd
Melbourne City College Australia RTO No: 45140 CRICOS: 03592B ABN: 77 602 164 625
CHCCCS025 Support relationships with carers
and families

 No Interest Loan Scheme - No fees. No interest. No charges.3

There will be many other services available to carers throughout Australia and your
organisation should have information on each one in your area so that you can provide
carers with the correct and most up-to-date information so they can be supported to
stay in their role as carer to a family member or friend in need.

3 https://www.carersvictoria.org.au/how-we-help
Learner Resource CHCCCS025 Page 38/40
Version: 2.0 Last Updated: 30 June 2017
Responsibility: Director of Studies Developed by Enhance Your Future Pty Ltd
Melbourne City College Australia RTO No: 45140 CRICOS: 03592B ABN: 77 602 164 625
CHCCCS025 Support relationships with carers
and families

SUMMARY
Now that you have completed this unit, you should have the skills and knowledge
required to work positively with the carers and families of people using the service
based on an understanding of their support needs.

If you have any questions about this resource, please ask your trainer. They will be only
too happy to assist you when required.

Learner Resource CHCCCS025 Page 39/40


Version: 2.0 Last Updated: 30 June 2017
Responsibility: Director of Studies Developed by Enhance Your Future Pty Ltd
Melbourne City College Australia RTO No: 45140 CRICOS: 03592B ABN: 77 602 164 625
CHCCCS025 Support relationships with carers
and families

REFERENCES
Carers in Australia, assisting frail older people and people with a disability. Australian
Institute of Health and Welfare, Department of Health and Ageing, Canberra.

The Australian Carer. Helen Croft, Pearson Australia.

Caring for an elderly relative. Dr Keith Thompson, OTIMA, Great Britain.

www.comlaw.gov.au for more information on legislation relevant to your work role

australia.gov.au/carers for comprehensive information on all aspects of carer


entitlements and support

Impact of Caring. https://www.carersvictoria.org.au/facts/impact-of-caring

Learner Resource CHCCCS025 Page 40/40


Version: 2.0 Last Updated: 30 June 2017
Responsibility: Director of Studies Developed by Enhance Your Future Pty Ltd
Melbourne City College Australia RTO No: 45140 CRICOS: 03592B ABN: 77 602 164 625

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