1. Successful completion of this training meets one hour of the four hour annual training requirement
for Personal Attendant Services direct care staff as provided through the WV TBI Waiver Program

2. •
Information included in this presentation
was current at the time it was developed
•
Presentation materials are reviewed on an
annual basis
2013
West Virginia TBI Waiver Program direct care staff annual training
2

3. Melodee A Hursey, MSW, LSW, CBIST
APS Healthcare, Inc.
TBI Waiver Program Provider Educator
Ms Hursey is a Certified Brain Injury Specialist Trainer through the Academy of Certified Brain
Injury Specialists and a West Virginia Licensed Social Worker. She has more than 17 years of
brain injury experience in a variety of areas including rehabilitation, waiver, support group
facilitation, training, and program development.
Contact information:
mhursey@apshealthcare.com
304-964-9007
2013
West Virginia TBI Waiver Program direct care staff annual training
3

4. Upon completion of this training participant
will be able to:
• Identify three responsibilities of a direct
care staff
• Describe two principles of direct care
• Identify five rules for maintaining
boundaries with members
• List three tips direct care employees should
remember to stay safe
2013
West Virginia TBI Waiver Program direct care staff annual training
4

5. Traumatic Brain Injury (TBI) is
an insult to the brain not of a degenerative or
congenital nature caused by an external physical force,
that may produce a diminished or altered state of
consciousness resulting in an impairment of
cognitive abilities or physical functioning. It can
also result in the disturbance of behavioral or
emotional functioning, may be temporary or
permanent and cause partial or total functional
disability or psychosocial maladjustment.
National Head Injury Foundation
(now the Brain Injury Association of America)
2013
West Virginia TBI Waiver Program direct care staff annual training
5

6. •
2013
A non-degenerative, non-congenital
insult to the brain caused by an external
physical force resulting in total or partial
functional disability and/or psychosocial
impairment
West Virginia TBI Waiver Program direct care staff annual training
6

7. Every 23 seconds, one person in
the United States sustains a
traumatic brain injury
• Each year, an estimated 1.7
million people sustain a TBI
•
Centers for Disease Control and Prevention
2013
West Virginia TBI Waiver Program direct care staff annual training
7

8. Watch the short videos below before continuing.
(Right click on each link and chose open Hyperlink)
Traumatic Brain Injury – Jerry’s Story
Traumatic Brain Injury – Josh’s Story
2013
West Virginia TBI Waiver Program direct care staff annual training
8

9. •
Provide long-term direct care and support
services
◦ To enable a member to remain at home rather than enter a
nursing facility
•
Assist the member with ADLs (activities of
daily living) and IADLs (instrumental
activities of daily living)
◦ To help the member to remain in the home
2013
West Virginia TBI Waiver Program direct care staff annual training
9

10. •
Assist the member in community activities
o
•
To help them develop and maintain social relationships
Assist the member with environmental tasks
and errands
o
That are essential for the member to remain in the home
•
Be compassionate, patient, and tolerant
•
Report significant changes in member’s
condition, any incidents, or environmental
hazards
2013
West Virginia TBI Waiver Program direct care staff annual training
10

11. Personal Attendant Service
agency staff cannot perform
any service that is considered
to be a professional skilled
service or any service that is
not on the Member's Service
Plan or Spending Plan
2013
West Virginia TBI Waiver Program direct care staff annual training
11

12. •
•
•
•
•
•
•
•
•
•
•
•
Care or change of sterile dressings
Colostomy irrigation
Gastric lavage or gavage
Care of tracheostomy tube
Suctioning
Vaginal irrigation
Give injections, including insulin
Administer any medications, prescribed or over-the-counter
Perform catheterizations, apply external (condom type)
catheter
Tube feedings of any kind
Make judgments or give advice on medical or nursing
questions
Application of heat
From page 31 of the WV Traumatic Brain Injury Waiver Program Manual
2013
West Virginia TBI Waiver Program direct care staff annual training
12

13. •
Independence:
o
•
Choice:
o
•
Each person chooses what to do and when to do
it; caregivers don’t tell them what to do
Dignity and Respect:
o
o
2013
Freedom to direct one’s life, able to do things for
oneself when possible
Each individual is a person, each person needs
respect, privacy and treated the way he or she
wants to be treated
When a member needs assistance they still need
to feel they are valued and in control
West Virginia TBI Waiver Program direct care staff annual training
13

14. •
Person-centered approach:
o
•
Participant-direction:
o
2013
Assistance or support is given when and how the
member needs it
When possible, the member tells the caregiver
what to do, when to do it, and how to do it
West Virginia TBI Waiver Program direct care staff annual training
14

15. Before continuing to the next slides, please
click the link to read the article
“How to Build Good Boundaries in Support Work”
2013
West Virginia TBI Waiver Program direct care staff annual training
15

16. •
•
•
•
•
•
•
Able to listen and understand
Good communication skills
Interested in working within the disability
field
Accepting of people with disability
Willing to collaborate and consult with
others
Able to accept and respect the choices of
other people
Respectful of different needs, values,
beliefs, culture
The Arizona Direct Care Curriculum Project (2011).
2013
West Virginia TBI Waiver Program direct care staff annual training
16

17. •
•
•
•
•
•
2013
Committed to increasing independence
and capability in others
Able to share knowledge and skills but
not to take over
Maintains a positive attitude
Aware of realistic goals and limitations
Consistent and able to follow through
Professional – human, friendly, but not
needy or dependent
West Virginia TBI Waiver Program direct care staff annual training
17

18. •
•
•
•
•
•
2013
Carry out responsibilities of the job the
best way you can
Maintain certifications and trainings
Be dependable and reliable
Maintain a high standard of personal
hygiene, health, and appearance
Show respect for the member’s privacy
Do not use the member’s things
West Virginia TBI Waiver Program direct care staff annual training
18

19. •
•
•
•
•
2013
Recognize and respect the right of selfdetermination and lifestyle
Keep your professional life separate from
your personal life
Control negative reactions to chronic
disability or living conditions
Maintain safe conditions in your work
environment
Do not bring your family or friends to the
member’s home
West Virginia TBI Waiver Program direct care staff annual training
19

20. Limits that allow for safe connections
between people
• A sense of personal identity and self that
remains consistent over time
• The framework within which the workermember relationship occurs
• Appropriate boundaries reduce risk of
member exploitation or mistreatment
•
2013
West Virginia TBI Waiver Program direct care staff annual training
20

21. •
Be clear about your role right from the
beginning
o
You may be helping the member BUILD friendships
and relationships but you are not THE friendship
•
Do not discuss your personal life with the
member and/or family
•
Do not borrow or loan money or items
2013
West Virginia TBI Waiver Program direct care staff annual training
21

22. •
Working in a member’s home can be very
rewarding
•
Working in a member’s home can be very
lonely and scary too
•
It is important that you protect yourself
•
Know your resources and surroundings
2013
West Virginia TBI Waiver Program direct care staff annual training
22

23. •
•
•
•
•
2013
Be alert
Be observant
Trust your own instincts
Know how and when to call for help
Communicate with the member, family, and
team anything that you observe
West Virginia TBI Waiver Program direct care staff annual training
23

24. •
For more safety information click on this
link to
safety tips for the direct care worker
2013
West Virginia TBI Waiver Program direct care staff annual training
24

25. Many people come in and out of a
member’s life
• You may be one of those people who
decides to leave for any number of reasons
• Be open, honest, and upfront about this
decision
• Allow the member to talk about their
feelings
•
2013
West Virginia TBI Waiver Program direct care staff annual training
25

26. •
•
Help with the transition to a new worker by
providing good documentation and
information
•
2013
A person with TBI often has difficulty with
change so there may be some anger and
sadness ~ don’t take this personally
Be positive and upbeat
West Virginia TBI Waiver Program direct care staff annual training
26

27. •
Communicate
o
o
•
Don’t overshare
o
•
The member does not need to hear that you are
leaving because you don’t like your employer or
because you’re getting a divorce
Stay member focused
o
2013
With the member, his/her family, the team
Let the member know the plan. When are you
leaving? When will the new staff start?
The service plan still must be followed
West Virginia TBI Waiver Program direct care staff annual training
27

28. •
If you’re the new person –
o
o
o
Allow the member time to adjust
Share basic information about yourself
Ask the member to tell you what they need help
with - how they want you to be involved in their
care
 And listen to the answers
o
Read the member assessment and service plan
 Ask questions to get clarification
o
o
o
2013
Follow the service plan
Talk to the team and family
Be patient and nonjudgmental
West Virginia TBI Waiver Program direct care staff annual training
28

29. Academy of Certified Brain Injury Specialists (2007). The essential brain
injury guide. Edition 4.0
Acquired Brain Injury Outreach Service (2011). How to build good
boundaries in support work
The Arizona Direct Care Curriculum Project (2011). Principles of caregiving:
Caregiving fundamentals (http://azdirectcare.org/Training-DCW_Curriculum.html)
Vick, J, Vanderlick, JA, & Merricks, T. (2004). Professional ethics:
Boundaries in helping relationships
2013
West Virginia TBI Waiver Program direct care staff annual training
29

30. You may want to explore additional resources
to help you do your job better*
Here are just a few:
o
o
o
o
o
o
o
brainline.org
Brain Injury Association of America
Centers for Disease Control and Prevention: TBI
National Directory of Brain Injury Services
National Resource Center for Traumatic Brain Injury
TBI Services at Center for Excellence in Disabilities
1-877-724-8244
TBI@hsc.wvu.edu
Brain Injury Alliance of West Virginia
* If you are seeking formal training please check with your employer to make sure the internet training
provider has been approved by APS Healthcare before you take the training
2013
West Virginia TBI Waiver Program direct care staff annual training
30

31. •
•
A score of 80% or higher is required
•
2013
To receive your certificate of successful
completion you must first pass the test and
complete an online evaluation
Once you have successfully completed this
training module you will receive an email with
your certificate of completion
West Virginia TBI Waiver Program direct care staff annual training
31

32. •
Please scroll down and take the test below.
•
Your thoughts and comments are very
important to us. You may submit your
comments here: TBI Training Survey
Thank You!
2013
West Virginia TBI Waiver Program direct care staff annual training
32