Outcome 5.5.1

Identifying, monitoring and managing clinical risks should be carried out in line with the principles of care planning, clinical governance* and comprehensive care* (Outcomes 3.1, 5.1 and 5.4). This is so older people can access health professionals* who have the appropriate skills with a scope of practice* to manage and treat their clinical care needs.

• Meeting clinical care needs includes providing older people with the information they need to make decisions about their care and making sure the person’s goals and preferences guide decisions. This includes supporting dignity of risk* (Outcome 1.3).
• Health professionals* referenced in these key tasks may include:
  • GPs and other primary health care professionals
  • geriatricians and other specialist doctors
  • nurse practitioners and specialist nurses
  • registered nurses
  • enrolled nurses
  • pharmacists
  • allied health* professionals
  • oral health* practitioners
  • multidisciplinary specialist teams, such as palliative care teams.
• Providers should partner with older people and make sure they have access to, and understand, the information they need to make decisions about their care so they can give informed consent*.
• Consider how you can support older people to maintain function through understanding what skills and supports allied health* professionals can offer to the older person.

Put in place systems* to promote clinical safety, particularly for identified high impact and high prevalence areas of risk.

• Using contemporary evidence and input from qualified health professionals*, have robust systems* that include processes* to:
  • identify, monitor and respond to clinical risks
  • escalate care
  • support older people to take part in activities that reduce clinical risk, optimise reablement and maintenance of function.
• Define workers’ roles and responsibilities* for clinical care*. Document outcomes* of assessment and clinical care needs.

Put in place processes* for clinical safety

Have robust processes* to support appropriately skilled and qualified workers to:

• identify clinical care needs:
  • at the start of care
  • regularly* during scheduled clinical reviews
  • when there is a change or deterioration* in an older person’s health.
• use validated assessments* and refer to a qualified health professional* as agreed with the older person.
• document outcomes* of assessment and the treatment options as agreed with the older person in the clinical information system*
• monitor outcomes* of assessment and care, working with appropriate health professionals*, to prevent and identify deterioration*
• respond to changes in an older person’s health using evidence-based* approaches
• manage high impact and high prevalence risks using multidisciplinary team approaches for holistic* clinical care*
• make sure health professionals* have the skills and competencies to manage and respond to the clinical care* needs of older people. This includes identified areas of risk outlined in Actions 5.5.2 to 5.5.10 and other high prevalence areas of risk such as diabetes, enteral feeding, catheters and management of other invasive devices*.
• consider how to transition older people appropriately and safely from your service to a health service. This includes sharing the necessary clinical information to care for the older person in a timely* way.

Monitor and review the effect of clinical safety risks and improve the safety of clinical care*.

• If you identify inappropriate clinical actions, review the effectiveness of clinical decision making, processes* for escalation and treatments. Use this information to improve care.
• Providers should use clinical data to monitor clinical safety in their service.

Outcome 5.5.2

Follow the principles of care planning and comprehensive care* as described in Outcomes 3.1 and 5.4. It’s important that an older person’s eating, drinking or swallowing difficulties are identified, assessed and safely managed by an appropriate health professional* in a timely* way. This needs to be in line the person’s needs and preferences. This may mitigate the risk of choking* and other adverse outcomes*.

Put in place processes* to support safe eating, drinking and swallowing.

• Make sure the processes* you develop to support safe eating, drinking and swallowing:
  • are evidence-based*
  • have input from, and regular review by, qualified health professionals* such as speech pathologists and dietitians.
• Support and train workers to understand their roles and responsibilities* for eating, drinking and swallowing difficulties. This includes:
  • identifying risks to older people when providing food, fluids, oral care and medicines*
  • responding to choking* incidents* in an emergency
  • making sure food and fluids are provided safely, and that supervision and assistance is provided when needed. Also, making sure workers understand best practice for preparing and providing texture modified food and thickened fluids in line with frameworks used.
  • accessing and using documented information about the older person’s safe eating, drinking and swallowing strategies, needs and preferences
  • using the incident* management system* to record, investigate, manage, and respond to choking* and swallowing incidents*
  • escalating care to supervisors and qualified health professionals* when needed.
• Put in place processes* so you can partner with the older person and their representative to make informed decisions and to agree on strategies for managing risks around eating, drinking and swallowing. This must include getting the older person’s consent and making sure they have enough information to make decisions and give informed consent* on the planned approaches for eating and drinking.
• Healthcare professionals such as trained registered nurses or GPs can screen at the start of care and on a regular basis for eating, drinking or swallowing difficulties using a validated assessment tool*. This may include recommending a simpler textured food, however should not include modifying or thickening fluids. They can manage risks in line with the service’s policy* and as supported by a speech pathologist until a full speech pathologist assessment is completed in a timely* way.
• Make sure eating, drinking and swallowing assessments are completed by a speech pathologist when risks are identified.
• Make sure the outcomes* of the speech pathology assessment are documented in a report, with recommended management strategies, to reduce risks during:
  • eating
  • drinking
  • swallowing. For oral medicines, speech pathologists should refer to the prescriber and pharmacist for appropriate substitutions or alternative routes of medication provision. This should be documented in the older person’s care plan and medication plan.
  • oral care.
• Make sure relevant health professionals* know about the outcomes* of assessments, such as the need for a nutrition and hydration review due to changes in clinical care needs.
• If the older person makes an informed decision to eat and drink food and fluids that they choose rather than what has been recommended by health professionals*, make sure appropriate guidance is in place such as an eating and drinking with acknowledged risk (EDAR)* management plan.
• Document the individualised risk mitigation strategies agreed on with the older person in all documentation where information relating to eating and drinking is recorded.
• Make sure necessary care changes are put in place when recommended by a qualified health professional*, including texture-modified foods and thickened fluids. These must be agreed on with the older person.

Monitor, review and improve processes* to support safe eating, drinking and swallowing.

• Regularly* review formal policies* for safe eating, drinking and swallowing.
• Regularly* review feedback to make sure you understand if the older person is satisfied with the level of input they have had into strategies to manage risk, including making decisions about their food, drink and dining experiences*.
• Make sure documented incidents* and outcomes* of care are used to inform processes* that support safe eating, drinking and swallowing and contribute to continuous improvement* plans.

Outcome 5.5.3

Good continence* care is very important to the health, quality of life* and wellbeing* of older people. Bladder and bowel problems are common in older people, particularly those with complex clinical needs. Providers need to make sure continence* care meets older people’s needs and preferences, protects their dignity, and optimises their functional capability.

Put in place processes* for continence care.

• Put in place processes* to make sure continence* care is person-centred*, evidence-based* and clinically informed, through assessment.
• Provide person-centred care* by partnering with the older person to find out their choice, values, goals and preferences for continence* care (Outcomes 1.1 and 5.4). Providers also need to document this information. Involve carers* as partners in care planning, in line with the older person’s preferences.
• Support the older person to maintain and improve their mobility and function. This includes improving the physical environment to help maintain continence* and independence.
• Identify if the older person needs a comprehensive, evidence-based* continence* assessment. This is to identify risks and treat issues that can cause or contribute to incontinence and bladder or bowel dysfunction.
• Providers need to support the use of tools for assessment and monitoring of bowel and bladder symptoms. Use the assessment to inform continence* planning, care and evaluation.
• Assessment includes review of current medicines* by a qualified health professional* when bowel or bladder symptoms are identified, such as urinary incontinence*, nocturia, constipation and overactive bladder.
• Consider different approaches when incontinence or other bladder or bowel problems are identified. Lifestyle interventions may be considered as a first line therapy.
• Facilitate access* to relevant health professionals* to support continence* care when needed (Outcome 5.4). This may include assessment by a continence* nurse.
• Make sure a suitably qualified health professional* assesses the need for dietary changes to manage incontinence or other bladder or bowel symptoms such as constipation. Health professionals* can include a continence* nurse, GP or dietician.
• Make sure strategies are in place to support both older people and workers to prevent, identify and manage urinary tract infections*.
• Identify, assess, monitor and evaluate decline in skin integrity and IAD. This includes putting in place a skincare program for preventing and managing IAD when needed.
• Prevent, identify and manage constipation with regular assessment and evidence-based* tools. This may include assessment by a continence* nurse, GP or dietitian.
• Make sure the use of continence* aids and products meet the older person’s clinical needs and preferences.
• Make sure workers and health professionals* have the required knowledge and skills to meet continence* care needs. Make sure workers understand and communicate changes in an older person’s continence* needs, or signs of IAD, and put in place strategies to reduce risk.

Monitor, review and improve processes* for continence* care.

• Review incidents* and feedback* from the older person, family, carers and workers about continence* care and if toileting assistance is:
  • timely*
  • meets the older person’s needs
  • in line with their preferences.
• Consider how workers deliver continence* care to support the older person’s dignity, comfort, functional capacities and mobility.
• Regularly* monitor the older person to make sure that adequate continence* products are available and provided.

Output 5.5.4

Falls* are a major cause of harm to older people. Many falls* can be prevented by a combination of interventions tailored to the risks and needs of each older person. Falls* prevention interventions:

• are planned and delivered in line with the older person’s goals and preferences
• respect an older person’s dignity of risk*.

Working with multidisciplinary teams, older people, family and carers* is important for falls* prevention.

Put in place processes* to minimise falls* and fall*-related harm.

• Put in place person-centred*, evidence-based* and best practice guidelines for falls* prevention in residential services, community and home settings. These need to be in line with the type of services provided and the context where care is delivered.
• After an older person falls*, undertake a post fall* assessment, monitor and escalate for review by an appropriate health professional*. This can include medication reviews*. Update the care and services plan* with assessment outcomes* (Outcome 3.1).
• Facilitate access* to health professionals* when needed, after talking with the older person. This can include GPs, nurse practitioners, registered nurses, pharmacists and allied health* professionals such as:
  • physiotherapists
  • occupational therapists
  • exercise physiologists
  • dietitians
  • podiatrists.

They can carry out assessments, treatment, ongoing evaluation and monitoring of falls* prevention approaches.

• Make sure workers and health professionals* are given training in falls* prevention and decline in an older person’s mobility or function (Outcomes 3.1 and 3.2).

Monitor, review and improve processes* to reduce falls* and harm from falls*

• Use the incident* management system* to analyse data on falls* and harm from falls* to review processes* and outcomes* of care.
• Monitor the timeliness of access to health professionals*, equipment and devices. Also, address access barriers.
• Consider feedback* from older people, workers and others about falls* prevention strategies, including any dignity of risk* considerations.

Outcome 5.5.5

Preventing and responding to malnutrition and dehydration in a timely* way is important as these conditions carry high risk of rapid clinical deterioration*.

Put in place processes* for maintaining nutrition and hydration.

• Make sure policies* , procedures* and processes* are in line with contemporary, evidence-based practice* guidelines and are developed in consultation with a dietitian. This is to identify, prevent and manage malnutrition and dehydration.
• Make sure workers and health professionals* talk with the older person about their needs and preferences for preventing and managing malnutrition and dehydration. This includes cultural safety* considerations, especially for older people who come from diverse backgrounds and have lived experience of trauma (Outcome 1.1). Document these in their care and services plan*.
• Include prevention of malnutrition and dehydration in the delivery of care and services, including (as relevant to the service):
  • making sure appropriate and varied foods and fluids with adequate nutrients are available that provide the opportunity to meet nutrition and hydration needs
  • considering the impact of chronic conditions
  • considering and minimising the impact of medicines* on risk for malnutrition or dehydration, including unplanned weight loss or gain, changes to appetite and bowel changes
  • facilitating access* to dietitians, speech pathologists, pharmacists, GPs, psychologists and other specialists and allied health* when clinically indicated.
• Define workers’ roles and responsibilities* to prevent malnutrition and dehydration and escalate concerns early. Identify tools and document processes* for workers to monitor nutrition and hydration. These workers must be qualified and working within their scope of practice* or role description.
• Put in place processes* to identify dehydration and malnutrition early. Then, assess and manage these conditions. This includes:
  • screening, using a tool validated* in aged care, to regularly* assess nutrition and hydration and document findings. This includes rescreening in line with contemporary, evidence-based practice*.
  • clinically assessing, reviewing and managing concerns regularly* and as clinically indicated in line with contemporary, evidenced based practice*. This needs to be done by a multidisciplinary team of qualified health professionals*, including a dietitian.
  • referring for specialist clinical assessment and advice where needed
  • involving health professionals* to decide if a nutrition or hydration intervention is effective
  • put in place recommended management strategies from health professionals’* assessments, and documenting these in the care and services plan*. Strategies may include therapeutic diets (such as high energy, high protein diet), texture-modified foods and thickened fluids. These must be in line with the older person’s preferences.
  • Consider how the care, mealtime environment and access to assistive devices (as recommended by a qualified health professional*) can optimise the older person’s independence, function and quality of life*.

Monitor, review and improve processes* for nutrition and hydration.

• Make sure the older person is satisfied with the strategies to manage risk. You can find this out by involving the older person in decision making and incorporating feedback*.
• Have a dietitian review the documented outcomes* of care (including weight and malnutrition screening) and reported incidents*. Use these to support continuous improvement* plans, including ongoing staff education.
• Monitor older people with chronic conditions or recent changes to medicines* that may increase the risk of malnutrition or dehydration.
• Consider referral or access to health professionals*, in line with the older person’s preferences, when chronic health conditions or lifestyle choices affect or are affected by nutrition and hydration.
• Analyse data collected and use these findings to improve care. This can include data on:
  • incidents*
  • unplanned changes in weight
  • use of relevant health professionals* 
  • hospital transfers.

Mental health* is a state of overall wellbeing* that can be supported or improved for all older people. Changes to mental health* and wellbeing* is not an inevitable part of ageing.

When there are changes in the mental health* of an older person, it’s important that you recognise these early and respond quickly.

Put in place processes* to optimise mental health* and respond to mental illness*.

Put in place processes* to make sure each older person is supported to maintain or improve their sense of mental health* and wellbeing*. This means processes* which:

• encourage positive mental health* for all older people in working practices
• use evidence-based* strategies to promote mental wellbeing*, such as:
  • serving and encouraging the eating and drinking of nutritious* foods and drinks
  • encouraging and organising physical activity and sleep hygiene. Sleep hygiene is the healthy habits, behaviours and environment older people can use to help them get a good night's sleep.
  • creating settings and supports that allow social connection and reduce loneliness and social isolation
  • encouraging activities that are meaningful for people like hobbies or community groups
  • encouraging sense of coping with stress.
• define workers’ roles and responsibilities* for older people’s mental health* and wellbeing*
• create a psychologically*, physically and sexually safe setting for older people in supportive and non-restrictive ways.

Put in place processes* to support recognising and responding to deterioration* in mental health*, to:

• prioritise working with each older person, their family and carers, to the extent the older person wants, to learn from their experience and knowledge about their own mental health*. This can include knowledge about what change, or deterioration* looks like for them, and strategies that have helped them maintain their mental health* or cope with stress in the past.
• make sure this knowledge and experience is included in both assessing mental health* needs at the start of care and planning a response to any deterioration*
• identify signs of deteriorating mental health* in a timely* way
• escalate worker observations and concerns to qualified health professionals*
• make sure workers are supportive and give person-centred* responses to older people who are distressed or who have symptoms of mental illness* (including thoughts of harm or suicide)
• make sure referral pathways are available to workers to escalate care
• make sure workers refer the person quickly if they identify deteriorating mental health*. Consider locally available options, which may include referral to:
  • allied health* professionals specialising in mental health*
  • assessment by a GP or nurse practitioner for access to an older person’s mental health team, a psychogeriatrician, psychologist or psychiatrist.
• monitor and document:
  • changes in mental health*
  • interventions and strategies used to respond to changes
  • observations of how effective interventions and strategies are.
• record in the care and services plan*:
  • the outcomes* of any assessments
  • recommended interventions and support strategies
  • responsibilities for implementing the recommended interventions and support strategies and reviewing progress.

Monitor, review and improve processes* to optimise mental health* and respond to mental illness*.

• Consider how to monitor the safety and quality of the organisation’s processes* to optimise mental health* and respond to mental illness*. Monitoring methods could include:
  • themes from incident* reports related to mental health* and trends in incident* numbers and types
  • feedback* from workers about their knowledge of and confidence in promoting mental health* and responding supportively to mental illness*
  • feedback* from older people, their families and other supporters.
• Consider how to use the information you collect during monitoring to identify areas for quality improvement*.
• Report the results of quality improvement* efforts to the governing body*, older people and workers.

Oral health* is important for overall health, wellbeing* and quality of life*. In older people, poor oral health* is related to:

• malnutrition
• swallowing difficulties
• pneumonia
• frailty*
• systemic inflammation
• diabetes
• cardiovascular disease
• bone and joint health
• depression
• delirium*
• dementia*, including Alzheimer’s disease
• cancer.

Oral pain* may affect an older person’s ability to eat, drink, swallow, speak and sleep. It may also affect their mood and behaviour. Older people living with cognitive impairment* may find it difficult to report their own pain* and discomfort. Oral health* interventions:

• are person-centred*
• are planned and delivered in line with the older person’s goals and preferences
• respect the older person’s dignity of risk*.

Put in place processes* to support the older person to maintain their oral health*.

• Put in place person-centred* processes* (Outcome 1.1) that support the older person’s independence and functional capabilities with oral health* care.
• In line with individually assessed care requirements, encourage and assist older people with:
  • natural teeth, to brush their teeth, gums and tongue
  • dentures, to brush and clean dentures.

The frequency of assistance, cleaning method and products used will vary based on individual needs and preferences, as well as recommendations by a dentist or oral health* practitioner.

• Facilitate access* to and use oral health* products, aids and equipment.

Put in place processes* to support oral health assessment and management.

• Facilitate access* to oral health assessment by a dentist or oral health* practitioner regularly*, including on commencement of care, to identify pre-existing oral health* concerns and strategies to prevent and manage issues.
• Complete an assessment of the older person’s mouth and oral cavity using a validated oral health assessment tool. This is done by a trained health professional*, such as a registered nurse, on commencement of care, regularly* and when changes or deterioration* are identified.
• Dentists or oral health* practitioners provide regular review and reassessment when you identify change or deterioration* (Outcome 5.4). Providers should refer older people to dentists or oral health* practitioners, including public dental services, in a timely* way. Recognise and respond to changes in an older person’s oral health* or ability to manage it themselves due to physical frailty* or cognitive impairment*. Escalate oral health* concerns to oral and dental health practitioners.
• Facilitate access* for review to other health professionals* such as doctors, pharmacists and speech pathologists as needed, such as when dry mouth is identified or when there is polypharmacy*.
• Make sure workers are trained to:
  • deliver oral hygiene* (including assisted brushing). This can include supporting older people with complex needs or changed behaviours* to maintain their oral health*.
  • identify poor oral health* and its impacts on the older person
  • refer older people to a dentist or oral health* practitioner for further intervention and follow-up in a timely* way.
• Identify, prioritise and deliver regular and appropriate oral care to older people with higher oral health* care needs. This may include older people:
  • living with cognitive impairment*
  • who are at the end of their life*
  • with eating, drinking and swallowing issues
  • with dry mouth (xerostomia)
  • with altered salivation (reduced or excessive)
  • who are nil by mouth (Outcomes 5.6 and 5.7).
• Consider the link between oral health* and diet and encourage nutritious* food and non-sugary foods and drinks, while supporting the older person’s choice (Outcome 1.3).
• Consider the impact medicines* changes have on oral health*.

Monitor, review and improve processes* to maintain oral health* and prevent decline.

• Analyse clinical records to identify where poor oral health* may be affecting the overall health of the older person. Do this in collaboration with health professionals* or oral health* practitioners and use this to improve care.
• Review clinical records on the frequency of oral health* assessments. Make sure that care and services plans include oral health* and the outcomes* of regular oral health* assessments. Include the older person’s ability to manage their own oral health* and required products, aids and equipment.
• Consider how to monitor oral health*, hygiene and access to oral health* products to make sure older people’s needs are met.
• Use feedback* from older people and workers on oral health processes* to improve the quality of oral health* care.
• Review and improve processes* for using validated oral health assessment tools.

Outcome 5.5.8

Effective pain management* is a key contributor to quality of life* for older people. However, pain* is sometimes difficult to identify and can be missed, especially if an older person can’t communicate their pain* verbally. This means that evidence-based* assessments are important in safe and quality care* for pain*.

Contemporary, evidence-based practice* to address pain* includes both nonpharmacological and pharmacological approaches. In many cases, nonpharmacological strategies can be highly effective. Strategies can include:

• psychological
• educational
• physical activity and movement
• nutritional
• complementary approaches (see Pain Management Guide Toolkit for Aged Care).

Have processes* to optimise pain management*.

• Put in place processes* that support identifying and managing pain* in a timely* way. These include:
  • regular assessment by a suitably qualified health professional* using validated assessment tools* . These include tools to assess older people:
    • who cannot verbally report pain*
    • experiencing delirium*, dementia*, cognitive impairment* or sensory impairment* from health conditions such as diabetes and peripheral vascular disease.
  • evidence-based* strategies for pain management*, including non-pharmacological options, tailored to the needs and preferences of the older person
  • monitoring and review by a qualified health professional* such as a GP, pain specialist or pain clinic for persistent uncontrolled pain*.
• Put in place processes* to support health professionals* and workers to know their roles and responsibilities* to identify, assess, manage and monitor pain*. These include:
  • for workers, identifying possible pain* (including where the older person can’t express the severity of pain*, its location or where their behaviour has changed) and escalating observations and concerns
  • for health professionals*, assessing, planning and providing pain* relief (both non-pharmacological and pharmacological) in line with the type of pain* experienced and the preferences of the older person. This includes the need to monitor and evaluate the benefit of interventions.
  • updating the care and services plan*, putting in place any care changes needed and informing family and others as appropriate.

Monitor, review and improve processes* to manage pain*.

• Consider how to monitor the safety and quality of the organisation’s processes* to improve pain management*. Monitoring could include:
  • for residential services, analysis of trends in older people’s responses to Question 2 of the QOL-ACC quality of life* tool (this is used for the Quality of Life indicator under the National Mandatory Quality Indicator Program). The question relates to the resident’s opinion on how often their pain* is managed well.
  • themes from complaints* reports and other feedback* from older people, their families and carers
  • feedback* from workers about their knowledge of and confidence in recognising pain*, including people who have challenges communicating their pain*.
• Consider how to use the information collected during monitoring to identify areas for quality improvement*. Tools from the Pain Management Guide Toolkit for Aged Care such as the Pain Management Audit Checklist and the Pain Action Plan can be helpful for residential services.
• Report the results of efforts to improve quality to the governing body*, older people and workers.
• Monitor benefits and safety of pain management* processes*, including escalating care of pain* to qualified health professionals*.

Outcome 5.5.9

Older people’s skin is vulnerable to deterioration* and breaks from pressure or other injury*. Strategies to prevent wounds include regularly* inspecting skin and managing other related clinical risks such as those described in Actions 5.1.3 to 5.1.10.

Using processes* as outlined in Outcome 1.3 and 2.1, put in place and plan processes* to prevent and manage pressure injuries* and wounds in older people.

Put in place processes* for preventing and managing pressure injuries* and wounds. These include:

• using validated assessment tools* to identify and assess wounds and monitor healing
• having a registered nurse or other qualified health professional* assess the risk of pressure injuries*, including but not limited to assessing:
  • the older person’s skin
  • mobility
  • existing pressure injuries* or breaks in skin
  • the effect of conditions such as diabetes, incontinence and malnutrition
• personalised, evidence-based* and risk-based pressure injury* prevention plans.

Processes* for delivery of care include:

• defining workers’ roles and responsibilities* to manage skin integrity and breaks in skin integrity. Workers also need to document wound management plans to manage acute and chronic wounds, and regularly* monitor wounds.
• referral pathways for escalating pressure injuries* and wounds when needed
• maintaining the dignity and cultural safety* of the older person when performing regular skin inspections
• referring the older person to qualified health professionals*, including allied health* professionals, to prevent wounds happening and to support wound healing
• considering nutrition assessment by a dietitian to support wound healing
• considering the benefits of maintaining or improving mobility and balance in reducing harm from pressure injuries* and wounds.

Monitor, review and improve processes* to prevent and manage pressure injuries* and wounds.

• Consider regular reviews of processes* used to monitor and respond to pressure injuries* and wounds.
• Consider what effective, holistic* and multidisciplinary pressure injury* and wound prevention looks like in your service.
• Consider how to make sure clinical interventions follow an evidence-based* pathway for wound care and that workers know what these are.
• Consider how aids and equipment, such as specialist mattresses may be accessed and used to reduce risk of pressure injuries*.
• Consider the use of data, on managing and preventing pressure injuries* and wounds, collected in the service, such as data on:
  • incidents*
  • quality indicator data
  • hospital admissions
  • trends in data related to pressure injuries* and wounds
  • feedback* from older people.
• Analyse data collected to inform and develop plans for continuous improvement* in relation to preventing and managing pressure injuries* and wounds.

Outcome 5.5.10

Put in place processes* to optimise support for people with sensory impairment*.

• When putting in place and reviewing the organisation’s policies*, protocols and procedures* for optimal care of people with sensory impairment*:
  • make sure they follow evidence-based* guidelines for supporting people with vision or hearing loss and for people with balance disorders
  • support timely* identification of sensory loss and development of personalised care strategies
  • define the roles and responsibilities* of workers and health professionals* in supporting an older person with sensory impairment*. This may include making sure supports, such as glasses and hearing aids, are clean and functioning.
  • consider how the care setting, meal presentation and dining experience*, and access to assistive devices can optimise the older person’s independence, function and quality of life*. Assistive devices and aids can include hearing aids, walking aids and glasses.
  • document requirements for assistive devices in the clinical information system*.
• Put in place processes* to:
  • identify changes and decline in sensory function in a timely* way
  • regularly* monitor the older person’s hearing, vision and balance to identify changes in sensory function and to make sure aids and devices are appropriate
  • refer to specialist health professionals* for management including diagnosis, treatment and management of devices and aids
  • access assistive devices and aids and regularly* monitor their use and how well they’re working
  • improve the care environment using strategies such as noise management, lighting, colour contrast, signage, textures and design.