Page Section: Centre Content Column
Education
The Code of Rights for the Chinese
community
Education for the Bhutanese
community
Learning from a
complaint
Education
session for people with hearing impairments
Visit to
retirement village
Educating rest home staff on
the Code
Educating
providers
Education session to women's refugee
group
An innovative educational
event
Medical Centre
session
Session for
nurses
The Code of Rights
for the Chinese community
An advocate was invited to speak to a Mainland Chinese Community
group on the Code of Rights, the Advocacy Service and the role of
the Health and Disability Commissioner. It was the first time this
particular group had heard about these topics, so they were keenly
focused on linking the Code of Rights to their own life
circumstances. There was great discussion with the group as they
identified a high need to be informed.
The advocate, speaking through a competent interpreter,
delivered key messages about the contents of the Code of Rights by
giving practical examples wherever appropriate, with a thorough
explanation of Right 5, effective communication, and interpreter's
indispensable role. This focused approach was very appropriate,
because communication is often a barrier for this group of
consumers who often have English as a second language, and who
often do not have the confidence to speak up. Two of the
participants, who had previously experienced difficulties with
their GPs, were keen to share their concerns.
The group felt the advocate's presentation was helpful to them
in terms of developing vital awareness among them about their
rights and protections when accessing Health and/or Disability
Services in NZ. The information which was new to them, and
made them feel empowered to speak up if necessary in the
future.
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Education for the Bhutanese
community
At the invitation of the Bhutanese Refugee Community the local
advocate presented an education session on the Code of Rights and
the Advocacy Service. This particular group of people had recently
arrived in the country after spending many years in refugee
camps.
Using a qualified interpreter, the advocate provided the
education session requested, paying particular attention to the
Consumer's right to effective communication, as this is an area
which can be a major barrier for this specific category of
vulnerable consumers who are new to the county, are not able to
speak English and have a low level of self-confidence. The audience
was interactive, engaging in discussions and reflections on the
various aspects of the Code and Right 5 in particular.
Four consumers, who had previously faced difficulties with their
primary healthcare providers, wished to share their experiences.
They said that interpreters were not provided in spite of their
explicit request when they booked their appointments. The lack of
interpreters meant there consultations did not go as well as they
could have.
The group was pleased with the information provided,
particularly when they were given handouts in their own language.
They were pleased to know there is a free independent organisation
to support them to have their Rights upheld.
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Learning from a
complaint
An elderly lady living in a retirement village, whose husband
had recently died, had concerns about his care in his final
days.
Following a request from Age Concern, an advocate contacted her,
and they discussed her concerns regarding dignity and independence.
The advocate arranged a meeting with the nurse manager and the
family which resulted in an open and frank discussion.
As a result of the meeting, the advocate was invited to the rest
home to give a presentation to the staff on the Code, with specific
reference to dignity and independence issues. The family was happy
with the outcome and pleased that further training was given to the
staff.
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Education session for people
with hearing impairments
An advocate received a request from a group from the Deaf
Association who wanted to hear about the rights conferred on them
by the Code. They had elected those who had partial hearing loss to
act as the spokespeople for the group and liaise with the
advocate.
It was decided the best way to communicate with the group was
for the advocate to utilise the skills of those with partial
hearing. The advocate showed a subtitled video. Attendees were
given the opportunity to discuss and question what they had seen,
with someone acting as sign language interpreter for the
advocate
Responses to questions were answered both in sign and by the
advocate writing answers on large pieces of paper for all the group
to see. Attendees were invited to role play the Code with
some aspects being conveyed through sign language.
The advocate reported that it was an interesting and sometimes
humorous process and the group reported it as being very
effective.
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Visit to retirement
village
An advocate went to a retirement village to speak to the
residents. She took along the 'Great Care Stories' booklet, a
Health Passport and guide to filling out a health passport,
information on advocacy and the Health and Disability Commissioner.
The residents were pleased that this material was free, and
that they could call the advocate if they had any questions.
The group asked good questions, and had no complaints. They were
very happy and couldn't speak highly enough of the staff,
activities and facilities.
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Educating Rest Home Staff on
the Code
An advocate used an exercise to demonstrate how staff
attitudes can impact on the rights of rest home residents. The
exercise used the words AGREE and DISAGREE which were placed at
opposite ends of the available space. Staff were then asked about
the issues, concerns or topics they wanted to discuss as part of
the education session. The following topics were agreed:
1) Residents should be allowed to eat their meals in their
rooms instead of the dining room.
2) Residents should be allowed to have sex.
3) Residents should be made to take their medication.
4) Residents should be allowed to wear the clothes they
choose.
As each of the four statements above was read out, staff were
asked to position themselves between the two words in a position
that best represented how they felt about each statement.
Participants were not challenged on the positioning they adopted,
but each statement created debate. Staff commented that they found
the session particularly useful as it challenged their own thinking
in relation to consumer rights.
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Educating providers
A recent audit of a day care facility identified that staff
required further training on the Health and Disability Consumers'
Code of Rights so they requested an advocate to do this.
A quick assessment at the beginning of the hour-long session
established that most of the staff were aware of the Code and that
they just needed to recognise how to link it to their work. The
goal for the education session was to 'unleash the potential' so
that the staff felt the presence of the Code when they were in
their work environment.
Resources:
The flipchart
Whiteboard/ pens
Brochures - Code of Rights, Learning from Complaints and
Advocacy
The Health and Disability Commissioner (HDC) Act provided the
starting point for the session. The two statements that are
enshrined in the Health and Disability Commissioner Act were also
included in the staff job descriptions and the overall business
objectives of the organisation.
- Promoting and protecting the consumers of health and
disability services by according them their rights under the Health
and Disability Consumer Code of Rights legislation.
- Facilitating the fair, simple, speedy and efficient
resolution of complaints
They discussed how their efforts to plan activities for the
consumers that would best meet their needs was consistent with the
Code. If all went to plan, the attitude and behaviour of staff
would be positive so that consumers would receive a quality
service. On the other hand, if planning was not carried out
appropriately, the opposite could occur, compromising the rights of
consumers as well as the service.
All present said they knew what to do if a consumer raised an
issue with them. If they could fix it straight away they would do
so, and if not they would refer the matter to the Manager. Usually
the issues were fixed immediately. Examples of what could happen
during a programme that might compromise a consumer's participation
were discussed using the empowerment model/ continuum. All agreed
it was best to resolve issues as soon as possible and that their
initial response could be the deciding factor for a consumer to
feel acknowledged and listened to.
The interaction with staff during this session was positive as
they were willing to share information about their roles and their
service. It was obvious they enjoyed their jobs and their
consumers.
The whiteboard was useful in providing a 'big picture' of where
the day centre fitted into the provider services of the MOH - DHB -
Private Provider Organisations as well as where the independent
health and disability advocacy service fits.
At the end of the session the advocate suggested a session
should be organised for the consumers. This was organised soon
afterwards.
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Education session to
women's refugee group
Education ~ Code of rights ~ Refugees
An advocate was invited to present an education session on the
Code of Rights and the advocacy service to a women's refugee group.
Within the group there were refugees who had been in NZ since 2000,
including people who had spent a number of years in various refugee
camps.
The advocate started with an overview of the Code, and then
provided a more in-depth focus on Right 5 as communication can be a
major barrier for refugees. The group became animated and expressed
a lot of interest in this right, as many had experienced
difficulties with health providers and wanted to share their
experiences. Many had not been offered the services of an
interpreter and felt that their experience would have been better
had this service been available. Some women felt disrespected and
uninformed because of the language barrier and lack of
interpreters.
The group felt that the advocate had empowered them with
information about their rights, encouraging them to speak up, and
providing them with contact details for the advocate if they want
support.
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An innovative
educational event
Respect ~ Independence ~ Dignity ~ Sexuality ~ Rest
Homes
A large rest home requested a presentation for their registered
nurses on the Code that incorporated the issues of Intimacy and
sexuality in residential homes. The advocate researched the topic
and found that a number of countries had adopted a protocol for
dealing sensitively with this issue. Some had worksheets that
staff, patients and families could use to develop practice
guidelines for their facility.
After some initial awkwardness about the topic they settled into
the session respectfully by answering the questions in a handout on
"Facts and Myths" . This set the scene for very open and honest
discussion about the rights of the residents particularly in the
context of the Code. It was an approach most of them hadn't given
any thought to before.
The changes in the maternity system were discussed as an example
of how a service had become consumer-centred. Only a few years ago,
childbearing women described "leaving their dignity at the hospital
entrance and picking it up on the way out". With the Code, women
now know they have rights and they are treated with respect and
retain their dignity throughout the pregnancy and birthing process.
By making the analogy of this change and looking at the residential
care facilities, it was acknowledged that they were well behind in
addressing issues such as sexuality and intimacy for the
residents.
The advocate encouraged them to continue the discussion with
management, other staff, families and the residents. She also left
them with resources to assist them in their efforts to work towards
introducing a protocol for their facility.
After this initial presentation, the advocate worked with
several other rest homes on the same topic. She has encouraged them
to organise a day seminar to allow time to draft a protocol that
reflects the Code of Rights and gives the residents living in these
facilities the freedom to express themselves intimately and
sexually, because the 'heart has no wrinkles'."
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Medical Centre
session
Doctors ~ Nurses ~ Support staff ~ Rights education ~
Limited understanding
The local advocate was invited to present at a medical centre
where doctors, nurses and support staff attended the education
session. The advocate presented information on the Code and
the role of advocacy. The session was very interactive with lots of
questions from those attending. Doctors sought answers about what
support and resources they should have when there are concerns the
consumer doesn't understand their explanations. One of the doctors
from overseas also commented that he thought having the free
advocacy service was great as there was nothing like that in his
country of origin.
As a result of the positive reception the advocate received, she
has been invited back to speak on other topics.
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Session for nurses
Nurses training ~ Rights education
The advocate was invited to present to a group of Pacific
Islands Nurses on the Code of Rights, HDC and the role of the
advocacy service. In addition to the nurses there were two auditors
attending the programme to ensure the training being received met
the required standard for the nurses to qualify for on-going
training recognition.
As a result of the session being well received, the programme
coordinator has given the advocate a regular slot in the nurses
training programme and also asked the advocate to speak on the
local PI radio.