Handwashing is one of the most important ways to prevent the spread of disease. It is important to use soap and water and wash your hands for at least 30 seconds or the time it takes to sing the ABC’s.
Hands should be washed:
Before, during, and after preparing food
Before eating food
Before and after caring for someone who is sick
Before and after treating a cut or wound
After using the bathroom, changing diapers, or helping someone in the restroom
After blowing your nose, coughing, or sneezing
After touching an animal, animal food or treats, animal cages, or animal waste
After touching garbage
If your hands are visibly dirty or greasy
What You Need To Know About Handwashing
Simon tells you, “I never knew how important handwashing was until I watched this video. It’s eye-opening to see how many germs stay on our skin.”
Watch this video for more information about how and why hands should be washed. The entire video must be watched before being able to move on.
A precaution is a plan beforehand to prevent something harmful, dangerous, unpleasant, or inconvenient from occurring.
Simon tells you, “We have all kinds of precautions around us. We wear a seatbelt to avoid serious injury in case of an accident, we wear gloves in the winter to keep our hands from getting cold, and crosswalks help pedestrians and motorists avoid collision.”
In this course, precaution is the plan to prevent the spread of infectious diseases.
Blood and Body Fluid Precautions
Before 1980, there was little understanding of how infectious diseases were transmitted from one person to another. As scientists began to understand blood-borne pathogens, measures were put into place to prevent the spread of disease from an infected individual. The initial measures, established in 1983, were referred to as the Blood and Body Fluid Precautions.
These precautions advised wearing gloves and a protective face shield when providing care to someone who has been diagnosed with a blood-borne transmissible disease.
A blood-borne disease is a disease that can be spread by blood and other bodily fluids containing blood. Blood and other bodily fluids may contain pathogens such as bacteria, parasites, or viruses.
Universal Precautions
Following the outbreak of AIDS around 1985, the CDC introduced Universal Precautions to treat every patient as if they were infected to minimize the risk and slow the spread of blood-borne pathogens from patients who had not yet been diagnosed with a transmissible disease.
Simon says, “Universal precautions must be utilized to prevent the spread of disease. You will not always know if a person has a disease or not. They may not have been diagnosed yet. We do what we can now to prevent the spread of disease later.”
Universal precautions did not apply to certain bodily fluids (feces, urine, sweat, vomit, tears) unless they were visibly contaminated with blood.
Body Substance Isolation
Body Substance Isolation Guidelines were introduced in 1987 instructing healthcare providers to avoid direct contact with all moist and potentially infectious body substances whether blood was visible or not.
Guidelines for Isolation Precautions (Standard Precautions)
In 1996, the CDC issued a Guideline for Isolation Precautions in hospitals; a combination of universal precautions and body substance isolation. The result was Standard Precautions.
Standard Precautions apply to everyone – regardless of their disease state, when there is a potential of exposure to blood, bodily fluids (not including sweat), non-intact skin, or mucous membranes.
Rosella is a 42-year-old woman living in a Personal Care Home. She is diagnosed with Bipolar Disorder, non-insulin-dependent diabetes, hypertension, and has a history of seizures. She also has a history of being exploited by others. Rosella is friendly, determined, and always willing to ask for help.
Several years ago Rosella completed her GED. She is able to cook with a microwave and is wanting to manage her diabetes better. She is not as skilled in meal planning, budgeting, and remembering to administer her medication. She already had basic skills in technology and is able to use the internet and has basic computer skills.
Rosella is involved in the community and loves to visit a local pet store where the staff let her play with the animals and help out, when possible. The staff enjoys her coming to the store and the animals always get excited when she comes by. Rosella really loves playing and working with animals. Regular customers know Rosella.
Team Member Roles
Using a person-centered approach to support Rosella’s goals, decisions, and desires ensures that she is supported to live in the community as a valued friend and contributing citizen. The more you know about a person, the better you are able to understand the person.
Rosella has set a goal to move into her own apartment and gain employment at a pet store. Now that we know Rosella a little better, let’s think about how we can use person-centered planning to help her achieve this goal.
Rosella’s Role:
To communicate with the team and work cooperatively towards this goal.
To work with her team on goal setting and eventual move.
To work on steps identified as part of a move-out plan.
To contact the Office of Vocational Rehabilitation and ask for an intake appointment
Guardianship State Service Worker (GSSW) Role:
To review the case history and determine any risk factors or barriers.
To communicate with Rosella and the team about any identified issues.
To support the planning process within the bounds of the guardianship court orders.
To set up the flow of funds to pay for things like classes, a bus pass, etc.
To sign needed consent documents/consent forms.
In-Reach Team Role*:
To assist with case history review and determine any risk factors or barriers
To assist with necessary evaluations and appointments for medical and psych services, if needed.
To facilitate the development of a detailed move-out plan, that includes the when, where, how & who is responsible for the tasks
To train Rosella and her staff on the final plan & assist her with the move out plan
To coordinate/facilitate ongoing meetings about the goal and how best to meet this desire
*In-Reach is through the Community Mental Health Centers to help individuals who are moving into independent living in the community.
Personal Care Home Staff Role:
To support Rosella and her desire to move out.
To assist in her education about medications.
To assist with her desire to be out in the community.
To communicate with the team her progress and any issues that arise.
This is Micah. Micah is a 33-year-old man who lives in a Supports for Community Living (SCL) Family Home Provider setting. He has an IQ of 59 and is diagnosed with a developmental disability from fetal alcohol syndrome. He requires assistance from a walker with ambulation or a wheelchair for longer distances. He is working on building his strength and stamina, as he has long wanted to travel. During his annual plan of care meeting, he verbalizes a goal to travel to Disneyworld for his 35th birthday (18 months away).
Team Member Roles
Using a person-centered approach to support Micah’s goals, decisions, and desires, ensures that Micah is supported to live in the community as a valued friend and contributing citizen. The more you know about a person, the better you are able to understand, that person. Micah has verbalized that he wants to travel to Disney World before his 35th birthday. Now that we know Micah a little better, let’s think about how we can use person-centered planning to help him achieve this goal.
Micah’s Role:
To communicate his desires for the trip & assist with an itinerary (where to stay, what to do, sites to see, etc.).
To work with his team on saving money for the trip, as it will be expensive.
To work on physical stamina and strengthening for the travel and park days.
Guardianship Social Service Worker (GSSW) Role:
To review the trip budget and assist with a savings plan.
To assist with obtaining the necessary travel ID.
To obtain needed out-of-state travel authorization.
To arrange the payment of the trip with his saved funds in the Kentucky Guardianship Association’s (KGA) Pooled Trust.
To consent to any pre-trip appointments, therapies, and possibly sign documents.
To communicate with the provider, and team, as needed.
To support the planning process within the bounds of the guardianship court orders.
Case Management Role:
To assist with trip details, itinerary and cost planning.
To arrange any therapy or physical fitness access so he can work towards improved stamina.
To coordinate/facilitate ongoing meetings about the goal and how best to meet this desire.
Provider Agency/Personal Assistance Direct Support Professional Role:
To assist and accompany on appointments
To support Micah’s desire to improve his physical stamina/strengthening.
To assess and arrange the staffing needed to support him while on the trip.
To provide any training to those accompanying him on his needs, plans, and safety provisions.
To maintain spending logs and receipts, and return them to the GSSW within 30 days of the trip.
Dr. Sheppard-Jones (she/her) is the Executive Director of the Human Development Institute at the University of Kentucky, which is Kentucky’s University Center on Disability. She holds a doctorate in Educational Psychology from the University of Kentucky, where she also serves as faculty in the Counselor Education program in the College of Education. She leads 275 interdisciplinary staff in promoting the inclusion, independence and contributions of people with disabilities and their families throughout the lifespan. An active researcher with nearly $40 million in lifetime externally funded grants and contracts, she oversees projects around employment, higher education, quality assurance, leadership and universal design.
Dr. Sheppard-Jones is lead administrator for the state’s Employment First Council, and sits on the state’s KentuckyWorks Collaborative along with state Cabinets’ secretaries and leaders from business, industry and education, charged with operationalizing the state strategic plan for education and workforce development. She leads multiple statewide initiatives and develops resources that can lead to innovations benefitting all workers, and that will help grow and retain a workforce that is inclusive of all people. She is also a certified rehabilitation counselor.
To begin, we will review the history and current definition of universal design.
Supported Decision-Making gives transition-age youth and adults choice and control in all decisions that affect them, from daily – “What would you like for breakfast?” to more complex decisions about job choices or living arrangements. “Presumption of competence” means that everyone, regardless of their perceived needs, including communication competence, can participate in and be supported in decisions that impact their lives. This is consistent with the Communication Bill of Rights in engaging AAC users at any level of competence in decisions about things that affect them directly. For transition-age youth and adults, this means even participating in the decisions about selecting and using their communication device. It is the responsibility of the communication partner to support the person’s decision-making and honor those decisions. Much more support of decision-making will be required for beginning AAC users versus more competent AAC users. Regardless, supporting decision-making for beginning communicators results not only in choice and control but also in building their competence in communicating. The profile on the left provides information about the person, their interests, things that help them learn, and things that don’t work well for them. This tool is helpful to care providers and unfamiliar contacts.
Leo tells you “I already mentioned my son has a disability. I have had to support him as he transitioned just as I’ve supported my other children. Registering to vote, completing the FASFA for college financial aid, making a decision on buying a car… these are all ways we support adult children, and it’s no different for people with disabilities.
The following video is an interview conducted with a young adult seeking AAC. Watch how the interviewer sets up the opportunities for this young woman to answer the interview questions.
Rosella is a 42-year-old woman living in a Personal Care Home. She is diagnosed with Bipolar Disorder, non-insulin-dependent diabetes, hypertension, and has a history of seizures. She also has a history of being exploited by others. Rosella is friendly, determined, and always willing to ask for help.
Several years ago Rosella completed her GED. She is able to cook with a microwave and is wanting to manage her diabetes better. She is not as skilled in meal planning, budgeting, and remembering to administer her medication. She already had basic skills in technology and is able to use the internet and has basic computer skills.
Rosella is involved in the community and loves to visit a local pet store where the staff let her play with the animals and help out, when possible. The staff enjoys her coming to the store and the animals always get excited when she comes by. Rosella really loves playing and working with animals. Regular customers know Rosella.
Team Member Roles
Using a person-centered approach to support Rosella’s goals, decisions, and desires ensures that she is supported to live in the community as a valued friend and contributing citizen. The more you know about a person, the better you are able to understand the person.
Rosella has set a goal to move into her own apartment and gain employment at a pet store. Now that we know Rosella a little better, let’s think about how we can use person-centered planning to help her achieve this goal.
Rosella’s Role:
To communicate with the team and work cooperatively towards this goal.
To work with her team on goal setting and eventual move.
To work on steps identified as part of a move-out plan.
To contact the Office of Vocational Rehabilitation and ask for an intake appointment
Guardianship State Service Worker (GSSW) Role:
To review the case history and determine any risk factors or barriers.
To communicate with Rosella and the team about any identified issues.
To support the planning process within the bounds of the guardianship court orders.
To set up the flow of funds to pay for things like classes, a bus pass, etc.
To sign needed consent documents/consent forms.
In-Reach Team Role*:
To assist with case history review and determine any risk factors or barriers
To assist with necessary evaluations and appointments for medical and psych services, if needed.
To facilitate the development of a detailed move-out plan, that includes the when, where, how & who is responsible for the tasks
To train Rosella and her staff on the final plan & assist her with the move out plan
To coordinate/facilitate ongoing meetings about the goal and how best to meet this desire
*In-Reach is through the Community Mental Health Centers to help individuals who are moving into independent living in the community.
Personal Care Home Staff Role:
To support Rosella and her desire to move out.
To assist in her education about medications.
To assist with her desire to be out in the community.
To communicate with the team her progress and any issues that arise.
This is Linda. Linda lives in her own apartment with Personal Assistance through the Supports for Community Living waiver. Linda never went to school but worked, mostly in part-time jobs, all of her adult life. At age 66, she retired and receives a substantial Social Security retirement payment because she worked.
Linda is a woman of few words but makes her personal preferences known when asked questions in response to a suggestion or request where she will respond emphatically with “yes” or ‘NO WAY.”
For example, going grocery shopping, picking up supplies for her black bunny named Midnight, picking up art supplies for her crafting/art projects, spending the weekend and holidays with her friend Bonnie (whom she has known since 1996), walking to get her steps in every day, looking at pictures of friends’ FaceBook page, attending a work-out class at one of her staff member’s church, hanging out with friends who live in the same apartment building in the common area, and cooking with assistance in her apartment are all activities she enjoys.
“NO WAY” includes possibly having to go to the hospital (which she did after she fell and fractured her pelvis in April of 2020 and then for surgery for an invasive melanoma in her scalp in January of 2021), gaining back the 50 pounds she has lost in the last three years, wearing hearing aids (had a bad experience with one of the amplifiers getting detached and stuck in her ear requiring outpatient surgery for it to be removed), and when asked if she has ever smoked. Like most people, she does not like change in her staff and is anxious about planning meetings as she is concerned it means something is going to happen.
Using a person-centered approach to support her goals, decisions, and desires, we will ensure that Linda is supported to live in the community as a valued friend and contributing citizen.
Team Member Roles
Using a person-centered approach to support Linda’s goals, decisions, and desires, ensures that Linda is supported to live in the community as a valued friend and contributing citizen. The more you know about a person, the better you are able to understand the person.
Linda has verbalized that she wants to travel to Disneyworld within the next two years. Now that we know Linda a little better, let’s think about how we can use person-centered planning to help her achieve this goal.
Linda’s Role:
To communicate her desires for the trip & assist with an itinerary (where to stay, what to do, sites to see, etc.).
To work with her team on saving money for the trip, as it will be expensive.
To work on physical stamina and strengthening for the travel and park days.
Guardian State Service Worker (GSSW) Role:
To review the trip budget and assist with a savings plan.
To assist with obtaining the necessary travel ID.
To obtain needed out-of-state travel authorization.
To arrange the payment of the trip with her saved funds in the Kentucky Guardianship Association’s (KGA) Pooled Trust.
To consent to any pre-trip appointments, therapies, and possibly sign documents.
To communicate with the provider, and team, as needed.
To support the planning process within the bounds of the guardianship court orders.
Case Management Role:
To assist with trip details, itinerary and cost planning.
To arrange any therapy or physical fitness access so she can work towards improved stamina
To coordinate/facilitate ongoing meetings about the goal and how best to meet this desire.
Provider Agency/Personal Assistance Direct Support Professional Role:
To assist and accompany on appointments
To support Linda’s desire to improve her physical stamina/strengthening.
To assess and arrange the staffing needed to support her while on the trip.
To provide any training to those accompanying her on her needs, plans, and safety provisions.
To maintain spending logs and receipts, and return them to the GSSW within 30 days of the trip.
So, what are the practices of good communication partners?
This list identifies skills used by good communication partners.
“Presume competence” meaning they believe that the AAC user has something important to say.
Acknowledge and Accept all forms of AAC – facial expressions, body language, device. Using a device is hard work… so encourage its use for important messages that can’t be communicated in other ways. To acknowledge a communication, say “I think you are telling me _________ with your _________. Is that right?”
Learn to use the AAC device that the student or adult is using, whether it is a low-tech picture system or a more complex speech-generating device.
Model or “speak AAC” using the device without expectation that the individual will use the device to communicate. It is scary for the person modeling who is also learning a new language, but think how hard and scary it might be to speak in a different language before you’ve had sufficient practice. AAC users may need to see/hear/experience many modeling opportunities before feeling confident enough to use the device.
Pause and Wait Expectantly – give the AAC user plenty of time (8 – 10 seconds or more) to process your language, develop a response, and then use the device to communicate the response. Use encouraging facial expressions.
Use comments, not questions… comment on what you see the person doing, and interpret it as communicative.
Provide prompts – verbal and modeling prompts may include:
“I think you have something to say.” Then pause and wait.
Point to the device and say, “Your talker might help me understand.” Then pause and wait.
Model some possible options… “I think you want to say ____________.”
Remember: “AAC near me.” Help the AAC user keep the device close and ready to use.
Leo says, “I would print this list and have it in my lunch box to review every day. These are great reminders and the best way to provide a student with a chance to communicate effectively.”
Communication Partners should Avoid
Failing to acknowledge communicative attempts, or assuming behaviors are not communicative.
Failing to wait expectantly – some people will need wait time to process auditory or visual information or respond motorically.
Failing to model how to use the device.
Asking yes/no questions.
Requiring the individual to use the device when other forms are understood.
Once an individual has been determined to be disabled, the court will decide what type of guardianship is needed. In Kentucky, the terms full, limited, guardian, and conservator are used to designate the type of guardianship needed.
Full – respondent is wholly disabled. A designation of fully disabled does not expire and will stay in effect unless a petition to terminate is granted or the individual passes away.
Limited – respondent is partially disabled. A designation of limited shall not be appointed for a term greater than 5 years, at which point, it must be renewed to continue.
A guardian is needed when the respondent cannot manage some or all of their personal affairs.
A conservator is needed when the respondent cannot manage some or all of their financial affairs.
Full Guardian
A full guardian is appointed when a respondent is found to be wholly disabled in managing their personal affairs.
The person appointed will make the respondent’s personal decisions and are responsible for managing the respondent’s personal affairs including but not limited to:
Disposing of property,
Executing instruments,
Entering into contractual relationships,
Determining living arrangements, and
Consenting to medical procedures.
Under full guardianship, the respondent will lose their right to obtain a motor vehicle license.
The respondent’s right to vote is determined by the judge.
Full guardianship does not expire. It will stay in effect unless a petition to terminate is granted or until the respondent passes away.
Full Conservator
A full conservator is appointed when a respondent is found to be wholly disabled in managing their financial affairs.
The person appointed will decide the respondent’s financial affairs and are responsible for managing the respondent’s financial affairs including but not limited to:
Disposing of property,
Executing instruments, and
Entering into contractual relationships.
The sale of any real property requires an order from the court.
In most situations, the court usually requires a conservator to post a bond to protect the respondent’s assets, however, the Cabinet for Health and Family Services is not required to (do this) be bonded per KRS 210.290.
Full conservatorship does not expire. It will stay in effect unless a petition to terminate is granted or until the respondent passes away.
Limited Guardian
A limited guardian is appointed when a respondent is found to be partially disabled in managing their personal affairs. Not all of the respondent’s personal rights will be removed and the judge will determine which right(s) they will keep. A limited guardian will be appointed to make all other decisions.
These rights include:
Disposing of property,
Executing an instrument,
Entering into a contractual relationship,
Determining living arrangements,
Consenting to medical procedures, and
Obtaining a motor vehicle license.
Unless otherwise indicated, limited guardianship appointments must be renewed every five years.
Limited Conservator
A limited conservator is appointed when a respondent is found to be partially disabled in managing their financial affairs. Not all of the respondent’s financial rights will be removed and the judge will determine which right(s) they will keep. A limited conservator will be appointed to make all other decisions.
These rights include:
Disposing of property,
Executing Instruments, and
Entering into contractual relationships.
Unless otherwise indicated, limited conservatorship appointments must be renewed every five years.
Combination of Full and Limited
The findings in a guardianship case can result in any combination of full guardianship, full conservatorship, limited guardianship, or limited conservatorship.
Petition for Relief, Modification, or Termination
Depending on the situation with the person under guardianship this form could be used to:
Renew a limited appointment for another 5 years.
Terminate a guardianship when it is accompanied by supporting documentation, proving that an individual is no longer in need of a guardian or conservator.
Modify guardianship, such as removing a guardian and appointing a successor guardian.
