Madge has been staying at Lotus Compassionate Care for the past two years. Madge has four children. All of them have their own families and are currently staying in different states across Australia. Madge was diagnosed with Alzheimer’s disease some years ago. Her dementia has progressed to the point that her family cannot provide the support she needs anymore. They decided to place Madge in the care of Lotus Compassionate Care, hoping that it would provide her with the support that she needed brought about by her dementia in a more stable and comfortable environment.

Scenario
Madge has been in your care since she arrived at the centre two years ago. However, you have been away on holiday for the last two months, so another support worker had to be assigned to care for Madge.
On your first day back, as you and another individual support worker were about to hoist her from the bed and onto her wheelchair, you noticed that Madge had sore, purple discoloured and painful spots about 8cm across on both her shoulders and a smaller one about 3cm across on the backside of her head. When she was on her side, you saw some bleeding through her pants and on the bedsheets from the upper part of her buttocks. It appears it has not been checked for at least a day or two. Her bed sheets were stained and smelled of faeces and urine. She looked in pain. You asked her if you could check what was causing her pain. You found that she had an open wound about 2cm across, and the skin surrounding it was very red and discoloured. Madge cringed in pain as you gently assessed the condition of her skin.
You later found out that she has not been out of her bed in two days. You asked her why she has not gone out of her bed, and she told you that she is just feeling too tired lately and going out just takes too much effort. She asked you if she could just stay in bed and rest today. You noticed that she seems withdrawn. You also noticed that she has lost a lot of weight since the last time you saw her about two months ago.
Madge asked you if you could get medication to help her with the pain. She started feeling pain in her buttocks and both shoulders two days ago but did not tell anyone until you were back from your leave. When you asked her why she did not tell anyone about it, she said she did not want to bother the nurse.
This made you worry about Madge and ask her if there was anything else that was bothering her. You found out that she has not had any bowel movements in two days, and urinating has started to become painful for her.
She asked if you could clean her wounds and give her pain medication. You explained to her that although you would love to help her, you are not qualified to perform those procedures on clients.
You checked her care plan and found that her nurse’s name is Olivia. You explained to Madge that registered nurse Olivia would be the best person to clean her wounds and help her manage her pain with medication as prescribed by her doctor.
Madge appeared nervous and anxious when you mentioned the nurse’s name. She hesitantly tells you that the pain is gone and she feels fine. She tells you she does not need the pain medication anymore.
(i) As a support worker, what is your responsibility when there are changes to the person’s physical and psychological health and wellbeing?