By the end of this chapter, the learner should be able to:

Gather information that helps to identify a client’s preferences using an appropriate method
Take steps to support a client’s preferences and ensure they are carried out. This may involve:
- keeping record of the client’s preferences, requests and stipulations
- continually consulting with the client to provide them with the opportunity to express their preferences
Make adjustments to services according to the specific needs and preferences of the client.

Identifying preferences

While there are a lot of aspects of aged care that will bear similarities to one another, you must also learn to treat each aged person as an individual. Therefore, you should conduct a full background assessment of the elder you are working with, so that you understand all of their needs. This should be combined with the ACAT assessment – another simple yet effective technique is to get to know the client's you work with. If possible, try to ensure that care workers work with the same people for an extended period of time, whether in residential or home care. This is because familiarity will instil confidence and make for a more personalised service.

Information regarding preferences may be gathered in a number of ways:

An informal chat with the client
Friends and family.
Observation e.g. you could notice photographs of them in their garden and ask them if they like to garden. (You could then ask if they would like to come with you to the garden centre to pick some plants out for the garden at the centre/home).
A more formal written document e.g. a questionnaire.

Supporting client preferences

Clients have the right to assert their preferences about any aspect of their care, whether they are in residential or private accommodation. Clients should be given the opportunity to make decisions and voice their preferences wherever possible.

When clients have preferences that are applicable to a situation, they should be confirmed with both the client and the supervisor, where required
Client preferences, requests and stipulations should be recorded in their notes; this ensures that their preferences are not overlooked, misunderstood or miscommunicated; for example, if a client states that they would like to be woken early in the morning so that they can listen to a radio show or watch a television show, this message may not reach the person on duty in the morning if it is only mentioned verbally, or the caregiver forgets to pass on the message.
Other preferences, such as that a client does not like to be called by their first name, should be recorded so that anyone who works with the client is informed of this.
Clients should be consulted as much as possible on aspects of their care and lifestyle; this empowers them and allows them to live more comfortably and happily
Over time, it is good practice to confirm that clients’ preferences are still accurate by asking them whether they are still satisfied with all aspects of their care. If they express a desire for a change, aim to rectify this ASAP
Unless clients inform you of changes directly, their preferences may have changed without you knowing – you should consult family members and advocates periodically to check if they are aware of any such desires for change

Having their particular preferences recorded and accessible allows you to provide a more friendly and personalised service, even if the care worker has never worked with a particular client before. By consulting notes, other care staff are able to see that the client prefers certain things, such as not being called by a nickname, not being touched on their shoulders and that they have difficulty taking tablets. This means that different carers can avoid making mistakes and portraying the service as impersonal by having to ask many questions

Adjusting services

You have a responsibility to ensure a safe environment for the client. You may want to try and empower the client and have them make decisions for themselves and help to give them some independence. However, you must be careful not be negligent of the risks involved in increased independence. For example, if a client enjoys gardening and there is a garden centre nearby, but the client is suffering from dementia, it would not be appropriate for you to suggest the client goes to the garden centre by themselves as you would be neglecting your duty of care
Carers should think about any risks that would be increased through the client partaking in an activity or anything that could prevent the client from obtaining that service.

You may need to adjust:

Times
Equipment
The type of service
Location

For example, if your client wanted to attend an exercise class and they had brittle bones or osteoporosis, there may be a risk of falling. How could you overcome this risk? One option could be to water aerobics; another could be for the carer to attend the class with the client. You will need to weigh up the options with the client and come to a decision on the best way forward.