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Slide 1

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH and DOE-approved textbooks, NOW AVAILABLE IN BOTH ENGLISH AND SPANISH (including a bank of 800 approved test questions in both languages), will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 1S

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH and DOE-approved textbooks, NOW AVAILABLE IN BOTH ENGLISH AND SPANISH (including a bank of 800 approved test questions in both languages), will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 2

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH and DOE-approved textbooks, NOW AVAILABLE IN BOTH ENGLISH AND SPANISH (including a bank of 800 approved test questions in both languages), will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 2S

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH and DOE-approved textbooks, NOW AVAILABLE IN BOTH ENGLISH AND SPANISH (including a bank of 800 approved test questions in both languages), will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 3

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH and DOE-approved textbooks, NOW AVAILABLE IN BOTH ENGLISH AND SPANISH (including a bank of 800 approved test questions in both languages), will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 3S

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH and DOE-approved textbooks, NOW AVAILABLE IN BOTH ENGLISH AND SPANISH (including a bank of 800 approved test questions in both languages), will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

Slide 4

Select Home Care Manuals

Serving the home health care industry for over 30 years!

Our New York State DOH and DOE-approved textbooks, NOW AVAILABLE IN BOTH ENGLISH AND SPANISH (including a bank of 800 approved test questions in both languages), will provide your students with the most comprehensive and professional training available for:
• Personal Care Aides (PCAs)
• Home Health Aides (HHAs)
• Homemakers
Each one of our books is an invaluable training tool for use in the classroom, as well as a permanent reference guide for the aide working out in the field. Theyʼre the perfect complement to the entire learning experience!

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Module VI English

Unit A: Understanding Developmental Disabilities
Defining Developmental Disabilities

Did you have trouble with math in school? Do you find it hard to understand engines of machines?

Most of us can identify areas where we have problems learning. Mastering these areas may take a lot of time and effort on our part. And sometimes, even with our best efforts, we can only progress to a certain point and no farther. For example, a person may learn to budget a paycheck with ease, yet not grasp algebra.

When it comes to learning, we all have different strengths and weaknesses. We all have a range of disabilities.

This same basic concept can be applied to mental retardation. The word "retardation" itself means "slowing down". Mental retardation slows down the ability to learn and limits the capacity to understand what are called abstract concepts. For example, a moderately retarded adult may not be able to tell time by looking at a clock that has the traditional hands and face. However, that same person may be able to tell time by looking at a digital clock. The important thing to remember is that mental retardation affects all areas of learning, not just one or two.

Mental retardation is sometimes called a "developmental disability". Developmental disabilities are a group of physical conditions that occur before, during, or shortly after birth. Other conditions such as cerebral palsy, cystic fibrosis, and muscular dystrophy are also developmental disabilities. However, mental retardation is the most common one.

Developmental disability affects a person's normal development in at least three of the following areas:
•    self-care
•    communication skills
•    movement
•    self-direction (control over life)
•    potential for independent living
•    potential for financial independence

Look closely at this list. Notice that one basic human ability – the ability to feel emotions – is missing. Developmentally disabled people experience the same emotions that we all have. They feel love, anger, sadness, joy. And they can feel these emotions as deeply as anyone else. Because their disability may affect their ability to communicate, however, they may have trouble expressing their emotions.

Causes of Developmental Disabilities

Many factors can interfere with normal brain development before, during, or after birth. These factors can cause developmental disabilities.

They include:
•    certain infections during pregnancy, such as German Measles
•    poor nutrition during pregnancy
•    premature birth (birth weight is the important factor)
•    brain damage during delivery
•    alcohol or drug abuse during pregnancy
•    lead poisoning (baby eats lead paint chips from walls or furniture)
•    inherited or other defects in the baby's genes (genes are the part of a cell that determines eye color, skin tone, height, etc.). One example is Down Syndrome (once called         Mongoloidism), which is marked by widely spaced eyes and a somewhat flat nose.

These known causes can explain less than half of all cases of developmental disability, however. In most cases, the cause is not known. Developmental disability can occur in families of any race, nationality, or economic level.

Degrees of Developmental Disabilities

As mentioned, the average person has a range of abilities for functioning in life. The same is true of the developmentally disabled person. These are known as different degrees of disability – mild, moderate, severe, and profound. Children who are mildly developmentally disabled are often not diagnosed until school age. They do not appear outwardly different from other children. The problem usually becomes apparent when they function below the level of other children in school.

Nearly 90 percent of all developmentally disabled people fall into the "mild" category. With proper education and training, they can become adults who live and work independently in the community. They can lead full and useful lives.

Children with moderate to profound developmental disabilities are often diagnosed long before they begin school. These children develop at a slower rate physically as well as developmentally. Whereas a normal child at age five has a large vocabulary and good motor coordination, a severely developmentally disabled five-year old may function at the12 to 18 month old level. He or she may have just started walking and may have a vocabulary of just a few words. It is not uncommon for these children to have physical handicaps as well, which can slow their development even further.

Information Sheet 1 briefly outlines the usual stages of development for children with mild to profound developmental disabilities. This sheet is only a general guide, however. As is the case with any other child, the individual development of a developmentally disabled child depends a great deal on how much stimulation and attention he or she receives.

Differences Between Developmental Disabilities and Mental Illness

Developmental disability and mental illness are often confused. Simply defined, developmental disability is a decline in intellectual ability that is severe enough to interfere with a person's daily functioning. Developmental disability is not a kind of mental illness; it is a different problem entirely.

Developmental disability differs from mental illness in several ways:
•    Developmental disability is a permanent condition. Mental illness can be a temporary problem.
•    Developmental disability occurs at or near birth. Mental illness may occur any time during life.
•    Developmental disability always lessens mental ability. Mental illness may or may not affect mental ability.
•    There is no cure for developmental disability, although developmentally disabled persons can be helped. Many mental illnesses can be cured with prompt and proper treatment.

Although developmental disability and mental illness are different problems, they do have one important thing in common – both developmentally disabled and mentally ill persons need support, understanding, and proper treatment and care.

In Unit A, you have learned some basic facts about developmental disability.
•    Developmentally disabled people can learn, but learning takes more time and is limited. Physical and social development is slower. Therefore, mental retardation is called a developmental disability.
•    Like all human beings, the developmentally disabled experience emotions. They have the basic human needs described in Module II.
•    There are different degrees of developmental disability, from mild (where the person can lead a full and useful life after receiving proper education and training) to profound (where a person cannot function independently).
•    Developmental disability differs from mental illness. Developmental disability is permanent, whereas mental illness can be temporary. Developmental disability occurs at or close to birth; mental illness may occur at any time. Developmental disability always lessens mental ability. Mental illness, by contrast, does not always affect mental ability. No cure exists for developmental disability. If promptly treated, some mental illnesses can be cured.

Autism (ASD-Autism Spectrum Disorder)

Autism is a complex, pervasive developmental disorder that involves the functioning of the brain. It is a neurological disorder and not simply a psychiatric disorder. Typically it appears during the first three years of life. In some cases, it can be detected by the age of one or younger. It is four times more prevalent in males than females and is most prevalent in Caucasian males. As of 2004, autism is treatable, but not curable.

Problems that May Accompany ASD

Many ASD children are highly attuned or even painfully sensitive to certain sounds, textures, tastes and smells. Some children find the feel of clothes touching their skin almost unbearable. Some sounds – a vacuum cleaner, a ringing telephone, a sudden storm, even the waves lapping the shoreline – will cause these children to cover their ears and scream.

In ASD, the brain seems unable to balance the senses appropriately. Some ASD children are oblivious to extreme cold or pain. An ASD child may fall and break an arm, yet never cry. Another may bash his head against a wall and not wince, but a light touch may make the child scream with alarm.

Mental Retardation (Developmental Disability)

Many children with ASD have some degree of mental impairment. When tested, some areas of ability may be normal, while others may be especially weak. For example, a child with ASD may do well on the parts of the test that measure visual skills but earn a low score on the language subtests.


One in four children with ASD develops seizures, often starting in early childhood or adolescence. Seizures, caused by abnormal electrical activity in the brain, can produce a temporary loss of consciousness, a body convulsion, unusual movement, or staring spells. Sometimes, a contributing factor is a lack of sleep or a high fever.

Parents are usually the first to notice unusual behaviors in their child. In some cases, the baby seemed "different" from birth, unresponsive to people or focusing intently on one item for a long period of time. The first signs of ASD can appear in children who seem to be developing normally. When an engaging, babbling toddler suddenly becomes silent, withdrawn, self-abusive, or
indifferent to social overtures, something is wrong.

Possible Causes of Autism

•    Vaccinations
•    Environmental toxins
•    Viral infections
•    Foods containing genetically modified organisms
•    A hiatal hernia that disrupts protein digestion

Imagine having a toddler who can't tell you where it hurts. Imagine having an 8 year old who can't say "I love you." Imagine having a teenager with a growing body but stagnant mental age. Imagine your child is an adult with autism who will need care long after you are gone. You are not alone. Meet other parents. Share resources . . . join ASA.

Modulo VI Espanol

Unidad A:    Entendiendo las Discapacidades del Desarrollo

Definiendo la Discapacidad del Desarrollo

¿Tuviste problemas con las matemáticas en la escuela? ¿Te resulta difícil entender los motores de las máquinas?

La mayoría de nosotros podemos identificar las áreas en las que tenemos problemas de aprendizaje. El dominio de estas áreas puede tomar mucho tiempo y esfuerzo de nuestra parte. Y a veces, incluso con nuestros mejores esfuerzos, sólo podemos progresar hasta un cierto punto y no más allá. Por ejemplo, una persona puede aprender a presupuestar un cheque de sueldo con facilidad, y aún no comprender el álgebra.

Cuando se trata del aprendizaje, todos tenemos diferentes puntos fuertes y débiles. Todos tenemos una gama de discapacidades.

Este mismo concepto básico se puede aplicar al retraso mental. La palabra "retraso" en sí significa "desaceleración". El retraso mental ralentiza la capacidad de aprender y limita la capacidad de entender lo que se llaman los conceptos abstractos. Por ejemplo, un adulto con retraso moderado puede no saber  decir la hora mirando un reloj que tiene las manos y la cara tradicionales. Sin embargo, esa misma persona puede decir la hora mirando un reloj digital. Lo importante a recordar es que el retraso mental afecta a todas las áreas de aprendizaje, no sólo uno o dos.

El retraso mental a veces se llama una "discapacidad del desarrollo". Las discapacidades del desarrollo son un grupo de condiciones físicas que ocurren antes, durante o poco después del nacimiento. Otras condiciones como la parálisis cerebral, fibrosis quística y la distrofia muscular también son discapacidades del desarrollo. Sin embargo, el retraso mental es la máscomún.

La discapacidad del desarrollo afecta el desarrollo normal de una persona en al menos tres de las siguientes áreas:

• autocuidado

• habilidades de comunicación

• movimiento

• autodirección (control sobre la vida)

• el potencial para la vida independiente

• posibilidades de autonomía financiera

Fíjate bien en esta lista. Ten en cuenta que una capacidad humana básica – la capacidad de sentir emociones – no se encuentra en la lista. Las personas con discapacidad del desarrollo experimentan las mismas emociones que todos tenemos. Sienten el amor, la ira, la tristeza, la alegría. Y pueden sentir estas emociones tan profundamente como cualquier otra persona. Debido a que su discapacidad puede afectar a su capacidad de comunicación, sin embargo, pueden tener problemas para expresar sus emociones.

Las Causas de la Discapacidad del Desarrollo

Hay muchos factores que pueden interferir con el desarrollo normal del cerebro antes, durante, o después del nacimiento. Estos factores pueden causar discapacidades del desarrollo.

Ellos incluyen:

• ciertas infecciones durante el embarazo, tales como sarampión alemán

• mala nutrición durante elembarazo

• nacimientos prematuros (el peso al nacer es el factor importante)

• daño cerebral durante el parto

 • abuso de alcohol o drogas durante el embarazo

 • el envenenamiento por plomo (el bebé come pedazos de pintura de plomo de las paredes o muebles)

 • hereditario u otros defectos en los genes del bebé (los genes son parte de una célula que determina el color de ojos, tono de piel, estatura, etc.) Un ejemplo es el Síndrome de Down (una vez llamado Mongoloide), que se caracteriza por ojos muy separados y una nariz algo aplastado.

Sin embargo,estas causas conocidas pueden explicar menos de la mitad de todos los casos de discapacidad del desarrollo. En la mayoría de los casos, se desconoce la causa. La discapacidad del desarrollo puede ocurrir en familias de cualquier raza, nacionalidad o nivel económico.

Module VIII English

Unit A: The Basics of Nutrition

In this Unit, you will learn about the five major categories of nutrients and their importance in promoting and maintaining good health.

Why is food the foundation of health? If you think about your daily activities, you will have the answer. Food provides the energy you need for work and play. It also provides the energy needed for growth and repair of tissues.

The food you shop for and the meals you prepare as a Home Care Worker can help:
• children grow, develop, and reach their mental and physical potential
• expectant and nursing mothers maintain their health
• adults and the elderly stay active and prevent them from developing certain health problems
• the ill recover more quickly and stay healthy
• the disabled maintain or improve their strength and overall health

When people feel better physically, their general outlook on life often improves. In this sense, nutrition can contribute to mental, as well as physical, well-being.

Take a few moments to think about the different foods you ate yesterday.  Note approximate serving sizes. Be sure to include any snacks or beverages you consumed in addition to your regular meals, as well as the number of glasses of water you drank.

During Jessie's training, she learned the meaning of some words she has been hearing all her life. Of course, she knew that foods were substances that you eat. But she learned that nutrition means how your body uses the food you eat. She also learned that foods contain nutrients, substances that nourish the body.

The Major Nutrients

Nutrients are the individual substances that combine to make foods and to supply our bodies with everything we need to live, move, and grow. Each nutrient has its own special function in keeping the body healthy. There are about fifty different nutrients, and they fall into major categories – proteins, carbohydrates, fats, vitamins, and minerals. Water is another substance that is very important to good nutrition.


Proteins build and repair body tissue. Proteins also help make hemoglobin, the red substance in the blood that delivers oxygen to and removes carbon dioxide from cells. Finally, proteins help form antibodies to fight infections.

Food sources rich in protein are beef, lamb, pork, poultry, fish, shellfish, eggs, and milk. These are called animal proteins. Food sources that are not as rich in protein are lima and kidney beans, chick peas (garbanzos), split peas and black-eyed peas, peanuts, and peanut butter. These are called vegetable proteins.

Larger quantities of vegetable protein foods must be eaten in order to provide the same amount of protein present in animal protein foods. In meal planning, animal and vegetable proteins can be combined to furnish the proper amount of protein. Some of these popular combinations are macaroni and cheese, beans and rice, cereal and milk, rice and fish, spaghetti and meatballs, baked beans and brown bread, vegetable stew with meat, and a peanut butter sandwich.

The amount of protein a person needs is determined by his or her size, age, amount of activity, and the state of health he or she is in.


The primary function of carbohydrates is to provide energy. When we eat foods that contain them, our bodies become able to use the energy from proteins for growth and maintenance. There are simple carbohydrates, the sugars, and complex carbohydrates, starches and fibers.

The starches include all grains and the products made from them (flours, bread and other baked goods, macaroni, spaghetti, noodles, and breakfast cereals), potatoes, sweet potatoes, beans, and peas. Fiber (sometimes called bulk) does not provide any energy, but it does assist in digestion. It is found in grains, vegetables, and fruits, but not in sweets.

Fat is a part of our cell structure. It forms protective cushions around our vital organs. It lets proteins go about their work of building and repairing by providing food energy, and, in a thin layer under the skin, it insulates the body and prevents loss of heat.

Fats are a concentrated energy source. They digest more slowly than proteins or carbohydrates. Therefore, they delay a feeling of hunger. Meat, fish, chicken, eggs, nuts, milk products, butter, margarine, salad oils, and mayonnaise all contain fats.

Are you familiar with the term polyunsaturated? Polyunsaturated fats are found in products made from corn, soy, safflower, sesame, and sunflower seeds. (Olive, peanut, and cottonseed
oils do not contain these fats.) Polyunsaturated fats are believed to have a desirable effect on the heart and blood vessels by helping to reduce cholesterol, a waxy, fat-like substance that can
build up inside the blood vessels. Research suggests that cholesterol is found only in the fats of animal foods, such as meat, milk products, eggs, and shellfish. It is very high in “organ" meats (liver, sweetbreads, and kidneys).

Saturated fats increase cholesterol in the blood. Beef is high in saturated fats, as are whole milk, butter, cream, coconut, palm oil, and lard.


Vitamins are essential to life and well-being. They help our bodies make use of the other nutrients (proteins, fats, carbohydrates, and minerals). Vitamins are necessary for the proper functioning of many of our body processes. They promote tissue growth, allow the nerves and muscles to function as they should, help the reproductive and digestive systems to work properly, and may help the body resist infections.

Since our bodies cannot manufacture most vitamins, we must get them from a variety of foods. The most important vitamins are Vitamins A, B, C, and D.

• Vitamin A helps keep the skin in good condition, facilitates normal bone growth, and allows the eyes to adjust to dim light. Liver, eggs, butter, whole milk, and cheese, as well as yellow and dark green vegetables and fruits, supply Vitamin A.
•  Vitamin B is actually a group of vitamins (Riboflavin, thiamin, and niacin are well-known B vitamins.) B vitamins help the nervous and digestive systems function properly. They are also good for the skin. Milk, whole grains, peas, beans, meat (especially lean pork), and some breads or cereals are sources of B vitamins.
•  Vitamin C helps the healing of wounds and bones. It plays a part in forming and maintaining the material that holds living cells together and strengthens the walls of blood vessels. Citrus fruits, like oranges and grapefruits, and such vegetables as tomatoes, broccoli, green peppers, and potatoes provide Vitamin C. Cantaloupe, orange juice, and strawberries are Vitamin C sources that contain other nutrients and provide fiber, which is necessary for digestion.
•  Vitamin D builds strong bones and teeth. The action of sunlight on the skin causes the body to make its own Vitamin D. Milk with added Vitamin D is the most common source of this vitamin in the diet. Some Vitamin D is also found in egg yolks, butter, and liver. Certain fish, particularly sardines, salmon, herring, and tuna, are excellent sources of Vitamin D.


Minerals are the substances our bodies require to strengthen certain tissues and to help in many bodily functions. Some important minerals are:

•  Calcium, which is needed for strong bones and teeth. It also helps blood to clot and nerves and muscles to react normally. We have a lifelong need for calcium, which can be obtained from milk and milk products, fish bones (such as those eaten in salmon and  sardines), and dark green leafy vegetables (collards, mustard, turnip, kale, and dandelion greens). People who cannot digest milk or milk products should not overlook the other sources of calcium.

•  Potassium, which works with calcium to keep the heart functioning properly. It is found in bananas, prunes and oranges, as well as potatoes that have been cooked in their skins.
•  Iron, which combines with protein to make hemoglobin (as mentioned earlier, the red substance in the blood that carries oxygen from the lungs to the entire body). Iron helps cells use oxygen.

When people do not get enough iron, iron-deficiency anemia can result, causing lack of sleep, reduced energy, and poor appetite. Studies have shown that iron deficiencies are a particular problem for infants, children, and the elderly. Women need extra iron to replace the iron lost in blood during childbirth and menstruation. Extra iron is also essential during pregnancy or when nursing.

Modulo VIII Espanol

Unidad A: Elementos Básicos de laNutrición

En esta Unidad, aprenderás acerca de las cinco categorías principales de nutrientes y su importancia en la promoción y el mantenimiento de una buena salud.

¿Por qué es la comida la base de la salud? Si piensas acerca de tus actividades diarias, obtendrás la respuesta. Los alimentos proporcionan la energía que se necesita para trabajar y jugar. También proporciona la energía necesaria para el crecimiento y reparación de los tejidos.

La comida que compras y las comidas que preparas como Ayudante de Cuidado  en el Hogar pueden ayudar a:

• los niños a crecer, a desarrollarse  y  alcanzar su potencial mental y físico

• las madres gestantes y lactantes a mantener su salud

• los adultos y personas mayores a permanecer activos e impedirel desarrollo de ciertos problemas de salud

• los enfermos a recuperar más rápidamente y a mantenerse saludables

• los discapacitados a mantener o mejorar su fuerza y la salud en general

Cuando la gente se siente mejor físicamente, su perspectiva general de la vida a menudo mejora. En este sentido, la nutrición puede contribuir al bienestar mental, así como la física.

Tómate unos minutos para pensar en los diferentes alimentos que comiste ayer. Anota las porciones aproximadas. Asegúrate de incluir cualquier merienda o bebidas que  consumiste en adición a tus comidas regulares, así como el número de vasos de agua que bebiste.

Durante el entrenamiento de Jessie, ella aprendió el significado de algunas palabras que ella había estado escuchando durante toda su vida. Por supuesto, ella sabía que los alimentos eran sustancias que se comen.

Ella se enteró de que la nutrición significa cómo el cuerpo utiliza los alimentos que consume. También se enteró de que los alimentos contienen nutrientes, sustancias que nutren el cuerpo.

Los Nutrientes Principales

Los nutrientes son las sustancias individuales que se combinan para hacer que los alimentos puedan abastecer a nuestros cuerpos con todo lo que necesitamos para vivir, movernos y crecer. Cada nutriente tiene su propia función especial en mantener el cuerpo saludable. Hay alrededor de cincuenta nutrientes diferentes, y caen en las categorías principales – proteínas, carbohidratos, grasas, vitaminas y minerales. El agua es otra sustancia que es muy importante para una buena nutrición.


Las proteínas se acumulan y reparan el tejido corporal. Las proteínas también ayudan a hacer que la hemoglobina, la sustancia de color rojo en la sangre que suministra oxígeno, elimine el dióxido de carbono de las células. Por último, las proteínas ayudan a formar anticuerpos para combatir las infecciones.

Las fuentes de alimentos ricos en proteínas son la carne de res, cordero, cerdo, pollo, pescado, mariscos, huevos y leche. Éstos se llaman las proteínas animales. Las fuentes de alimentos que no son tan ricos en proteínas son las limas y habichuelas, garbanzos, arvejas y frijoles de ojo negro, maní y mantequilla de maní. Estos se llaman proteínas vegetales.

Unit C English



In your past experience, you learned how to help clients plan, shop for and prepare tasty, nutritious meals.

You learned about the five basic food groups:
•  milk and dairy products
•  meat and meat substitutes
•  fruits and vegetables
•  grains
•  "others," such as sugars and fats

You learned that well planned meals:
•  contain a variety of foods from the five basic food groups
•  suit the client's cultural and personal preferences
•  should cost no more to prepare than the client can afford

You also learned that when you assist a client in preparing meals, you must be sure that you:
•  cook the foods so that the greatest number of nutrients remain
•  prepare the food in ways that are appetizing and tasty
•  serve the foods in an attractive manner
•  store food properly for safety and to retain the nutrients

You learned to recognize some simple modified diets. Many times, clients are advised by their doctors to modify their diets in order to improve their health. They may be advised, for instance, to increase the fiber in their meals to relieve a constipation problem. Or they may be advised to cut down on calories in order to avoid gaining weight. They might also be advised to reduce salt intake. These are examples of simple modified diets with which you have become familiar in your studies and your work.

In this unit you will be given background information essential for assisting a client with the preparation of complex modified diets. You will learn what complex modified diets are. You also will learn the reasons why these diets are important and ways to make these diets more enjoyable for the client. You will learn your role in assisting a client with a needed diet. You also will learn what an exchange list is and how it works.


Some physical conditions require specific diet modifications. Diabetes requires a careful balancing of foods in order to maintain good health. Some heart conditions require a strict limit of salt (sodium) in food intake plus lower cholesterol levels. Sometimes kidney or liver problems require a complex, carefully controlled diet.

Complex modified diets are of three general types. They may be:
•  measured or weighed carefully in order to control amounts of various nutrients, such as in a diabetic diet
•  two or more simple modifications combined, such as a low salt/high protein diet
•  a simple modified diet with supplement added for extra nourishment


By now you have had some experience in assisting clients with simple modified diets. You may have been assigned to assist in planning meals according to the diet restrictions and to find alternatives that met your client's preferences as well as dietary needs. You probably have prepared shopping lists and purchased food for your client. You also have had experience in recording and reporting problems you observed. These same activities will be part of your role when assisting with more complex modified diets.

As part of your role in assisting with the preparation of complex modified diets you should know the activities you are allowed to do. These activities are only to be performed if they appear on the client's Care Plan.

•  plan meals in cooperation with the client or with a family member
•  prepare shopping lists appropriate for the diet
•  purchase special foods and foods appropriate to the diet
•  assemble or set up necessary equipment, diet utensils and supplies for meal preparation procedures
•  prepare meals and/or special foods
•  add nutritional supplements and stool softeners to food
•  serve meals
•  clean cooking areas, equipment and utensils
•  store uneaten foods properly
•  observe, record and report changes and problems

You also should know the activities you are not allowed to do.

•  mix oral medications into foods or liquids



If you are assigned to assist a client with a complex modified diet, you need some special knowledge in order to provide the right kinds of assistance. You will need to understand:
•  what the diet means
•  how the diet works in treating the illness
•  how to make the necessary adjustments in planning, shopping and preparation
•  how best to assist the client to follow the diet
•  how to weigh or measure foods
No matter what your assignment is when assisting clients with the preparation of complex modified diets, you should always remember that it is important to encourage them to be independent in every way possible.

You may be assigned to assist with only a part of the food planning or preparation – the part which your client is unable to complete. Your instructions will be written on your client's Care Plan.

An example of a Home Care Case involving a complex modified diet follows. It will help you understand your role.

Case Example: Mrs. Bates
Mrs. Bates is a 70-year old woman who lives alone. She has had diabetes for a number of years. In addition, more recently, she has had problems with hypertension and must restrict the salt in her diet. During her last trip to her doctor she was told that her cholesterol level was too high and the doctor prescribed a low cholesterol diet. All of these special diets together have been confusing to Mrs. Bates.

Fortunately, Jessie, her Aide, had been taught to assist with the preparation of diabetic, low sodium and low cholesterol diets and how to help Mrs. Bates manage all of them together. Mrs. Bates is an example of a client who needs assistance with a complex modified diet.

Helping a Client Understand and Accept a Diet

Mrs. Bates may be similar to other clients you will be assisting. Many clients are confused about their prescribed diets. They hesitate to ask their doctors for explanations. They may come from the hospital or the doctor's office with only a vague understanding of the doctor's orders regarding diet. You and the nurse can help the client better understand the reasons for the diet, how it will affect the client's health and how to maintain good taste and appeal in meals.

Sometimes clients also feel that it isn't fair that they have to give up their favorite foods or seasonings and that a little cheating won't hurt. Often, when a person is elderly or has lost friends and family, or is not healthy enough to be active and useful, eating becomes the most important activity of the day. Restrictions and bans can be depressing or may even cause anger. You can emphasize the variety of foods that still remain possible. You can use your imagination to create tasty and interesting foods, even with limited choices. You can assist in making mealtime a happy time, and this will greatly increase the willingness of the client to follow the diet.

Diets are individually prescribed to meet the needs of a specific person. Each client should have a written diet sheet from the doctor detailing his or her own instructions. Be sure to read this carefully and to be sure your client understands it.


Recognizing Your Own Feelings About Diets

Clients on special diets may seem to be unreasonably cautious and sensitive. It may not seem normal to spend so much time thinking about food, planning meals or worrying about it. It may seem boring or the food choices may seem unappealing to you. However, special diets are part of a doctor's treatment plan. You and your client can work together better if you recognize the importance of this kind of treatment and show patience and interest in meeting your client's needs. With this in mind, you will make the food look and taste as appetizing as possible for the client. You will do everything you can make mealtime a happy time for your client.


What is Diabetes?

Diabetes, or more properly, diabetes mellitus, is a disorder in which foods are not used correctly in our bodies. When foods are eaten, carbohydrates, protein and fats are broken down into a sugar called glucose. This glucose enters the bloodstream where it goes to all the body's cells to provide energy and nourishment. An important hormone, called insulin, normally manufactured in our bodies, controls the flow of glucose from the bloodstream into the cells. People with diabetes (diabetics) lack sufficient insulin to do this job properly.

There is no known cure for diabetes. Most diabetics can control the condition, however, with one or more kinds of treatment. Diet control must be followed by all diabetics. Their meals are
carefully measured and timed to provide glucose in amounts that the body's supply of insulin can handle. Some require, in addition, oral medication (pills) to stimulate the body to manufacture more insulin. Still others, besides following a diet, must take shots (injections) of insulin to make up for the body's inability to manufacture its own supply.

When the lack of insulin interferes with the way the body uses glucose, the body's cells become undernourished. The person feels weak, tired and hungry and loses weight. Two of the early symptoms of diabetes are frequent urination and extreme thirst.

Because of the poor health of the body's cells, diabetics may have skin problems, poor circulation, poor eyesight, and low resistance to disease. Diabetes is a contributing factor to many other serious illnesses such as heart disease, strokes and kidney disease.

In a person without diabetes, the body adjusts the insulin level depending on the person's level of activity, when he or she chooses to eat, and how much the person feels like eating. However, when a person has diabetes and has to be given insulin as part of the treatment, it must be given in set, pre-determined amounts. Diabetics on insulin must adjust their eating to fit the strength and amount of insulin. For this reason, diet control is very important.


Unidad C Espanol



En tu experiencia anterior, aprendiste cómo asistir al cliente a planificar, comprar y preparar comidas sabrosas y nutritivas.

Aprendiste acerca de los cinco grupos de alimentos básicos:

• leche y productos lácteos

• la carne y sus sustitutos

• frutas y verduras

• granos

• "otros", tales como azúcares y grasas


Aprendiste que las comidas bien planificadas:

• deben contener una variedad de alimentos de los cinco grupos de alimentos básicos

• deben adaptarse a las preferencias culturales y personales del cliente

• no deberían costar más en preparar de lo que el/la cliente pueda costear


También aprendiste que cuando asistes a un/a cliente en la preparación de las comidas, debes estar seguro/a de que tú:

• cocinas los alimentos de manera que el mayor número de nutrientes permanezcan

• preparas la comida de manera que sea apetitoso y sabrosos

• sirves las comidas de una manera atractiva

• almacenas la comida adecuadamente para la seguridad y para conservar los nutrientes


Has aprendido a reconocer algunas dietas simples modificadas. Muchas veces, los/las clientes son asesorados por sus médicos para modificar sus dietas con el fin de mejorar su salud. Ellos pueden seradvertidos, por ejemplo, que deben aumentar la fibra en sus comidas para aliviar un problema de estreñimiento. O pueden ser aconsejados para reducir el consumo de calorías para evitar subir de peso. También podrían ser aconsejados para reducir el consumo de sal. Estos son ejemplos de las dietas simples modificadas con los que te has familiarizado en tus estudios y tu trabajo.                          

En esta Unidad se te dará información básica esencial para ayudar a un cliente con la preparación de dietas complejas modificadas. Aprenderás quéson las dietas complejas modificadas. También aprenderás  las razones por las cuales estas dietas son importantes y las maneras de hacer que estas dietas sean más agradables para el/la cliente. Aprenderás tu rol en ayudar a un/a cliente con una dieta necesaria. También aprenderás lo que es una lista de intercambio y cómo funciona.


Algunas condiciones físicas requieren modificaciones específicas de la dieta. La diabetes requiere un cuidadoso equilibrio de los alimentos con el fin de mantener una buena salud. Algunas enfermedades del corazón requieren un límite estricto de sal (sodio) en la ingesta de alimentos más ingesta de niveles de colesterol reducidos. A veces los problemas de riñón o hígado requieren una dieta compleja cuidadosamente controlada.

Hay tres tipos generales de dietas complejas modificadas. Ellos pueden ser:

• medido o pesado cuidadosamente a fin de controlar cantidades de los diversos nutrientes, tales como en una dieta para diabéticos

• dos o más modificaciones sencillas combinadas, como una dieta alta en  proteínas /baja en sal

• una dieta simple modificada con un suplemento añadido para la alimentación adicional

Unit F English



In this unit, you will review routine skin care. You will learn what is meant by special skin care. You will learn that your attitude toward assisting with special skin care is important. Your role in
assisting with special skin care will be discussed. Two specific skin conditions, stasis dermatitis and decubitus, will be described. Measures you can take to prevent these conditions will be discussed. You will learn what to observe, record and report when assisting with special skin care.


The skin is the outer covering of the body. It consists of hair, nails, oil and sweat glands and mucous membranes. The skin has two layers. The outer layer is constantly shedding and replacing itself. The inner layer is thicker and contains blood vessels, nerves and nerve endings. Hair follicles (roots), and sweat and oil glands are in this layer of the skin.

Normal skin is warm, smooth, slightly oily and elastic (if gently pinched it will return quickly to its original shape). Skin color varies from person to person.

The skin serves many purposes.

•  protects the body from infection and injury
•  eliminates body wastes through perspiration
•  insulates the body from heat and cold
•  senses heat, cold, pain and pressure

When the skin is injured, it cannot serve its disease-producing organisms to enter the body. To protect the skin from injury, it must be kept clean, dry and lubricated.

Routine skin care is important in preventing injury to the skin. Routine skin care includes all activities normally performed on a regular basis to maintain the skin in good condition. Routine skin care may include assisting the client with:
•  bathing
•  showering
•  giving a back rub
•  fingernail care
•  toileting
•  hair care
•  changing position
•  applying cream or lotion

Bathing keeps the dirt out of the pores of the skin and removes dust, bacteria and substances that cause allergic reactions. It is the time to note any danger signals such as rashes, infected areas, bruises, or cuts on the skin surface.

Certain non-prescription products are used, such as lotions, creams and oils, to lubricate the skin and help keep it moist.

Proper nutrition is important to routine skin care. The color and texture of the skin depend a great deal on good, nourishing food.

Obese clients may have skin that has lost its elastic nature or they may have poor circulation. They may have folds of skin. Cleaning under these folds may be very difficult and the skin may show signs of irritation. Elderly or frail clients have thin skin that may be very dry. These characteristics make the skin easy to injure. Gentle handling must be used to care for these clients.

Very thin clients may have poor nutrition. This often means their skin is thin and easily injured. Gentle handling is important for these clients.

Observing, recording and reporting are also part of routine skin care. When observation skills are used, danger signs of skin breakdown can be recorded and reported early. Skin can be treated promptly and breakdown can be prevented.

Proper hand washing technique is an important factor to consider when assisting with routine skin care. Hand washing helps protect you and your clients from infections or diseases that can be spread by germs carried on the hands.


Special skin care includes activities performed as needed to protect a wound or to prevent skin problems from occurring. For example, the skin may have to be washed with a special soap, or
a scrub brush may have to be used.

Special skin care is only done on a stable skin surface. A stable skin surface may have a wound but the wound is not open, infected or draining.


The attitude you have toward a client or toward assisting with special skin care is just as important as your skill at performing the task. When you demonstrate a positive attitude toward assisting with special skin care, you improve the client's outlook. It comforts a client to know there is someone to assist who has a caring attitude.

Always attempt to provide as much privacy as possible when assisting the client with special skin care. You should make the client as comfortable as possible. Be sure linens are free from wrinkles. Use support equipment such as sheepskins or cushions.



As part of your role in assisting with special skin care, you should know the activities you are allowed to do. These activities are only to be performed if they appear on the client's Care Plan.

•  assemble necessary equipment and supplies
•  position client
•  apply prescription and/or non-prescription topical medications to stable skin surface
•  clean reusable equipment
•  store reusable supplies
•  observe, record and report

As part of your role in assisting a client with special skin care, you should know the activities you are allowed to do under special circumstances only. These activities are only to be performed if they appear on the client's Care Plan and you have been shown how to do them by your supervising nurse when you are in the client's home.

Dos, Special Circumstances Only  
•  cut nails

You should also know the activities you are not allowed to do.

•  apply prescription and/or non-prescription topical medications to unstable skin surface


Stasis Dermatitis
One type of skin condition you may encounter in home care is stasis dermatitis. Stasis dermatitis occurs mostly on the lower leg and is usually caused by a problem in circulation. The early signs of a stasis dermatitis may be a rash or a scaly, red area or itching. Stasis dermatitis can occur and continue for many years without affecting the surrounding skin or it can become more severe and become an open wound. Stasis dermatitis is the first step in a severe skin condition that leads to a stasis ulcer or open wound.

Stasis dermatitis is common in the elderly and may be due to:
•  tight stockings
•  tight shoes
•  casts
•  braces
•  splints
•  injuries

Unidad F Espanol


En esta unidad, repasarás el cuidado rutinario de la piel. Aprenderás lo que significa el cuidado especial de la piel. Aprenderás que tu actitud hacia la asistencia con el cuidado especial de la piel es importante. Se discutirá tu rol en ayudar con el cuidado especial de la piel. Se describirán dos condiciones de la piel específicas, dermatitis por estasis y decúbito. Se discutirán las medidas que puedes tomar para prevenir estas condiciones. Aprenderás qué debes observar, registrar e informar alayudar con el cuidado especial de la piel.


REPASO DEL CUIDADO RUTINARIO DE LA PIEL                                                                              

La piel es la cubierta exterior del cuerpo. Consiste en el cabello, las uñas, las glándulas sebáceas y sudoríparas y las membranas mucosas. La piel tiene dos capas. La capa exterior está constantemente exfoliando y sustituyéndose a sí misma. La capa interior es más gruesa y contiene vasos sanguíneos, nervios y terminaciones nerviosas. Los folículos pilosos (raíces), y las glándulas sudoríparas y sebáceas se encuentran en esta capa de la piel.

La piel normal es cálida, suave, ligeramente aceitosa y elástica (si se pellizca suavemente volverá rápidamente a su forma original). El color de la piel varía de persona a persona.

La piel sirve para muchos propósitos. La piel:

• protege al cuerpo de las infecciones y lesiones

• elimina los desechos del cuerpo a través de la transpiración

• aísla el cuerpo del calor y de frío

• detecta calor, el frío, el dolor y la presión

Cuando la piel se lesiona, no puede servir a sus muchos propósitos. Las lesiones en la piel destruyen su naturaleza protectora y proporcionan aberturas para que organismos productores de enfermedades entren en el cuerpo. Para proteger la piel de lesión, se debe mantener limpia, seca y lubricada.

El cuidado rutinario de la piel es importante en la prevención de lesiones en la piel. El cuidado rutinario de la piel incluye todas las actividades normalmente realizadas  regularmente para mantener la piel en buenestado. El cuidado rutinario de la piel puede incluir asistir al cliente con:

• bañarse

• ducharse

• darle un masaje en la espalda

• cuidado de las uñas

• acicalamiento

• cuidado del cabello

• cambiarse de posición

• aplicación de crema o loción

Bañarse evita la suciedad en los poros de la piel y elimina el polvo, bacterias y sustancias que causen reacciones alérgicas. Es el momento para observar cualquier señal de peligro, tales como erupciones, áreas infectadas, contusiones o cortes en la superficie de la piel.

Ciertos productos de venta sin receta se utilizan, tales como lociones, cremas y aceites, para lubricar la piel y ayudar a mantenerla húmeda.

Una nutrición adecuada es importante para el cuidado rutinario de la piel. El color y la textura de la piel dependen en gran medida de comida buena y nutritiva.

Los/las clientes obesos pueden tener piel que ha perdido su carácter elástico o pueden tener una mala circulación. Pueden tener pliegues en la piel. Limpiar debajo de estos pliegues puede ser muy difícil y la piel puede mostrar signos de irritación. Los clientes de edades avanzadas o débiles tienen la piel finita que puede ser muy seco.Estas características hacen que la piel sea fácil de lesionar. Debes usar un manejo suave  utilizado para atender a estos clientes.

Los/las clientes muy delgados pueden sufrir de una nutrición pobre. Esto significa que su piel muchas veces es finita y fácil de lesionar. El manejo suave es importante para estos/estas clientes. 

La observación, el registro y la presentación de informes son también  parte del cuidado rutinario de rutina de la piel. Cuando se usan las habilidades de observación, las señales de peligro de ruptura de la piel se pueden grabar y reportaron temprano. La piel puede ser tratada con prontitud y el deterioro se puede prevenir.

Unit H English



The beginning of this unit gives an overview of ostomies. You will learn what an ostomy is and why an ostomy may be formed. You also will begin to understand your own and your client's feelings about an ostomy and ostomy care.

Following the overview, four specific ostomies are explained in detail. Ileostomy and colostomy are discussed together because they are similar. Gastrostomy and tracheostomy are discussed also.



An ostomy is a surgically formed opening in the body. Each ostomy is formed for a different purpose. Usually it is done because the client has a disease (such as cancer), an illness that interferes with the normal functioning of a part of the body or an injury.

Each ostomy functions in a particular manner that will determine the care the client requires and the equipment that is used.

Included in the discussion of each type of ostomy is a description of the ostomy, why it is usually done, the effect the ostomy has on the functioning of the body and the feelings of the client, the specific equipment that may be required to care for the ostomy and the care the ostomy client may require. In addition, your role in relation to each type of ostomy is explained. Problems you should observe, record and report are included.    


There are many types of ostomies. This unit will discuss four types of ostomies.

They are:
•  ileostomy – a surgically formed opening in the small intestine
•  colostomy – a surgically formed opening in the large intestine
•  gastrostomy – a surgically formed opening in the stomach and through the abdominal wall
•  tracheostomy – a surgically formed opening in the windpipe (trachea)

Each of these types will be described and discussed in more detail.


Your role in assisting the client with ostomy care will depend on the type of ostomy the client has. Many of the tasks you will perform for clients with different types of ostomies will be similar, even though the location and functioning of the ostomies may be quite different.

When you are assigned to assist a client who has an ostomy, the ostomy will always be mature and stable. This means that the ostomy is not new and is not changing. The client will have acquired a certain technique and routine for managing the ostomy. The client also will have selected the equipment or accessories that work best.

Often a client experiences better health and well-being after ostomy surgery than he or she had before. However, all clients will need to make adjustments. For some clients, these adjustments to ostomy care may be hard to make.

A client might be concerned about what a spouse or friends will think about the ostomy, especially when an appliance is worn.

Some clients even show concern about their diets. They may be hesitant to eat the foods they enjoy. Clients often have concerns about the possibility of the appliance leaking or having an offensive odor. In time, most clients usually work through their concerns as they adjust to their ostomies.

A client's psychological adjustment to an ostomy refers to his or her attitude or feelings about the ostomy. The attitude a client has about the ostomy will have an effect on the client's ability
to be as independent as possible. Any adjustment takes time. You should report your observations to your supervising nurse.

Report such things as:

•  language (verbal and non-verbal)
•  interest in personal appearance
•  willingness to do ostomy care
•  attitude toward socializing with others

Here are some questions you can think about when trying to determine how the client is adjusting.

Does the client:
•  follow a regular routine for ostomy care?
•  take an interest in how the equipment is functioning?
•  have to be prompted to do ostomy care?


One of the functions of your role, as you work with clients, is to give emotional support. You may find that when assisting a client you may need some reassurance. Why? You are facing a very new and different responsibility. Sometimes it is difficult to put your feelings into words. Be conscious of the tone of voice used, your facial expression and the manner in which you assist
a client. Your verbal and non-verbal expressions should relay the same caring and helpful message. Whenever you feel you need clarification about any part of ostomy care, seek the advice of your supervising nurse. You can also talk to your Supervisor about how you feel about ostomy care. You want to demonstrate an accepting attitude. Remember that the clients you will be assisting have had time to deal with their feelings. You may also need time to deal with your feelings.


Ileostomy and colostomy will be discussed together because the care involved and your role will be very similar.

An ileostomy is a surgically formed opening in the small intestine. It usually is done because the client has a disease that has permanently damaged most or all of the large and/or small
intestine and prevents it from working the way it should. The entire large intestine may be surgically removed.

A colostomy is a surgically formed opening in the large intestine. It usually is done because the client has a disease or other problem in a part of the large intestine. A section of the large intestine that is diseased or injured must be surgically removed.


When food is taken into the  mouth, it is chewed, swallowed and goes through a tube-like structure called the esophagus into the stomach. In the stomach the food changes as it mixes with special digestive juices.

The mixture then goes into the small intestine which is a very long tube coiled upon itself and has several different sections. The food mixes with different digestive juices in the small
intestine. In addition, the nutrients from the food pass through the wall of the small intestine into the blood stream and are carried to different parts of the body where they are needed for

The food mixture then goes into the large intestine. This is also tube-like in shape but it is not as long as the small intestine and it is bigger around. The large intestine also has several
sections. The main purpose of the large intestine is to remove water from the food mixture and return it to the body. When the mixture first enters the large intestine it is very liquid. By the time it reaches the rectum (the end of the large intestine), the mixture is formed into the consistency we know as stool.

Stool is stored in the rectum until the person has the urge to move the bowels. It then goes through the anus, which is the opening between the buttocks through which stool passes, to the outside of the body.

Unidad H Espanol


El comienzo de esta unidad ofrece una visión general de las ostomías. Aprenderás lo que es una ostomía y por qué se forma una ostomía. También comenzarás a entender tus sentimientos propios y los de tu cliente acerca de una ostomía y el cuidado de la ostomía.

Después de la información general, verás cuatro ostomías específicas que se explican en detalle. La ileostomía y colostomía se discuten juntas porque son similares. La gastrostomía y la traqueostomía se discuten también.



Una ostomía es una abertura formada quirúrgicamente en el cuerpo. Cada ostomía se forma para un propósito diferente. Por lo general, se hace debido a que el/la cliente tiene una enfermedad (como el cáncer), que interfiere con el funcionamiento normal de una parte del cuerpo o una lesión.

Cada ostomía funciona de una manera particular, que determinará el cuidado que el/la cliente requiere y el equipo que se utiliza.

Se incluye en la discusión de cada tipo de ostomía una descripción de la ostomía, por qué se hace por lo general, el efecto que la ostomía tiene sobre el funcionamiento del cuerpo y los sentimientos del cliente, el equipo específico que puede ser necesario para cuidar de la ostomía y el cuidado que el/la cliente con la ostomía pueda requerir. Además, se explica tu función en relación con cada tipo de ostomía. Se incluyen los problemas que debes observar, registrar e informar.


Hay varios tipos de ostomías. Esta unidad repasará cuatro tipos de ostomías. Ellas son:

• ileostomía – una abertura formada quirúrgicamente en el intestino delgado

• colostomía – una abertura formada quirúrgicamente en el intestino grueso

• gastrostomía – una abertura formada quirúrgicamente en el estómago y a través de la pared abdominal

• traqueostomía – una abertura formada quirúrgicamente en la tráquea (tráquea) Cada uno de estos tipos se describirá y se discutirá en más detalle.


Tu rol en ayudar al cliente con cuidado de una ostomía dependerá del tipo de ostomía que el/la cliente tenga. Muchas de las tareas que realizarás para clientes con diferentes tipos de ostomías serán similares, a pesar de que la ubicación y el funcionamiento de las ostomías pueden ser muy diferentes.

Cuando se te asigna para ayudar a un/a cliente que tiene una ostomía, la ostomía será siempre maduro y estable. Esto significa que la ostomía no es nueva y no está cambiando. El/la cliente habrá adquirido una cierta técnica y rutina para el manejo de la ostomía. El/lacliente también habrá seleccionado el equipo o accesorios que funcionan óptimamente.


A menudo, un/a cliente experimenta una mejor salud y bienestar después de la cirugía de ostomía delo tenía antes. Sin embargo, todos los/las clientes tendrán que hacer ajustes. Para algunos clientes, estos ajustes en el cuidado de una ostomía puede ser difícil de hacer.

Un/a cliente podría estar preocupado por lo que un cónyuge o amigos pensarán acerca de la ostomía, especialmente cuando se usa un aparato visiblemente.

Algunos clientes incluso muestran su preocupación acerca de sus dietas. Ellos pueden ser renuentes a comer los alimentos que les gustan. Los/las clientes a menudo tienen preocupaciones acerca de la posibilidad de la fuga en el aparato o de tener un olor desagradable. Con el tiempo, la mayoría de los/las clientes suelen resolver sus preocupaciones mientras se adaptan a sus ostomías.

El ajuste sicológico del cliente a una ostomía se refiere a su actitud o sentimientos hacia la ostomía. La actitud que tenga el/la cliente hacia la ostomía tendrá un efecto en la habilidad del cliente a hacerse lo más independiente posible. Cualquier ajuste toma tiempo. Debes informar tus observaciones a tu enfermera supervisora. Informa sobre cosas tal como:

  • lenguaje (verbal y no-verbal)

  • interés en su apariencia personal

  • la actitud hacia la socialización con otros.

Aquí hay algunas preguntas que tú puedes  tener en cuenta cuando se trata de determinar cómo el/la cliente se está ajustando.

¿El/la cliente:

• sigue una rutina regular de cuidado de la ostomía?

• toma interés en cómo el equipo está funcionando?

• tiene que ser impulsado a hacer el cuidado de la ostomía?


Una de las funciones de tu cargo, mientras trabajas con los/las clientes, es dar apoyo emocional. Puedes encontrar que al asistir a un/a cliente es posible que necesites un poco de consuelo. ¿Por qué? Tú estás enfrentando a una responsabilidad muy nueva y diferente. A veces es difícil de poner tus sentimientos en palabras. Sé consciente del tono de voz utilizado, tu expresión facial y la forma en que ayudas a un/a cliente. Tus expresiones verbales y no verbales deben transmitir el mismomensaje cariñoso y servicial.

Choose a chapter

  • Module VI English

  • Modulo VI Espanol

  • Module VIII English

  • Modulo VIII Espanol

  • Unit C English

  • Unidad C Espanol

  • Unit F English

  • Unidad F Espanol

  • Unit H English

  • Unidad H Espanol

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What’s Inside…

Volume One PCA Topics include:
• Introduction to Home Care
• Working Effectively with Home Care Clients
• Working with the Elderly
• Working with Children
• Working with the Mentally Ill
• Working with People with Developmental Disabilities
• Working with People with Physical Disabilities
• Food, Nutrition and Meal Preparation
• Family Spending and Budgeting
• Care of the Home and Personal Belongings
• Safety and Injury Prevention
• Personal Care Skills

Volume Two HHA Topics include:
• Orientation to Health Related Tasks
• Performing Simple Measurements and Tests
• Assisting with the Preparation of Complex
  Modified Diets
• Assisting with a Prescribed Exercise Program
• Assisting with the Use of Prescribed Medical Equipment,   Supplies and Devices
• Assisting with Special Skin Care
• Assisting with a Dressing Change
• Assisting with Ostomy Care

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Our Clients and Testimonials

A partial list of agencies that have used our books:



• Able Health Care Services, Merrick, NY

• Aides At Home, Hicksville, NY

• Allen Health Care Services, Forest Hills, NY

• All Metro Health Care, Lynbrook, NY

• Beacon Healthcare School, Brooklyn, NY

• Family Home Health Care, Tarrytown, NY

• Jzanus Home Care, Floral Park, NY

• MetCouncil, New York, NY

• People Care, New York, NY

• Personal Touch Home Care, Jamaica, NY

• Premier Home Health Services, White Plains, NY

• Robynwood Home for Adults, Oneonta, NY

• Progressive Home Health Services, New York, NY

• Self Help Community Services, New York, NY

• Special Touch Home Care Services, Brooklyn, NY

• Summit Home Health Care, Brooklyn, NY

• Unlimited Care, White Plains, NY

• Utopia Home Care, Kings Park, NY

• VIP Health Care Services, Richmond Hill, NY

and many more!

Finally a book in Spanish that makes teaching our Spanish-speaking students effortless!

Thank you, Select, for translating your English books. Having a complete Spanish textbook is long overdue.

These are the only books that follow the flow of the NYS curriculum. Our teachers prefer them over any other books out there.

Having identical English and Spanish manuals has made training so much easier for both our trainers and students.

They’re so affordable that we can easily give them away to our students. With all the cutbacks we’re facing these days, this is such a huge savings for our company.

So much supplemental information, illustrations, and charts in addition to the required material. Really a great value for the price.

Students are testing better than they have with other books we’ve used in the past.

The students love these books. Very easy to follow and they don’t have to flip back and forth to find the material we’re discussing.

To Place an Order

All information is required to fulfill your order

Company Name
Your Name
Phone #

First Location

# of PCA Books

# of HHA Books

Class Start Date (00/00/00)

Ship to:

Second Location(Optional)

# of PCA Books

# of HHA Books

Class Start Date (00/00/00)

Ship to:

Third Location(Optional)

# of PCA Books

# of HHA Books

Class Start Date (00/00/00)

Ship to:

Any Questions or Instructions

Free Trial Offer

We're very excited about being able to offer you the first complete, translated Spanish textbook for New Yorkʼs home health care industry. For those agencies who are already training in Spanish, as well as those who have been reluctant to do so without an approved textbook, we'd like to make the following offer.

Let us send you samples of our English and/or Spanish books for your review.
If you like them, we'll then provide you with twenty sets of books,
FREE OF CHARGE, for your next training class. We'll only bill you upon completion of the class. If you find that you prefer your old books, just return ours in the same condition that you received them in, no questions asked. We’re so sure that your teachers and students will see the benefits, as well as the savings, of using our books that we can make this offer to you with total confidence.

Just give us a call at 516-377-4949 and let us know where to send the books.


Questions regarding our books?

Contact us