Care Outside the Home
Name one reason you might escort a client outside the home.
Medical appointments, pick up prescriptions, grocery shop (only if in Care Plan).
What does ORR stand for?
Observe, Record, Report
What should you do when you first meet a client as a substitute?
Introduce yourself, explain you’re filling in, acknowledge the change.
How should you handle a delay when you have another client?
-Notify Service Support immediately – let them know the reason for delay and how late you expect to be.
-Call/text CS to report the situation and ask for guidance on next steps if needed.
Support your current client
-Stay calm and transparent
Your client feels dizzy during an errand — what’s the first thing you do?
Help them sit and check if they’re okay. Call MCToD if further guidance is needed.
Name 3 items on your outing checklist
-Client medical ID
-List of client conditions or medications
-Cell phone
-Water
-Clipper card
-Client cash/card for payment (co-pays, groceries, etc.)
What does objective mean when recording an observation?
Recorded observations are based on facts and evidence. We are only recording the facts!
True or False: You can add tasks if the client asks, even if not in the plan.
False.
How should you respond to an emergency when out with a client?
-Stay calm
-Ensure safety
-Call for help – 911 for immediate emergencies and MCToD or Service Support if unsure
-Communicate clearly
-Document what happened and report to CS
Client hasn’t eaten for 3 days but denies help — what do you record?
“Client refused food for 3 days.”
List 2 pros and 2 cons of using public transit with your client.
Pros: accessible, budget-friendly
Cons: Delays, crowding, having to stand
Name 3 reasons why ORR is important.
-Safety
-Quality of care
-Communication
-Legal and ethical compliance
Name 2 reasons a client might refuse care from you as a substitute provider.
-Lack of trust
-Trauma, paranoia, or confusion
-Change can feel threatening for clients with mental health/substance use issues
Urgent: non-violent delusions, refusing meds, hygiene decline. ORR to Care Supervisor.
Emergency: physical aggression, suicidal threats, overdose signs. Contact MCToD or Service Support if guidance is needed. Contact 911 if immediate danger to life or safety.
You get lost going to an appointment — who do you call?
Service Support
Name 2 questions you should ask yourself during a 5 second scan when outside the client's home.
-Where’s my client walking? – sidewalks, curbs, obstacles
-Who is nearby?
-What could make us stop or hurry?
-Is there a safe escape route?
-Do I feel “off”?
Name 2 substance use signs to ORR
-Slurred speech, unsteady walking, nodding off
-Finding paraphernalia
-Repeated bathroom visits, locked door
-Unusual secrecy or evasiveness
Why should you document a client refusing help?
Protects you, helps the team track patterns, keeps everyone safe.
If a client refuses help because you’re new as a substitute, what should you do?
Stay calm, reassure them, then call MCToD, SS, or CS if refusal continues.
Client wants to buy alcohol on an errand — should you help?
No; politely refuse and ORR to CS.
Name 3 tips for using language that respects dignity and promotes independence when escorting a client outside the home.
-Use person-first language
-Ask before helping
-Replace commands with choices
-Describe actions transparently
Name 3 behavioral changes to ORR
-Sudden mood changes – irritability, elation, sadness
-Increased isolation or refusal to engage
-Verbal aggression, threats, or pacing
-Talking to oneself, paranoia, or responding to unseen stimuli
-Changes in sleep, appetite, hygiene, or appearance
What’s the first thing you do if you feel unsafe as a substitute?
Leave if needed, get to safety, and call CS/Service Support.
List 3 reasons for when should you call SS or CS for clarification as a substitute provider?
-If a task feels unsafe or unclear
-If a client refuses care or you feel at risk
-If you find missing info that affects your visit
-Always document what you saw and who you called
What’s a respectful way to hold a boundary when a client pushes?
“I’d love to help, but I have to follow your Care Plan.”