DOCUMENT 9

I-CAN v6 Workshop 2

Cohort Focus: Person with physical disability

Domain Focus: Mobility / Physical Health

ndis.gov.au | 1

Acknowledgement of Country

Before we begin, I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. I pay my respects to their Elders, past present and emerging.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

Accessibility

There will be questions and answers at the end
Raise your hand if you have any questions
Live Captions are available
An accessible recording will be made available

Housekeeping

Keep yourself on mute unless speaking
Raise hand it wish to speak
Cameras, turn them on when speaking and introduce yourself.
Phones, put on silent, take calls if an emergency
Should you have any connection issues, log out and rejoin meeting
We will have a 10-minute break halfway through the workshop
Look after yourself, write ‘be right back’ (BRB) in the chat.

Agenda

Welcome and objectives
Key component of the I-CAN
I-CAN Statements and Scoring
How to describe supports for people with progressive or fluctuating disabilities
Case Study Introduction - Person with physical disability
- Practice writing I-CAN statement
- Practice sessions around scoring I-CAN statements
Considerations for completing an I-CAN via telehealth
Questions and Answers

Learning Objectives

By the end of this session, participants will be able to:

Explain the key components and purpose of the I-CAN
Develop skills in writing strengths-based I-CAN statements
Apply the scoring system accurately across domains
Analyse a case study involving physical disability to determine appropriate support needs
Accurately document support needs in the I-CAN report for people with progressive or fluctuating disabilities
Understand the key strategies for completing I-CAN assessments via telehealth

Welcome and Introductions

Introductions
Pre-workshop documents
- Case Study: Tom Thomas – About Me, I-CAN Scoring Activity
- I-CAN v6 Scoring Manual
- I-CAN v6 Scoring System
- Allied Health Professions Australia - Telehealth Guide for Allied Health Professionals & Checklists for Clients and Clinicians

The Core of the I-CAN

The success of the I-CAN relies on the use of the strengths-based statements.
The ‘I-CAN formula’ is key for producing strong, clear, strength-based statements.
As your confidence grows, the structure will become more natural, and you may not need to use the formula word-for-word – but the same principles still guide your writing.

I-CAN Formula re-cap

(name) can (do what) with (this type of support)

For example:

John can take his regular medication when his support staff put his pills out with a glass of water with his breakfast and dinner.

Describe - I-CAN statements

Using the ‘I-CAN’ formula:

Simon can make a hot drink when the tipping kettle has been filled to hold 1.5 cups of water by a carer and the items Simon needs are left in a position that Simon can reach.
Omar can take his dog for a walk when he a carer puts the dog on the lead and hands the lead to Omar. He can manage when the carer accompanies Omar and assists Omar to care for his dog when out in the community, and takes the dog off the lead and places him in the backyard on their return.
Lily can shower every morning in her accessible bathroom, when she is seated in her shower commode chair, all the items she needs are positioned within reach and when a carer washes the areas of her body that she is unable to reach.

I-CAN Scoring Steps

DESCRIBE
IDENTIFY
SCORE

Scoring: Frequency of Supports

Frequency of Support

Score	Frequency	Description
0	Never	No support is required
1	Occasionally	Less than once per week
2	Weekly	1-6 times per week
3	Daily	1-3 times per day
4	Frequently	4 or more times per day
5	Continuously	Consistently throughout the day

Scoring: type of support

Score	Type	Description
0	Not Applicable	The described support need has been scored elsewhere in the I-CAN, or the domain is not relevant at the time of assessment.
0	Independent	The person does not need any support.
1	Managed Independence	This support need is managed through the independent use of aids or equipment e.g. wheelchair, hearing aids, glasses, communication device or a simple strategy such as independently using a checklist or phone reminders.
2	Minor	The person may need brief or minor support from another person, for example simple first aid, giving a brief prompt or word of reassurance, minor setup or occasional supervision or mentoring, monitoring for signs of discomfort, or brief physical assistance for a minor aspect of the task.
3	Moderate	The person may need a series of prompts or instructions, reassurance or emotional support or more regular supervision, interpreting or clarifying communication for an unfamiliar communication partner, or physical assistance for some aspects of the task.
4	Extensive	The person needs extensive support for the majority of or for the entire task, such as hand over hand support, extensive emotional support, intensive communication support including speaking on behalf of the person, input or assessment by health care professional, or close supervision/monitoring. Alternatively, this task is completed wholly for the person, for example external financial management or guardianship.
5	Pervasive	The person needs the direct simultaneous support of two or more people, such as a 2:1 hoist transfer or 2:1 response to behaviours of concern such as administering PRN.

I-CAN Scoring- things to remember

Score the highest cumulative support
Duplicate scoring
Never/not applicable
Scoring of goals – making sure the goal has a support need to score

Activity 1 – Scoring I-CAN statements and goals

Review and score the 6 I-CAN statements and goals on the next 2 slides
Use the I-CAN v6 Scoring Manual – use as a reference for scoring
- What is the Frequency of Support?
- What is the Type of Support?
You have 10 minutes and then we will review as a group

I-CAN Scoring

Score the following I-CAN statements:

Transfers & Positioning: Emma can transfer between her bed and her wheelchair, and between her wheelchair and the toilet, and her wheelchair and her tilt tub water chair, with the support of two support workers and a hoist. Emma transfers at least 6 times a day.
Transfers & Positioning: Sam can manage all transfers with the use of rails, arm rests. He can transfer on/off his bed, shower chair, utility chair, toilet, lift recline chair and into/out of a vehicle.
Walking & Moving: Pete can use his wheelchair to move around the home environment, using his feet to self-propel. He can access the community 4 times per week when staff propel his wheelchair.

I-CAN Scoring

Score the following I-CAN goals:

Community, social & civic life: Tom to be able to use his iPad to activate his TV and choose what to watch. Tom to be assessed by an Occupational Therapist to review his technology options to control his TV.
Mobility Goal: Mia will work with her physiotherapist each week to improve her safe mobility and community access by increasing her lower limb strength, enhancing balance, and reducing her risk of falls.
Physical Health Goal: Olivia would like to maintain good hydration and nutrition to support her skin integrity and assist with her pressure injury management. Olivia to be assessed by a dietitian every 6 months, with a personalised Nutrition Plan developed and implemented by Olivia and her support workers.

Fluctuating or progressive conditions

Describe what changes, how often, and how long support needs fluctuate.
Note episodic patterns (days/weeks/months) in the subdomain.
Outline all supports used during different phases.
Estimate how much of the year each support is required.
Score based on the highest cumulative support need.
Document short-term higher support needs in the description.
For progressive conditions, note recent changes and expected future needs.

Fluctuating condition – Example I-CAN Statement

Dave can mobilise safely with his 4 wheeled walker with regular supervision to ensure his safety. During winter and times of illness, his mobility may temporarily reduce, and he can mobilise with support using an attendant-propelled wheelchair. These episodic periods typically last for approximately 1-2 months, after which Dave is usually able to return to his baseline mobility once his health improves or the weather becomes warmer.

Progressive conditions – Example I-CAN Statement

Sam can manage soft, minced foods and thickened fluids safely with supervision and support from his carers, who assist with pacing, safe-swallow strategies, and monitoring for signs of fatigue. During periods of deterioration, Sam can maintain his intake with increased support, including spoon-feeding, additional time, closer supervision, and assistance to reduce aspiration risk, as well as supplements to support his nutritional needs. These episodes are occurring more frequently, 2-3 times per week, and his Speech Pathologist, Jenny Smith, has indicated that he is likely to require more intensive support over time, including possible transition to alternative feeding methods.

Case study: Physical Disability Support Needs

Tom is a 53-year-old man with a spinal cord injury at level C6/7 result in quadriplegia and other health related conditions. He lives in Sydney with his wife, Maisie, and their dog, Buddy. Tom has two adult children. Daniel, who lives in Newcastle, and Sophie, who lives in Launceston, and he maintains regular contact with both.

Tom enjoys a range of community activities, including going to the movies, doing the grocery shopping, and socialising with friends and family. He is an avid sports fan, following the Sydney Swans in the AFL and the Cronulla Sharks in the NRL. On Sunday mornings, he likes to listen to Macca on the radio and often tunes into The Conversation Hour during the week.

Activity 2 – I-CAN Statement

You have 5 minutes to re-write this into an I-CAN statement using the I-CAN formula:

Tom is unable to eat independently due to reduced hand function and fatigue. He requires lightweight cutlery and can only drink from straw. Carers need to place the cutlery and his thermal insulated mug in his hand as he can’t do this independently.

Once completed, feel free to post in the Teams chat function or you can you feedback to the group.

Activity 3 – I-CAN Scoring

Work in groups of 5-6 people to score the subdomains for Tom:
- Groups 1-2: Mobility Domain
- Groups 3-4: Community, Social & Civic Life Domain
- Groups 5-6: Physical Health Domain
These domains were provided in the pre-workshop materials
Use the I-CAN v6 Scoring Manual – use as a reference for scoring
You have 15 minutes to score and report back to the group

Telehealth assessments

Key considerations:

How to engage with your participant via telehealth
Ensure your participant has the technology and appropriate supports for the assessment
Check your technology prior to assessment, and have a plan if technology fails
Allow for breaks and have regular check-ins.

Questions and Answers

ASK YOUR QUESTIONS | SHARE YOUR INSIGHTS | DISCUSS ANY CHALLENGES