A Person Centred Approach
Person centred working is vital when planning, which is something that is ongoing when someone has dementia due to the constant changing nature of the condition. When planning, the following person centred working strategies should always be employed:
- Valuing the relationship between planning and services.
- The importance of relationships and interactions between all involved.
- Identifying actions to be carried out.
- Resolving issues.
- Assessing the cost and use of resources.
The overriding aspect to all of these principles is that person centred planning should involve the individual and, where appropriate, their carers as much as they are possibly able to contribute. Any kind of care and support should be tailored and delivered in line with the individuals preferences and wishes so that their perspective is respected and they are treated with care, empathy and dignity throughout the process.
How To Listen To Someone Living With Dementia
It is important to learn how to listen to someone with dementia, keeping close attention to their body language too.
- Listen carefully to every word and try to encourage someone to speak.
- If you cant understand what the individual is saying, tell them what you think you have understood and gauge if this is correct by their body language.
- Enable the individual to have a lot of time to respond.
- Enable individuals to express their feelings.
Use of body language and physical contact with someone who has dementia:
- Learn what the individual is trying to say through their body language.
- Make sure your words and facial expressions match.
- Use physical contact to provide reassurance, such as holding the individuals hand.
- Never stand too close to someone or stand over them if they are sitting.
What Should I Say To Someone Living With Dementia
It is important to know what to say to someone living with dementia, this way they wont get as confused or frustrated.
- Do not ask multiple questions one after the other.
- Stick to just one idea at a time.
- Make information manageable by breaking it down.
- Ask closed questions that can be answered with just yes or no when the individual is being asked to make a decision.
- Rephrase something rather than repeating it.
- Try not to contradict and correct someone who is confused about what is real and what isnt such as happens in later stages of dementia.
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Three Facts Worth Knowing
1. The person-centred approach was developed in the UK by Professor Thomas Kitwood, a pioneer in the field of dementia care in the 1980s and has since received worldwide recognition and praise.
2. Person-centred care has been shown in studies to reduce agitation and aggression in people with dementia.
3. Another study of person-centred care showed it significantly reduced the number of people with dementia needing hospital treatment or anti-psychotic medication both of which can be the result of aggressive behaviour.
Your Person Centred Checklist
If your loved one is in a nursing home you might want to check that theyre receiving the person-centred care they have a right to.Heres what to look out for to make sure their care plan is right for them.
1. Are they being treated with dignity and respect?
2. Do staff know their likes and dislikes, their favourite music, hobbies or when they like to take a bath?
3. Is their opinion and personality understood and taken into account?
4. Do they seem valued as a human being, regardless of their age or how advanced their illness is?
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Person Centred Care For Dementia Patients
Info: 3592 words Essay 24th Nov 2017 inHealth
This paper presents the different aspects of person-centred approach in the promotion of health to the elderly with dementia and other geriatric health conditions. The principles of individuality, rights, choice, privacy, independence, dignity, respect and autonomy are discussed. Impacts of equality, culture and diversity in the provision of person-centred approach are also presented within the scope of public health, health promotion, attitudes toward health and the demand for healthcare.
The non-person-centred approach namely institution perspective and bio-medical perspective are also reviewed. By gathering information through the internet, other approaches to the provision of healthcare to the elderly are also discussed and presented so as to give us a better view of the different approaches that facilities might be using and help us understand the structure of care available.
We are all unique in every way, although we may come from one cultural background and even from the same family, we possess our own set of traits that make up our identity. Similar yet different in many ways.
Regardless where life takes us, I believe that each and every one of us has the right to be respected and as we grow older, we continue to live life with dignity.
- Public Health and Health Promotion
- Attitudes to health and demand for healthcare
Knowing Watching And Understanding
here is a big difference in people with dementia it’s knowing, watching and understanding the parts of the illness and the different behaviours it’s just treating people with respect, with individuality.
moved slowly and deliberately but with confidence as she removed the blood-soaked dressing, washed the wound, and applied fresh bandages. She was also careful to tell me exactly what to do, and to point out the patient’s preferences e.g. she prefers not to wear the net knickers because they are too tight, she prefers to leave her upper body and feet uncovered by the sheet, etc.
One patient was so used to going to work, he still believes that he should be working, he doesn’t realise that he’s retired so he still gets up in the morning thinking he’s going to work and we’d say no, you’re not going to work so well, it was my idea actually, a rota where we give him a specific task to do and he did it and it did work So we try each day and see which mood he’s in, if he moans about his work we give him little jobs to do and if he don’t, then we leave it.
In this example, the carers attempted to redirect the confusion and frustration of the patient into an activity that would be productive and satisfying for him, although still within institutional parameters related to routines and responsibilities.
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Power Knowledge And Legitimacy
To examine how direct-care staff experience and engage with their own empowerment/ disempowerment in the dementia care context, we start with Foucault’s conceptualisation of power. Foucault suggests that power is both relational and productive: relational because it is present in all human relationships, whether amorous, institutional, or economic, and productive because, rather than merely repressing, it also produces or enables particular ways of being . Underpinning this conceptualisation is the essential connection between power and knowledge: there is no power relation without the correlative constitution of a field of knowledge, nor any knowledge that does not presuppose and constitute at the same time power relations . According to Foucault, power/knowledge constitutes both what we are as subjects and what we know as objects of knowledge. The task of analysis, therefore, is to focus not on how one person or group wields power over another, but by what tools, techniques, and technologies power relations work through and upon individuals .
What Is A Person
A person-centred approach is more of a vague term that isnt exclusive to care. It is an approach that can be used for many different sectors such as education, law, schools, universities, mental health facilities, care homes and many more establishments.
It follows the same values and principles as person-centred care, but simply follows different paths depending on the context it is in.
To get a better understanding, here are the outlines of this approach compared to a service/ system centred approach:
- Talking with the individual rather than about them
- Planning and brainstorming with the individual rather than doing it for them
- Procedures are put in place to support the individual rather than for the benefit of the service
- Focus is put on the abilities and skills of the individual rather than the labels, statistics and diagnosis.
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One Practical Method To Communicate Resident Preferences
Research conducted through Miami University in Ohio outlines a practical way to identify and communicate person-centered preferences. Researchers developed a tool called Preferences for Every Day Living Inventory there is a version for those living in the community and for those living in a facility. The PELI helps identify and rank the importance of personal preferences.
Once we know what’s important to someone, the next challenge is to communicate these preferences to those around the individual who is receiving care. The recommendation from the PELI team is to use a five-by-seven laminated card to clearly communicate the preferences of the person, including some fundamental information about his or her background, family, personality, work, and the types of activities enjoyed. This card can then travel with the person, such as on their walker or wheelchair, enabling others around her to quickly know some key information about this person.
Be certain to exclude HIPAA informationthat is, information that would violate the privacy and security of health information.
This certainly isn’t the only way to communicate personal preferences, but it does provide a usable tool to help honor the individual choices of those being cared for.
Approaches To Dementia Care
Quality care is very important especially to the people who suffer from diseases like the elderly. There are several geriatric health conditions that affect the lifestyle, day-to-day living, social and emotional, and spiritual aspects of their lives. Seniors who have dementia are entitled to be treated well. There are different approach that healthcare providers must know for them to become effective caregivers. In the same manner, patients expect to receive an appropriate care from their carers.
In this paper, with the best of my knowledge, I will discuss and explain the person-centred and non-person-centred approach to dementia, different techniques, and the impacts of equality, diversity and cultural issues, as well as the effects of legislation and policy on the person-centred approach for people with dementia.
Person-centred approach is a philosophy that acknowledges the unique characteristics of each individuals living in a rest home. The employees interact with the patients based on the personality, medical history and their values. Its main objective is to create partnerships between the staff, demented patients and their families which will give the best results and improve the quality of care and life for the unwell persons. This philosophy mainly focuses on the people rather than on the health condition, and on the individuals abilities and strengths rather than losses. There are eight principles of care involved in this approach, and these are the following:
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Staff To Family Communication
Caron et al found relatives of people with dementia sought involvement in care discussions, especially when the illness worsened, requiring medical intervention. However, McCarthy et al found 39% of relatives considered their questions did not receive in-depth answers staff preoccupation with daily routine tasks often interfered with such communication .
Exclusion Of Healthcare Assistants
From staff comments it is clear that some homes had strict role demarcation managers felt separate from nurses, and nurses felt separate from healthcare assistants. This is a potential source of conflict and such demarcation appears to limit valuablestaff to staff communication about residents care:
All respect to number 3 , but she doesnt work with us. We are on the floor 24-7 dealing with the residentsShe doesnt know what its really like .
Other homes had separate handovers for nurses and healthcare assistants. One healthcare assistant from a home where such handovers were the norm said that if she wanted to raise a concern about a residents health/behaviour, standard practice was to note it on a card index for the nurses to discuss. In one third of homes, handovers involved the senior on duty only.
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Research Design And Methods
Observations were recorded as brief jottings on shift and converted into full-length fieldnotes thereafter. Taking an inductive approach, the research team for the first study began by collaboratively analysing the fieldnotes and interview transcripts through line-by-line coding, then built these open codes into themes examples included routines, challenging behaviour, humour, and the team. for a more detailed discussion of this study’s methodology.) KS followed the same process to analyse the data-set from the second study. In developing this manuscript, KS and SB reanalysed both data-sets in order to draw out comparisons between them with regards to the issues of power, positioning, and individualised care.
Formal ethical approval was granted for the HCA study by the local Research Ethics Committee and for the care home study by the School of Sociology and Social Policy at the University of Nottingham and the research-governance committee of Forest Lodge.
Takes A Mind Body & Soul Approach
A holistic approach to care perceives the mind, body and soul as interconnected entities. In doing so, the caregiver will give equal attention to their loved ones emotional, mental and physical needs.
You can take a mind, body and soul approach by allowing your loved one to have a voice. In practice, youll involve them in decisions related to their life and health. You should also continue to show them respect and dignity no matter the state of their health.
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Data Synthesis And Analysis
All data analyses and syntheses were performed using comprehensive meta-analysis software, Version 3.0. The standardized mean difference was calculated with 95% conference interval , as the included studies used different measures in scoring outcomes. Additional subgroup analysis was performed to study heterogeneity between the studies using the I2 value. The included studies were divided into four subgroups on the basis of the following:
The severity of dementia in the study participants was determined using the mean mini mental state examination score. The severe dementia group had an MMSE score 10, and the less severe dementia group had an MMSE > 10.
The intervention type: staff training or culture change vs individualized activities.
The duration of the intervention: short term =10 days3 months long term => 3 months.
Tailoring Interventions And Environments For Long
Long-term care remains one of the biggest issues in dementia care, with some countries spending up to 4.3% of gross domestic product on this in 2014.16 For those people entering nursing homes however, it is the impact on their quality of life that is possibly of greatest concern.
Interventions or environments that encourage communication and provide opportunities for social interactions between residents or with caregivers may be of considerable value
Many people living with dementia find nursing homes to be lonely places, often lacking in meaningful friendships and supportive social relationships.17 In this respect, interventions or environments that encourage communication and provide opportunities for social interactions between residents or with caregivers may be of considerable value.
The environment in which we live is important for us all, and for those living with dementia, it can have a supportive or debilitating impact. A recent set of practice recommendations for delivering patient-centered long-term care highlights the need for community, courtesy, comfort, choice, and engagement.18 Moving from traditional medical models and hospital-like institutions towards smaller, home-like settings may meet these needs, and in doing so reduce agitation and cognitive decline and improve quality of life.
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The Key Points Of Person
- Treating the person with dignity and respect
- understanding their history, lifestyle, culture and preferences, including their likes, dislikes, hobbies and interests
- looking at situations from the point of view of the person with dementia
- providing opportunities for the person to have conversations and relationships with other people
- ensuring the person has the chance to try new things or take part in activities they enjoy.
Family, carers and the person with dementia should always be involved in developing a care plan based on person-centred care.
Their knowledge and understanding of the person is extremely valuable to make sure the care plan is right for them.
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How Important Is Compassion In Healthcare
It is hard to imagine healthcare without a focus on compassion, but of course we are all aware of care situations that seem to lack compassion.
It is hard to imagine healthcare without a focus on compassion, but of course we are all aware of care situations that seem to lack compassion. However we shouldnt objectify compassion in a way that somehow privileges it over other values such as dignity, respect, kindness and love.
These principles are equally important to compassion and indeed all of them are necessary for care to be person-centred. However, I get concerned these days when compassion seems to be used as a catch-all for everything that is good care almost a replacement for other principles .
A person-centred approach has compassion at its core. It focuses on cultivating a culture of care that tries to create as much happiness as possible for everyone. Increased happiness results in increased well-being. A person-centred culture enhances the well-being of everyone.
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Encourages Feelings Of Independence And Dignity
No-one wishes to feel imprisoned within their own body particularly those who are mentally or physically restricted. It can be all-too-common a feeling, though, for those whore less able and its by no means any more acceptable.
You can give a sense of independence and control back to your loved one by offering person-centred care. Wherever you can, encourage your loved one to venture outdoors. Additionally, you can try involving them in a new hobby such as knitting or gentle yoga. Be sure to relay the benefits of engaging in such practices, but make sure to respect their response.