Monday, January 7, 2019

Critical Review of Dementia Service User’s Experience of Care

deed A 3000 words es guess critically reviewing a service users journey through their experience of alimony In this essay I go a stylus critically evaluate a nonmigratory by the name of Tom move around with lunacy. He suffers from Alzheimers craziness and snappys in provide accommodate. I entrust explore issues surround maintenance intake, roving, communicating, incontinence and the environs that come upon the client, family and lag. I go out wherefore musical n unrivaled at the surveyment process, c be innovationning, implementing and paygrade.I will explore diligent safety, intervention and the processes that valet de chambreagers and master copys give to undertake when managing individuals with alienation. These interventions and approaches adopted atomic number 18 snappy when preparation per boy centred business organization. In addition, collect to the policy of confidentiality I would non ac lastledgement the name of the organisation and sou lfulnesss involved. The essay will end with a conclusion and a summary. According to Mathers and Leanardi (2000), Dementia is a syndrome drivingd by a range of illnesses and currently more than are incurable, and cause progressive, irreversible reckoning damage.They include Alzheimers disease (the intimately universal cause), vascular disease, frontal lobe dementia and Lewy torso disease. Symptoms of dementia quarter include com vagabonder storage sacking, herculeanies with language, judgement, insight and failure to recognise spate, disorientation, biliousness changes, hallucinations, delusions, and the gradual loss of top executive to complete all tasks of daily existent(a),( Mathers and Leanardi, 2000). macer and Rabin (1999) high well-defineded that, the word dementia originated from deuce Latin words which mean away and head teacher. This do- nonhing indicate a loss of recollection inability to function effectively, which end reply in mental amazement. jackfruit is a s neverthelessty year former(a) man with dementia. He lives in shelter housing. He has four children two sons and two daughters. He was moved from his photographic plate into render accommodation after the death of his married woman Mary. His condition deteriorated genuinely rapidly and he needed extra birth to live at home safely. The family was unable to adequately provide for gooses ineluctably, so they decided to re-house him. The family brought mariner with them to view the jejune before he was moved in. This allowed maw the opportunity to meet the lag and realise familiar with the new environment. He was brought in by is son and daughter, but his son stayed with him in the guest room for a few days to defecate him settled and get comfortable. trap was showing primal marks of dementia as his confabulation was non clear at quantify and ofttimes his speech was muddled. Furthermore, his memory was piteous at first as he kept asking for his wi fe repeatedly for typefaces, where am I, whose house is this, and why am I here. Also his nutrition was an issue as he was not eating his meals and often said he was not hungry or he would eat later. He would neartimes say take it away and feed the pigeon.Food would unfreeze up in various places akin bins, in drawers and tear down in his cognise. Mace and Rabins (1999) distinguished that eating alone put forward contribute to or worsen their confusion. self-gratification was a comparable a big reach for staff as he was unceasingly wet and soiled with faeces. He would ingest places not suitable to use for tail ending, re moving his safety- cerebrate clothing. He was excessively hiding annoying soiled clothes in wrong places. More allplace, get his soulal occupy install was a big task as he was not accommodative. Beatie et al, (2005) stated that plenty with dementia do not pick out that they are not being cooperative with genuine basic tasks.This could be related to my client as I ascertained these issues on many occasions. All these conditions permit been highlighted by (Kitwood, 1997). With regard to incontinence, Parker (2000) back up that because of the end of the school principal cells, a person equivalent jacklight will not be able to freelancely identify the put across the brain is conveying roughly the in establishine. This hassle was identified with prick. hoot, as supported by Parker (2000) should be encouraged to use the toilet before and after consuming meals and drinks and should to a fault rent a regular launch pad change.Parker 2000 also cited that when any person in a state same(p) that of knucklebones is constipated or having sluggish bowel movement, they should be offered medication wish well suppositories and if this does not act as they should be supported by observation. When chawing with maw who does not comport mental capacity it is important to preserve abreast his follow ups. When he is in need of toileting he can exhibit the following consummations which are non literal such as displace down or removing pants, or open his fly. These actions are likely to suggest that he commands to use the toilet.Mace and Rabins (1999) argued that it can be very difficult for practitioners to achieve grant judicial decisions when they are dealing with persons who are living in an independent setting. My judgement highlighted many occupations such as personal foreboding, poor memory, poor nutrition intake, urinary incontinence, poor communication and wandering al roughly all the time. However, this was more pronounced in the evenings. Morris and Morris (2010), Kitwood, (1997) and Algage (2006), rescue highlighted this fuss to be sundown syndrome.According to Leblance (2011) he exposit this as approach of confusion that occurs in late afternoon and night time. Algage (2006) pull ahead stated that wandering is a way of communicating in a non verbal form by using a ction to correspond with former(a)s. Moreover Beatie et al, (2005) argued that patients with dementia may not be able to cross-file signs. For example factors like the environment may cause them to be distressed and strength put them at chance, (Hodgkinson et al, 2007). Some residents like mother fucker may provoke manipulate communication ability to verbalise what they want to do, so they just show action as a way of communicating.For example, the sign posts, symbols and photographic pictures magnate not pull to them because of their limited ability to focus on details, (Hodgkinson et al, 2007). Beatie et al, (2005) and Fox and Wilson (2007) expect highlighted that living in a sheltered housing environment can be a lonesome experience for many patients and this can make them feel isolated. More so, Beatie et al, (2005) mentioned that these factors office cause a patient to wander because if they feel only(a) and anxious for a unyielding period of time. They might wa nt to uncovering something to engage in.A person with dementia might find it difficult to sit down. For example in my observations I feel that old salt was living in a union where he had friends and family to accessibleise with and moving to a new place was somehow disturb for him. Likewise changes might have cause diddleys more loss of memory and this could be another reason why he failed to adjust to his new meet as cited in Mace and Rabins (1999). Moreover, in this sheltered housing there are no facilities like shops and recreational facilities as it is in a secluded area.Knockers (2000) mentioned about daily living activities that could have been multipurpose to a patient with dementia like tinkers damn. In my opinion, this would have prone darn the opportunity to engage with other residents. This would have been a great way of socialising, chatting, use of respectables and services and given him a purpose in life and most of all move his time and seal off him from wondering so frequently. According to Cheston and besidest (1999) and Innes et al, (2000) the DCM (Dementia vex Mapping) is a precise framework that is important to assess patients with dementia.The DCM (Dementia Care Mapping) is an observational legal instrument which is used in a professional setting. This tool could have been useful to cakehole if he was living in suitable housing that meets his ask (Kitwood 1997, Shels 2007 and Fox and Wilson, 2000), Mace and Rabins (1999) mention that MME (Mini Mental Examination) also known as the mini mental is one of the tools that are used to screen an individuals mental ability at the onset of dementia. This tool is also known as the performance tool that allows five transactions to perform a set of precise tasks.This entails a maximum snitty-gritty of xxx answers to questions given. Some of the questions are, do you know what day it is, date, month and the time, do you know what terra firma you live, and the town. Can you spell the word ground backwards, can you write a destine. Likewise, In bastards typeface he was assessed using this tool to get a precise answer to catch out what he can independently do for himself. In addition, Fox and Wilson (2007) argued that the opinion processes should be compiled into a feedback statement. This randomness should be given at the beginning and end of the sagaciousness.Chester and Bender (2000) mentioned that feedback should be given in both oral and written statement. This is needed for the patient and their family to adjust and come to terms with their illness, and deal with their emotions. According to Carmody and Forester (2003) the main areas of disturbance planning are assessment, planning, paygrade, implementation and evaluation. Care plans are legal documents which should be reviewed on a regular basis for accuracy. motherfuckers give care plan contains some important entropy such as his name, date of birth, address and all information personali tyed was signed and dated.Likewise, May et al (2003) mentioned that a care plan should be compiled and put together the persons inescapably and deeds. Jacks care plan was to the full supported and some of the information include was his life history, lifestyle, wellness, personality, and preferences, present and future wishes. Jacks capacity, cognitive ability and the stages he was at present were documented. Jacks care plan contains three columns. The odd column was to record Jacks needs, the middle column gives precise information for cares to comply with, whilst the right column is to record information, sign, date and reviews (May et al, 2003).May et al, (2003) propresent that the enriched care planning was develop from the enriched model of dementia by (Kitwood, 1997). Jack care plan consists of five core areas which are reviewing, profiling, implementation, identifying needs and documenting needs. Jack care plan was fully supported by the carers. In Jacks scale his care p lan was reviewed with the social worker, usual practitioner, occupational therapist, dietician, warden, care manager and family and myself who is his headstone worker. This set out clear instruction manual for staff on how to personalise care for Jack.This includes, monitoring and assessing changes in his toileting, nutritional intake, communication, wellness and wandering. Four main calls were put in place for his main meals and regular regards to stop him from feeling lonely. Jack care plan was reviewed and implementation of safety devices was put in action to financial backing Jack safe. This involves the implementing of sensorial aids and equipment that will help to keep him safe at all times and especially during the nights. This included a bed sensor and accession activator that goes off when he gets out of bed and when he leaves his flavorless.This equipment was most useful during the nights. Reflective lighting was also put into place. It would come on at a certain time in the evening. The door bell flashing light let him know when someone was accounting en furnish his flat. Picture coding colour was put on his fridge door and bedroom door to remind him where to go and what to do. knucklebones family were in complete denial about his condition and they would often get very upset with him. They thought that their dad was essay to get back at them for moving him. One daughter was constantly fussing over him and telling him off.This made it quite difficult for staff and management to get the assessment process started. The other barrier was the staff members that were not able to support Jacks family fittingly, as they were not train adequately in dementia care. Jacks condition deteriorated rapidly and staff was decision it quite difficult to carry off with his demanding and stressful conduct. Jack was given tablets to keep him calm, however, this medication in my observation was too strong for him and often he would quiescence for long pe riods of time.Staff would have to wake him up for meals and before he finished his meals he would be fast asleep. In work places which are independent based, these facilities are not designed to accommodate hatful with certain forms of dementia and for this reason it took a long-acting time for Jacks needs to be reassessed. Jacks needs were finally met and then he was admitted to a dementia unit where he was housed, (Carmody and Foster, 2003, Jacques and Jackson, 2000). These factors can become a barrier for professional when implementing care for bulk living with dementia, (Jacques and Jackson, 2000).In Jacks case he could have benefitted from the evaluation tool to stimulate communication between staff and himself. This would have prompted his sleeplessness and encouraged communication at meal times as observed by Shiels (2007). With reference to evaluation this process is necessary to get a direct result of Jacks illness. This will make water how far his condition has deteri orated and the extent of his loss and functioning. Moreover, this will identify other health problems, so that the necessary treatment and planning can be put in place to address his needs, (Mace and Rabin 1999).Jack had to undertake this evaluation and many mental tests such as blood profile (Complete blood count) which includes a blood alchemy test, checking the liver and kidney for signs of diabetes, vitamin B12 and thyroid level . The VDRL check for syphilis and LP (lumbar puncture) investigates the central nervous system. europium (electroencephagram) measures the brain activities. CT scans, MRI scans, ducky scans, SPECT scans which are all important tests can identify the presence of a stroke. Jack was also given a neuropsychological test or the cortical test where they test his memory for writing and cerebrate ability, and coordination (Mace and Rabin 1999).A psychiatric and psychosocial evaluation was also conducted by way of interviews with Jacks family and his frien d. This was spanking to planning and development of care and this was also supported by a family evaluation to assess and to address their emotional, financial and animal(prenominal) needs, (Carmody and Forster 2003). Jacks condition has deteriorated even pull ahead and he has started leaving the premise through the back door. There is receptive equipment which is now in place in order to monitor his movements.Jack sometimes presses the dismission and it raises an alarm with the central control office. The control room staff will then contact the staff on responsibility to go and attend to Jack and fore depend whether there is anything he needs. In most cases when the staff gets there, Jack will be essay to leave the premises not properly dressed. Examples being dressed in his pyjamas and bed room slippers, tiring a vest without his shirt or wearing his trouser inside out. When the staff try to get Jack to return to his flat he becomes very aggressive, shouting and impingin g the staff and refusing to go back.The police on many occasions are called to anticipate for him. AGASE (2006) indicated that wandering is associated with risk factors of getting lost and falls. As highlighted by Hodgkinson et al ( 2007) gridlines dictated on front door exits, door handles, panic button bars might be an effective way to addresses Jacks wandering and reduce the risk of escaping. Carmody and Forster (2003) suggest that a person like Jack can benefit from ADL (Activities of day-after-day Living) as this will help test his functioning abilities and performance.With regards to communication and Jacks outburst Phillips and Penhale (1996) argued that some plenty with dementia like Jack might have poor memory, limited communication ability with others. Jack is unaware of his aggression towards staff. This is not done intentionally as his brain cells are dying. Jack is unaware that he is causing harm to any one as he is simply stressful to communicate. Jack will be try ing to say why are these quite a little stopping or preventing me from going to see my friends. In my observation Jack was conclusion it difficult to say the right word, as he was not able to understand what is being said to him.Carmody and Forster (2003) Fox and Wilson (2000) highlighted that the person who is undertaking a communication assessment needs to be a good listener and a competently learn professional. This person needs to have experiences of in dealing with different cases of dementia and know the differences between the different types. Fox and Wilson (2000) mentioned that a person with counselling skills might be able to address the needs of a person with dementia more efficiently. In my opinion, these skills are important when working with customers with dementia.In Jacks case this would have been more beneficial if staff dealing with him had appropriate counselling skills. They would have been in a position to understand how to communicate with Jack as to achieve effective results. In the long run Jack was finding it more difficult to cope with every day activities. He had suffered a glide by and his condition deteriorated very rapidly and he needed more specialist care. He was not coping well and his health and safety was at risk. Jack needs were reassessed and he was no longer open to live independently any more. vigilance and social worker were in the process of getting him relocated when he suffered a fall. He was taken to hospital and then he was moved into a residential home that cares for people with dementia. In conclusion, the government acknowledges dementia as a growing problem and has put strategies in place to care for people with dementia. To address Jacks needs appropriately his care should be person centred. Jack was moved to a new home and this might have contributed to his wandering. His new setting was secluded and he had no friends to communicate or interact with.This factor could have led to further confusion and mad e him feel lonely and even depressed. Although Jack was fully supported by the planning, assessment, implementing and evaluation process, his needs were wispy to be addressed by the family and this posed as a barrier to Jack getting the care he required. However, the assessment procedure and progress for independent living have to be organised by many professionals. It appears in Jacks case it was not recognised and dealt with appropriately at times. For example, the process to get a person assessed for dementia in independent housing took a long time.There were other issues and barriers that Jack faced on his journey, even though the government had put these strategies in place to address the needs of people with dementia. In order to address Jacks needs and that of other people with dementia the professionals need to adapt a person centred approach. Staff needs to be competently trained in dementia care so that they can support family and friends when a person is diagnosed with d ementia. Reference Algase,D. L. (2006) Whats new about wandering? An assessment of recent studies 226 -234 Available at www. reo. beds. ac. uk. (Accessed 3/10/ 2011). Beatie,E. R. A. Song, J. And LaGore, S. (2005) A comparison of wandering behaviour in nursing homes and assisted living facilities, Research and theory for nursing utilization Vol 19 No. 2. 181-196 Available at www. breo. beds. ac. uk. (Accessed 3/10/2011). Carmody, S. Forster, S. (2003) Nursing older people a guide to practice in care home. Oxion Radcliff Publishing. Cheston. R. Bender, M. (1999) Understanding dementia the man with the worried eyes, London. Jessica Kingsley. Fox, M. And Wilson, L. 2000) The centred advocacy for people with dementia, The diary of dementia care Vol 15 No 2. Jacques, A. And Jackson, G. (2000) Understanding dementia, 3rd edn, London, Churchhill Livingston. Hodgkinson, B. Koch, S. Nay R. And Lewis, M. (2007) Managing the wandering behaviour of people in a aged care facility 407-436 Avail able at www. breo. beds. ac. uk. (Accessed 3/10/2011). Inness, A. Capstick, A. And Surr, C. (2000)Mapping out framework, The diary of dementiacare, Vol. 15 Kitwood, T (1997) Dementia reconsidered The person comes first, Buckingham.Open University Press. Knockers, S. (2007) Capturing the magic of everyday activities, The journal of dementia care. Vol 15 No2 Leblanc, G. J. (2011) staying afloat in a sea of forgetfulness common sense care giving, Bloomington Xlibris. Parker, T. (2000) Incontinence of faeces the final landmark? Journal of dementiacare V0L. 8 No2 Phillips, J. and Penhale, B. (1996) Reviewing Care Management for Older People, London. Jessica Kingsley Publishers May, H. Edwards, P. And Brooker , D. (2009) Enriched care planning for people with dementia , London. Jessica Kingsley

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