I found it easier to sit beside Mrs D and use closed questions, as these invited a short, limited response.
I spoke slowly, and clearly, using plain language, repeating myself several times to make sure Mrs D understood me. I had to be non-judgemental, speak in an adult matter, and see past her disability.
It was important for me to remember ‘Simmons Roach’s ‘Principals of Caring’:
Because Mrs D has dementia, she becomes easily confused, and therefore I had to use non-verbal communication such as eye contact, facial expressions and gestures. I had to adopt a friendly rather than a defensive position, to make Mrs D feel at ease with me.
It was important for me to empathise rather than sympathise with Mrs D and appreciate her view on people and the world in general.
While talking to her I had to be careful not to upset her, although crying and emotional release seem to help her rather than hinder her.
One of the symptoms Mrs D suffers from is incontinence, because she forgets she needs to use the toilet. This is linked to her dementia.
She develops skin rashes if her pads are not changed frequently, or if her skin is not carefully washed after each episode of incontinence.
This incontinence causes Mrs D distress, as she is aware of what has happened after the event. She becomes upset and annoyed, and she requires reassurance and care.
The care assistants try to remind Mrs D to go to the toilet at certain times to prevent this upset to her.
Mrs D undergoes sympathetic, supportive nursing care in a homely environment, which offers her the best chance of maintaining what quality of life she has left.
Although Mrs D suffers physically and mentally, she still merits consideration, kindness and respect as a human being, and this care is given to her in this residential home.
When Mrs D entered the home, she was only suffering from mild confusion and was in the early stages of dementia.
Now that this condition, along with her incontinence has deteriorated, she is unable to communicate her needs to the staff, but as her carers have seen this progression, they know her very well, and this doesn’t cause a problem.
Had Mrs D been admitted into the home with advanced dementia, it would have been difficult to provide the type of care she needed, mainly because the staff would not know her. When Mrs D entered the home she was able to tell her carers of her interests, how she liked to dress and style her hair.
A written record was kept and now all staff can identify her wishes and can carry these out.
Mrs D is capable of dressing and feeding herself, but still has physical, emotional and intellectual needs to be met.
It is very important to review and monitor Mrs D’s care plan, for example in her care plan, she will become more incontinent if she forgets to go to the toilet.
Although the care manager may draw up the care plan, the care assistant may need to monitor daily any provision of service, and contact the care manager promptly if there are any problems with this.
The psychologist ‘Abraham Maslow’ formulated a theory to explain the motivation of human behaviour, which gives us yet greater depth of insight.
He stated that human beings have certain needs, which must be met if they are to achieve their full potential, and that their behaviour is driven by the necessity of meeting those needs.
He distinguished six levels of human need, ranging from those to satisfy basic physical functioning to those leading to complete self-fulfilment.
Maslow’s ‘Hierarchy of Need’
Some children’s attitudes to the elderly are positive but most are negative. It is not surprising that this attitude has developed, considering the images, which surround old age in western societies.
Elderly members of our society form an increasing proportion of the population, yet they remain largely on the periphery, unable in many cases to enjoy the benefits of a developed society to which they have all made contribution.
In the care home no prejudice or discrimination took place within view or hearing during my time there.
The attitude in the care home is the complete opposite of our society. Care workers, like myself will naturally take in first impressions from the posture, dress, manner and speech of a client.
But their professional training will have taught them the importance of self – knowledge, so that they will be aware of any stereo - types and prejudices they might hold, and so be able to keep an open mind.
I had to keep an open mind at all time and I also had to try and not let my emotions get involved which proved difficult. I had to be flexible, not get involved but I had to care for my own sake.
Teamwork is vital.
I was responsible along with the other care staff to treat Mrs D’s pressure sores. One of the care staff assessed the sore and planned the treatment and care. This included changing Mrs D’s position regularly. Mrs D’s pressure sore was covered with a protective dressing to keep the wound clean.
I enjoyed taking part in this clinical procedure.
I enjoyed my work-placement and taking part in a clinical procedure made it that little bit more exciting and made me feel like one of the staff.
I understood the importance of confidentiality was and abided by it as I knew it could destroy the relationship between the staff, the residents and I.
The thing I liked best about work – placement was the fact that Mr. B (the owner) didn’t make his staff wear a uniform as he felt it made the residents feel institutionalised.
I only think that there was one area for improving while on my work - placement. I felt that the resident’s were very bored during the day. They just slept.
I feel that if they had something to keep them occupied this would not be the case.
Other than that everything else was perfect.
VOCATIONAL PRACTICE
ASSIGNMENT NO. 3
CASE STUDY
CLAIRE ~ LOUISE MCNEILL
