Person-centred care Flashcards
What are the aims of person-centred care?
Describe the best way to look after people with dementia. Person-centred care aims to help people with dementia live better lives, despite their limitations, and make their experiences less distressing.
What are the 4 elements of patient-centred care?
- Valuing the person
- Providing individualised care
- Trying to see things from the individuals perspective
- Enhancing the social and emotional environment
What does valuing the person with dementia involve?
This involves respecting the individual by promoting their rights and entitlements as citizens regardless of age or cognitive impairment and rooting out discriminatory practice.
What does providing individualised care involve?
Providing individualised care means making the health care fit the person, rather than making the person fit the rules and procedures of the health care organisation. This means taking into account the patient’s physical and mental health, retained abilities and disabilities, personality, biography, preferences and values.
What does trying to see things from the individuals perspective involve?
Trying to see things from the individual’s perspective means thinking about how our actions might make them feel. It is important to ask the person with dementia what they want and be prepared to negotiate to agree a compromise that’s acceptable to the person and the health care team.
What does enhancing the social and emotional environment mean?
Enhancing the social and emotional environment involves developing and using relationships to provide comfort, inclusion, occupation, attachment and to support the person’s identity or how they see themselves as a person. We need to be aware of how our responses to people with dementia might unintentionally neglect these things.
What are different factors necessary to address in individualising care for a patient (10)?
- Beliefs
- Distress factors
- Personality
- Life history
- Social situation
- Relationships
- Resources
- Support
- Routines
- Advance care plans
What do you need to take into account of when considering treatment options for a patient (3)?
- What is possible
- What is wanted
- What would have been wanted if the person with dementia could tell you
What is the most important thing about social environment for a patient?
Relationships
-need to feel comforted, have a sense of their own identity, feel attachment to others, have occupation and feel socially included.
To deal with patient’s perspectives, how do you deal with the following scenarios?
- Environments
- Hallucinations
- Aggression
- Feeling threatened
- Forgetfulness
- Environments:
- Help to orientate patients with large face clocks, orientation boards, signage and colour coding of bays. Try to keep noise and clutter to a minimum - Hallucinations
- If they say something untrue, do not deny it, respond to what they see as a reality and work out how to comfort or reassure - Aggression
- Deal with it in a non-confrontational way. They may be overwhelmed, if they do not understand, feel threatened or scared etc - Feeling threatened
- Strange people doing unfamiliar things can be seen as threatening, so introduce yourself and say what you are going to do and tak about it as you do it every time - Forgetfulness
- means things might be interpreted in terms of past memories
What are 3 aspects of communication?
- Means
- Means can be verbal, written, gestures, signs or body language. Further meaning is conveyed by speech volume, tone and fluency - Reasons
- There are four main reasons to communicate. These are expressing needs and wants, to share information, to develop social closeness and for respect. It is important not to limit communication to just the first two. - Opportunities
- Opportunities implies that there is someone to communicate with, that the person is included and allowed to take part in the conversation. We also need a shared language, desire to communicate, and an appropriate time and place.
Why do people with dementia have difficulty with their means of communication?
- Problems understanding
- Problems with memory
- Disorientation to time and place
- Problems with hearing, speech and vision
- English as a 2nd language
How do you create opportunities to communicate (3)?
- Try and incorporate conversation into daily care activities and encourage family and friends to visit the patient.
- Activities organised by volunteers or activities coordinators
- Social closeness can also be conveyed by non-verbal communication such as smiling, touch, eye contact and a calm and friendly tone of voice.
How can you improve communication with a patient with dementia (11)?
- Use touch, such as hand-holding to build relationships and to gain attention
- Make eye contact as much as possible
- Tone of voice can be more important than content, particularly when the person has severe demntia
- Try and avoid intense questioning, multiple choice qs or long lists of options
- Gain attention - use persons name, say who you are, what yoi are doing, before you do it and as you do it
- Speak at a normal rate but keep language simple
- Keep sentence short
- Check for understanding and repeat or re-phrase things that you can see the person has not understood
- Where appropriate, use props including gestures, pictures and writing
- Reduce distractions
- Don’t correct incorrect speech/facts, as it can lead to resentment and alienation
If a patient is agitated or distressed what hidden causes should you consider (6)?
- Pain
- Thirst
- Constipation
- Urinary retention
- Needing the toilet.
- Actively look for conditions likely to be painful such as a wound or arthritis
