To understand and practice the principles of care is very helpful. We care for the individuals, and support them at work. Supporting and caring includes understanding the rights of an individual and taking risk. It also includes the relationship between taking risk. To understand the relationship with the client, it’s very important to understand the principles involved.
- FOLLOWING ARE THE PRINCIPLES INVOLVED IN THE PERSON CENTERED APPROACH TO DEMENTIA-
Individuality- an individual person should never be assumed. And the organization should not except that the person is or have to fit in with anyone or with the organization. People should have their own right to make their own choices, they should be given right to think about themselves. Their likes and dislikes should always be kept in mind. What are the differences between the neighbours, and other people, should be understood. And if they have different ethnicity or religious beliefs, they should be respected.
Rights-the clients or residents in the care should always be allowed to enjoy the same rights. It’s not only when they are dependent on the carers but also when they are living their live independently. Every individual we look after or support can refuse the things they don’t want, or in other words they have the right to say no, the right to keep any relationship, the right to refuse their care. But it’s important to maintain the balance between their rights against their responsibilities.it is important to find the balance as it makes easier to find if they are at risk or not?
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Choices- Every person we are supporting or look after should be given freedom to make choices. They should be given proper information, so that they can make safe choices, and acknowledge the benefits of their decisions.
Privacy- privacy is the major principle that should be kept in mind, while looking after a person. Knock the door and get permission before entering the room. Make sure any other person enters the room with invitation only. During personal hygiene Closing the doors and drawing the curtains should be kept in mind. They should be provided with privacy for example, letters, phone calls, communication with visitors and while reading mails etc.
Independence- Independence makes people more live, they feel as if they have control on their live. Carers should allow the people to do things themselves, it could be of any type big small, doesn’t matter. Being independent does not mean staying alone or isolating a person. It means that a person is given enough time to do for themselves. They should not be forced to do the things quickly, but on the other hand they should be given sufficient time, to maintain their independence.
Dignity-: it refers to the respecting the client and and having self-respect. It includes ever minor thing that plays an important role in day to day life. It could be related to anything eating, sleeping, living day-to-day, and dying. It includes that the care givers should maintain our quality of life, while supporting a client. They should be aware of maintain a person’s dignity, careers should ask their client how they wish to be addressed, carers should take their time to listen them, use of towel while caring them, offering them regular shave.
Respect-making someone that you care and support them is very important, supporting them in every single aspect for example whatever is the age, cultural difference, disability, gender, belief or sexual preference, etc. A carer should not ignore the client’s needs while looking after a client. They should listen them, give them importance, ask about their choices, what would they be called as, how they should be cared, etc.
Autonomy– Working together with other agencies, colleagues and families to support the client. Remember your client’s wishes and needs should come first.
- Non person centered approach to dementia-
Non-Person-centered care is an approach that does not care for the clients ,respects and honors the unique qualities, interests, and needs of each person – it is of one-size fits all approach to care. Person-centered dementia care does not refers to the approach and practices used for people who are living with dementia, but it includes the two perspectives-
- Institution perspective
- Bio-medical perspective
- Institution perspective
Every person with dementia have different set of abilities and care needs and it gets worst with change of time. Institution perspective, is care that is provided in the care home. Person can experience joy, comfort in rest homes, they are cared in the rest homes etc.
- Bio-medical perspective
A person that shows some behavioral changes needs proper medical evaluation, especially when symptoms occurs all of a sudden. Bio medical perspective includes, treatment, drugs, the medication etc.
- Reality –orientation approach– To reducing confusion in geriatric patients, Reality Orientation approach is used as treatment in dementia client. Confusion amongst the client includes-(a) under stimulation of the patient, (b) lack of normal behavior (c) desired behavior. It works with the presentation by asking client about various things e.g. time, place and person-related, which tells about the understanding of the person, sense of control. There has been criticism of RO in clinical practice, with some fear that it has been applied in a mechanical fashion and has been insensitive to the needs of the individual.it is thought that reality orientation can cause mood and self-esteem problems.
- Validation approach–
Validation method is a way in which there is interaction with people with the dementia in the last stages of Alzheimer’s. People with Alzheimer’s have incomprehensible, behavior, sometimes they have abnormal behavior, and there is mood swing amongst the clients. For example, they may start thinking that they are living in a different time or place. Sometimes they may repeat physical gesture. Sometimes they may repeat the things again and again .and many people think that while handling these type of clients care givers should ignore their behavior or correct them.
- Assistive technologies–
A hoists the most commonly used aids. They are used by the people who are not able to move at all, and most of the time they are heavy and hard for single person to handle. Secondly walker based device. Thirdly touch-screen, fourthly technologies are used to monitor vital signs and basic metabolic parameters (e.g., temperature) multiple parameters simultaneously (e.g., pulse, blood pressure, oxygen saturation, blood glucose).Alarm systems occurs to alert caregivers of a fall e.g.-sensor matt.
- Holistic approach-
Holistic care simply means addressing all aspects — body, mind, and spirit — of the person. A holistic approach links mainstream medical treatments with both herbal supplements and attention to emotional health. Before health promotion strategies mainly focused on lifestyle programs. But later health promotion practice mainly focused on Human rights, health and improving health equality, Diversity. Health promotion action provides a set of values, tools (knowledge and skills) and practice.
A number of models useful for health promotion action include:
- Te Whare TapaWha (Durie et al., 1982)
- Te Pae Mahutonga (Durie, 2004)
- Te Wheke (Rose Pere, 1984)
- TU-HANZ – Health Promotion Forum (Martin, 2002)
Public health and health promotion-
Values and beliefs about health and wellbeing provides health promotion. There is great diversity amongst people as many of them share similar values including love, respect, humility, caring, reciprocity, spirituality, humors, unity and believing in the importance of family. Health care access is a supply side issue indicating the level of service which the health care system offers every individual with access to health care .In newzleand health care system follows the centralized approach where all the individuals are able to access health care, while inequalities in health care is said to be access persist.
Equality of access requires that, for different communities (Wondering et al, 2005):
Travelling, transport and communication service. The clients are equally informed about the availability and their effectiveness of treatments. All the Charges are equal. Access to health care treatment was utilized. But, utilization of health services may differ from several other reasons for example benefits or availability, alternative therapies etc. Several access to health care are-
Availability: Some health care services are not available to some population groups, or some treatment to patients may differ population groups, even where they have identical needs.
Quality: The quality of care offered to patients may vary between different groups.
Costs: some health care services may be costly, which vary between population groups.
Information: The health care organizations may fail to ensure for example that all population groups are equally aware of the services available.
The major two believes of the people are: Good health i.e., except spiritual, physical, emotional and mental dimensions. As family is important same way health matters to every individuals. Different health standards beneficial in Newzleand
In Newzleand, the main focus is on the well-being and quality of life rather than the behavior management.
- Memory-impaired individuals are not able to look after them as they are prone to forget things. Dementia mainly focus on physical and mental wellness, during the onset of the disease. However, the care programs are set in which they concentrate on what a patient is able to do rather than on what they cannot do. This is the major difference. This approach is made for a person so that they are able to continue their daily activities that may lead to healthy living, it also helps in maintain the independence of the client. That is the reason why individual assessment of the client is necessary and care plans are set and play an important role.
- To understand a client, health care team not only see medical records, but also health conditions, as well as history of the client.
- Family and friends can help in getting the information about a person. Such type of information becomes beneficial for the care givers and the nurses who are looking after them.
- Comprehensive patient assessments should be the important for care givers and for dementia treatment. For example, Care Givers use a social history form to evaluate the needs and interests of a person with dementia, and then promote clients’ health care.
- Knowing a person’s family situation, such as marital status and every single detail, can help care givers to have proper interactions with their patients and provide them proper care. Ties to the community can help as well. Keeping a patient involved with their religious groups, local organizations can help an individual to interact with their community.
- Alzheimer’s disease, develop emotional distant and affects the regular interaction. But having professional caregiver who are able to engage the client in daily activities enjoys interactions with family members.
- People living with dementia usually suffer and struggle with self-awareness. Different roles and hobbies develop their confidence and ensure feeling of accomplishment and purpose.
- Care providers familiar with their patient’s hobbies and interest make their individual routine. For example aby as her dementia, she began symptoms of depression. A Care Giver working with aby learned from her family that aby was once interested in gardening, so the caregiver provided her with plastic pots, gloves, soil and seedlings. She even helped aby in doing gardening, and noticed that she involved in everything that was related to gardening. And aby on the other side was able to continue with her favorite hobby, as a result Abby’s mood improved and she was able to sleep all night. And she was able to add more meaningful activities. Dementia can often cause a feeling of being lost. But a meaningful interaction can improve the person with dementia.
- A professional caregiver knows how to encourage independence. For example if a person is having dementia, care givers should be ready to handle the situation, trying showing and explaining everything related to the procedure. Some people with dementia want to participate in their own care. Brushing teeth, could became a tough task for dementia people, but a professional caregiver prepare a toothbrush with toothpaste and help Serena brush her teeth. This type of environment helps person to get back their sense of security about their place. Family of the dementia client should be helped, they should be given regular awareness about dementia and lectures, of handling these kind of people. They should be given regular counselling sections etc.
- Durie, M. (2004). An indigenous model of health promotion, World Conference on
- Health Promotion and Health Education, Massey University, New Zealand. Retrieved
- (11.19.2010) from http://www.hpforum.org.nz
- Reid, P., & Robson, B. (2006) http://www.hauora.maori.nz
- Te Aka MÄori-English, (online version) from http://www.MÄori dictionary.co.nz/
- Goddard M, Smith P (2001). Equity of access to health care services: theory and evidence from the UK: pp1149-62.
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