Exploring Nursing Expertise in Residential Care

Question: Discuss about the Exploring Nursing Expertise in Residential Care . Answer: Introduction: Person centered assessment is considered as a crucial aspect in rendering customized and individual suited health and social care services to cater to the specific needs, preferences and demands of the person through exhibition of enough respect and accurate responses to their requirements. Planning, improvisation and monitoring of care is carried out by means of this approach to better recognize the health outcomes that is adequate to address the definite issues relevant to the person (Starfield 2017). This person centered care has received much attention and prominence in the recent years to address specific needs pertinent to geriatric individuals who require specialized care services congruent to their health condition (Martnez et al. 2016). In the following essay, this approach will be demonstrated with respect to an old person named John who has been admitted in the residential aged care setting to receive proper care and treatment for his prevalent condition of dementia that h as markedly affected his quality of living. In an effort to enhance the quality of life in the given setting, promotion of everyday activities will be beneficial (Edvardsson et al. 2014). Analysis and discussions will be carried out with respect to the given scenario and in compliance with the measures readily available to handle such circumstances. In course of my interaction with John I came to know that he is in greater need for emotional support rather than clinical intervention to account for better holistic outcomes. The care provided must be congruent to respecting the clients preferences. Coordination and integration of care will facilitate the alleviation of feelings of vulnerability of the client. Further provision of adequate information and education will allay all sort of apprehension and fear of the client specific to the condition. Physical comfort will be given through proper pain mitigation strategy and assistance offered in course of activities of daily living. Better outcomes may be expected on involvement of family and friends while continuity and transition to care will be further enhanced through assembling of adequate information regarding the medications, dietary requirements and physical limitations. The key issues identified from Johns perspective included inability to perform activities of daily living due to restricted mobility, lack of family support couple with disorientation of thoughts and forgetfulness because of the debilitating condition of dementia. However the positive aspect includes the clients strive to lead a better life without depending much on others that must be treated with dignity, respect and sensitivity through proper decision making efforts. Person centered care is generally carried out in the outpatient care facilities as well as community based setting in case of older adults suffering from chronic conditions and functional impairments. Traditional biomedical model has been replaced in this context for personal choice and autonomy with respect to the service recipients. The multifaceted approach normally resort to six noteworthy domains encompassing holistic care, choice, value and respect, dignity, self determination in conjunction with purposeful living. The measurement of the person centered care in case of these clients has been found to be heavily dependent upon factors including self, family apart from service provider and organizational facilities. Matters relevant to health and social aspect of the client need to be addressed properly to account for better outcomes. The need for standardization of the accepted parameters with regards to the person centered care has been emphasized in literature (Kogan, Wilber a nd Mosqueda 2016). Further study has highlighted upon the application and effective utilization of a composite person centered care model characterized by usage of Montessori principles. Emphasis was laid upon developing the capacity and ability of the dementia residents by virtue of considerable changes made in the context of staff education, environmental modification along with organizational involvement and community participation. Curtailment of the rates of antipsychotic and sedative medications apart from significant behavioral alterations was noted after the introduction of the model. Experienced organizational culture along with enhanced knowledge and insight regarding dementia on the part of the staff working at the dementia care facilities harbored positive outcomes that satisfied the family members of the affected individual as well. Hence adoption of this specific model is found to be beneficial in the residential aged care facility (Roberts et al. 2015). Other studies have considered the psychological needs of the patient with dementia that must delve deeper into catering to the needs related to attachment, inclusion, identity, comfort and occupation through referring to the central theme of love. The impact of the caregivers on the individual has been of particular importance that aims to address the interaction between the individual and the environment. The efficacy of a person centered observational tool (FADe) to recognize fear and anxiety components among the dementia patient has been tested in a research. The subsequent treatment methodologies and intervention strategies to be adopted by the physicians in association with other healthcare practitioners has been recommended to create conducive environments devoid of fear and anxiety for ensuring better health related outcomes and quicker recovery (Traynor et al. 2016). The need for implementation of definite effective strategies for delivering utmost person centered care has been attended to in study where the role of the healthcare staff is given much importance. The competency, skills, domain related knowledge and prudence of the healthcare professionals are desirable in this respect to steer positive changes in dement ia care for the aged person. Improvements in attitudes and perceptions towards the dementia affected individuals by the staff were reported after formal training to account for increased satisfaction among the service receivers. Changes in attitudes of the staff were noted through provision of foundation level training (Surr et al. 2016). Other empirical findings have emphasized upon relationship building, effective communication, maintaining the respect and dignity of the patients to generate fruitful results on the part of the healthcare and nursing professional responsible for treating patients with dementia. Within the nursing home setting, overcoming the cultural and educational barriers by the service providers was identified to be particularly challenging. Quality of living underwent significant improvement for the dementia affected through staff training based on dementia care mapping in conjunction with person centered care. Tendency to succumb to the pressure of social exclusion has also been found to majorly impact the behavioral and cognitive outcomes in case of the dementia patient thereby necessitating the responsibility of the staff to nurture the emotional and spiritual needs of the dementia affected (Yasuda and Sakakibara 2016). Another recent study focused on the issue of efficient implementation of national guidelines for person centered care of persons with dementia within the framework of residential aged care facility. Effects of intervention on person centeredness of care were evaluated in course of the study design that depicted vital implications. At the follow up, significant alleviation of the staff stress of conscience as noted that indicated the enhanced capacity of the staff to render the best quality care to the concerned individuals. Systematic and interactive intervention modality comprising of knowledge transition, generation of novel and pragmatic ideas as well as dissemination of pertinent knowledge to the staff lead to the improved outcomes in the dementia affected population in line with the national guidelines. Thus establishment of proper national policy will act to address the situation relevant to the aged dementia affected individuals thereby aiding in the professional practice of t he staff operating in the residential and hospital based setting (Edvardsson, Sandman and Borell 2014) (vide Appendix 2). The suitability of the person centered care in providing holistic solutions to aged persons suffering from dementia has been reported across various academic literatures. The prevalence of a congenial working environment within the residential aged care facility or community based setting has been proposed to bear fruitful outcomes. Encouragement of a positive and supportive psychosocial climate together with a working environment where there is a balance between the workload and output of the staff to ensure a person centered care practice. Heightened satisfaction of the staff, reduced levels of job strain along with lower levels of stress of conscience have been tested to account for better responses in the patient (Sjgren et al. 2015). Further nursing expertise in treating these patients have stressed upon the need to maintain the ethical and moral virtues while providing care services to the vulnerable population. Definite skills must be applied to bring about optimal outcomes in the patients. The ensuing challenges that might appear due to educational insufficiency, knowledge gap and cultural incongruity must be adequately addressed to mitigate the problem (Phelan and McCormack 2016). Hence similar interventions and strategies may be applied in the context of John who is likely to be benefited by such measures to improve his quality of life as a consequence to dementia. The success and applicability of the person centered care to treat the aged patients suffering from dementia has long been established. The primary responsibilities rest with the healthcare professional entrusted with the duty of caring these persons to harbor maximum outcomes and holistic development. Significant improvements in terms of enhanced quality of living may be expected under satisfactory execution of the duty with respect to dealing with the affected individual by those healthcare staff. Therefore acquisition of prudent knowledge and skills to execute the duty is desirable through proper formal training (Olsson et al. 2013). The barriers and challenges encountered in course of rendering adequate care to these patients thus need to be deftly handled by the healthcare professionals through proper resources and evidence based practices in conformity with the existing ethical and legal competencies for providing satisfactory solutions to the concerned individuals. References Edvardsson, D., Petersson, L., Sjogren, K., Lindkvist, M. and Sandman, P.O., 2014. Everyday activities for people with dementia in residential aged care: associations with person?centredness and quality of life.International journal of older people nursing,9(4), pp.269-276. Edvardsson, D., Sandman, P.O. and Borell, L., 2014. Implementing national guidelines for person-centered care of people with dementia in residential aged care: effects on perceived person-centeredness, staff strain, and stress of conscience.International Psychogeriatrics,26(07), pp.1171-1179. Kogan, A.C., Wilber, K. and Mosqueda, L., 2016. Person?Centered Care for Older Adults with Chronic Conditions and Functional Impairment: A Systematic Literature Review.Journal of the American Geriatrics Society,64(1), pp.e1-e7. Martnez, T., Surez-lvarez, J., Yanguas, J. and Muiz, J., 2016. The Person Centered approach in Gerontology: New validity evidence of the Staff Assessment Person-directed Care Questionnaire.International Journal of Clinical and Health Psychology,16(2), pp.175-185. Olsson, L.E., Jakobsson Ung, E., Swedberg, K. and Ekman, I., 2013. Efficacy of person?centred care as an intervention in controlled trialsa systematic review.Journal of clinical nursing,22(3-4), pp.456-465. Phelan, A. and McCormack, B., 2016. Exploring nursing expertise in residential care for older people: a mixed method study.Journal of advanced nursing,72(10), pp.2524-2535. Roberts, G., Morley, C., Walters, W., Malta, S. and Doyle, C., 2015. Caring for people with dementia in residential aged care: Successes with a composite person-centered care model featuring Montessori-based activities.Geriatric Nursing,36(2), pp.106-110. Sjgren, K., Lindkvist, M., Sandman, P.O., Zingmark, K. and Edvardsson, D., 2015. To what extent is the work environment of staff related to person?centred care? A cross?sectional study of residential aged care.Journal of clinical nursing,24(9-10), pp.1310-1319. Starfield, B., 2017. Is patient-centered care the same as person-focused care?.Issues,2016. Surr, C.A., Smith, S.J., Crossland, J. and Robins, J., 2016. Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study.International journal of nursing studies,53, pp.144-151. Traynor, V., Stephen, S., Barkus, E., Pavlik, H., Yu, P., Qian, S., Carrigan, N. and Li, M., 2016. Developing a Person Centered Fear and Dementia (FaDe) assessment tool for individuals living with a dementia. Yasuda, M. and Sakakibara, H., 2016. Care staff training based on person-centered care and dementia care mapping, and its effects on the quality of life of nursing home residents with dementia.Aging mental health, pp.1-6.