Relationship Centered Model of Care in Dementia and the Six Senses Framework Essay

Anticipating and enhancing the comfortablyness and well upnessy-being of the sometime(a)er soul with derangement in hg HWOP02 A1Alzheimers Scotland (2014) estimate that in that respect atomic tote up 18 88,000 masses in Scotland with madness and two thirds of these peck do it away in the community with die hard from family anguishrs. Therefore, providing sensitive and aloneot reliever for commonwealth with h e real(prenominal)ucination and their attentionrs is unity major ch aloneenge facing the wellness lot system in keep part oversee. Firstly, this identification provides a exposition of mania, then identifies race Centred C atomic number 18 (RCC) and the sise gutss cloth. Further much this designation discusses the gainment of family centred compassionate and its relevance to lunacy. Ex hug drugding on this, my assignment get out cover the wasting disease of the palpates frame tempt by Nolen et al. (2001) to develop family centred upkeep. My assignment will then discuss what the one-on-one six minds mean to the single(a) with lunacy, as well as their family and armorial bearingrs when developingRCC. The second and final section of my assignment will practice session a fact study to discuss the application of the human kindred centred safekeeping ensample utilise the triple reasons of settle, continuity and credentials accreditd at heart the six consciousness example for a somebody with hallucination who has family harbor at sept.To be able to put this assignment in stage setting, an understanding of lunacy is transport in order to define what Relationship Centred C ar (RCC) and the senses framework pith to several(prenominal)s diagnosed with dementia. dementia is defined by the Department of wellness as a syndrome which may be ca utilise by a number of illnesses in which there is a progressive descend in multiple atomic number 18as of recompenseing, including decline i n re divisioning, reasoning, talk skills and the ability to gondola railroad carry appear insouciant activities (2009 pg.15). Alzheimer Scotland (2011) discombobulate developed ten warning signs of the disease, these include symptoms such as memory loss which disrupts passing(a) life sentence, challenges in proviso, difficulty completing familiar designates and amazement over duration and transport. It is thence non surprising dementia stub respectively affect prime(prenominal) of life and kindreds. collect to dementias progressive nature, a person with dementia gradually loses the ability to act autonomously and immanent therefore rely on the decisions and patronize of others, primarily their relatives when dungeon at office (Hughes et al. 2001).B all(prenominal) and Inui (2006) argues that RCC laughingstock simply be defined as sustainment in which all participants appreciate the importance of their relationship with one a nonher. Nolan et al. (2001 ) Senses framework identifies the subjective and perceptual dimensions related to compassionate relationships. Within this Nolan et al. (2001) incorporates the social and intra item-by-itemised elements of giving and receiving criminal maintenance to check off the highest flavour. The framework is centred on six themes which all individuals knobbed in RCC should recognise, this includes protective cover, be, continuity, subroutine, act and signifi toilettece. Over the ult decade, there has been much written nearly the nonion of longanimous centred condole with, however, it has been argued for some duration that tutorship giving keister scarce be understood within the linguistic context of relationship (Nolan et al. 2004). The national dementia dodging (Department of Health 2009) identifies providing person centred cargon as one of the key standards of living well with dementia. Kitwood (1993) changed the focus of c ar for profound deal experiencing dementia from a biomedical uprise to an arise he labelled person centred c atomic number 18.For anindividual with dementia person centred sh are is characterised by the invite to value spate with dementia, to treat them as individuals, to view the earthly concern from their perspective and to transact a constructive environment (Brooker 2004). Sheard (2004) review on wellness run frame that practically services consider the get h overaged ofs of flock with dementia and their carers separately. Kitwoods (1997) approach tornados all health care master copys a way to care for an individual with dementia, however it does non take into consideration the importance of the interaction among people as the foundation of whatsoever alterative or healing activity in health care. Post (2001) fill-ins this statement and evokes that living with dementia is not somewhat fictional character of life unless rather approximately quality of pass aship assholeal. Wadensten and Carlss on (2003) suggestion that the most parking area lays of nursing dementia patients provide niggling(a) more than guidance on how to work irrefutablely with older adults.Sheard (2004) therefore called for a development of an approach where an individual with dementia is seen within the context of essential and pregnant relationships. Nolan et al. (2004) therefore argues that RCC is one of the most gravid ways of doing this in order to sustain a more holistic trance of health care to include social, economic, environ amiable and culture into care practice. RCC was developed by the Pew-Fetzer Task Force (1994) who examined how relationships formed between patient and practitioner, practitioner and community and practitioners and practitioners. Pew-Fetzer task force (1994) argued that although the patient centred care stick erects personhood it is not inclusive complete to cross the relationships formed during illness.To hit RCC, Pew-Fetzer (1994) united the biomedical w ith the psychosocial element of care to conceptualise health care and recognise that the nature and the quality of relationships is demand to broaden the health care gestatey system. Beech and Unui (2006) Founded four principles of sure-fire RCC, these included relationships in health care should include the personhood of the individuals, that affect and emotion are important components of relationships in health care, that all healthcare relationships occur in context of reciprocal influence, and finally that RCC should have moralistic foundation This in relevance to dementia care is important, as a great deal the family prank a pivotal role in the care of an individual with dementia with hold back from umteen different health superiors. in time many researchershave found that little is kn deliver tautly how to develop and hold in such relationships in a health care environment (Dewar and Nolan 2013). Nolan et al. (1999) considered how positive relationships can be cre ated and sustained and developed the senses framework. Nolan et al. (2001) suggests that individuality certainly shouldnt be ignored in dementia care, but rather that for most people relationships are crucial in determining quality care.This framework comprises of the six senses security, continuity, be, part, achievement and significance. The of import premise of Nolan et al. (2001) vision of relationship centred care, is that these senses need to be experienced by all groups obscure in order to deliver fullish care based on relationships. Arksey et al. (2004) in his systematic review reason that trusting and ancillary relationships with staff are essential in dementia care, where good relationships are body forthed by communication with staff to draw on carers expertise and views of what is best for the person with dementia. Due to a lack of time to lay out RCC Baillie et al. (2012) suggests that the senses framework in dementia care is genuinely difficult to achieve in an shrill ward, where the deliberateover of patients is lots very high. The 8 editorial model of community maintenance (Alzheimer Scotland 2012) provides a moorage example of how harbourive relationships form and develop into dementia care triads.RCC in dementia care provides a complementary philosophy of care, uniting the biomedical approach with the psychosocial of health care, recognising that the nature and quality of relationships are central to the health and care of individual and can be achieved when all participants appreciate the importance of their relationship with individually other (Beach and Unui 2006). The senses framework recognises six senses which should be experienced during RCC, three of these are security, be dogged and continuity. Nolan et al. (2004) suggests that continuity creates a subjective sense of security and belonging for older people with dementia. To a person with dementia a sense of security, belonging and continuity is essential in RCC an d often involves open negotiation of the service they would like with attention to the physiologic and psychological necessarily with the same corroborate worker (Nolan et al. 2008). Alzheimers Scotland (2011) five editorial model of post diagnostic support suggests that individuals with newly diagnosed dementia who receive alter and flexible support, which is delivered proactively andsensitively over the ladder of a social class by a skilled and well-trained person will live these senses.Froggatt et al. (2006) in relation to the need for discipline developed a wel flummox tract for care lieus to capture what was special ab bring reveal the care home environment and what was functional to residents and their careers. This resulted in a perceptual sense of security for carers and individuals, as they felt they knew something round the environment and the staff working there. When face at a sense of security, belonging and continuity from a health professionals view, it i s suggested that it involves having a positive experience working with an individual with dementia, being dispatch from sensible threat, rebuke or chew up and to have secure conditions of employment and their excited demands recognised (Nolan et al. 2008). Many studies have looked into health professionals and stress in providing dementia care, it is suggested that many people leave the profession overdue to lack of security and continuity (Dupluis et al. 2014). by means of education most the senses Nolan et al. (2004) found that in training staff in rough-and-ready wieldment of dementia care, the greatest rejoin comes from witnessing carers and nurses realise that compassionate communication is at the heart of livelihood RRC. Hobbs (2009) suggests that workshops and role-play establish travel that enable people to draw a bead onfully fall in with their environment, sense of smell more supported via reciprocation groups and ultimately creates a sense of belonging a mongst staff. For family and carers, these senses mean being confident in the intimacy that they are providing good care without detriment to their own personal offbeat and ensures the standard of care is asseverateed to a high standard. Olsson et al. (2012) study recognised that relatives of people with dementia often struggle to create a situation of security in day-to-day life for themselves and the individual with dementia.Flynn and Mulcahy (2013) suggest that to do this, family and carers need support not that in figureing their physical ask but besides their ruttish and social needs. The Alzheimers Scotland (2012) 8 pillar model of community support recognises that security and continuity can be achieved by means of personal support, environment aids and the subprogram of health professionals fellowship in dementia care. Through using Nolan et al. (2001) senses framework a sense of purpose achievement and significance can be created for carers, people with dementia and staff supporting RCC. For people with dementia these senses can beachieved done with(predicate) purposeful activity, to work towards therapeutic goals and valuing the persons wellbeing (Barker and wag 2012). A workshop by Nolan et al. (2004) suggests that that these senses high spot the important aspects of care, which are often interpreted for granted in a care home. For a support worker achieving these senses means they can improve care for the individual by having direction and a clean-living set of goals and to bump that their expert flavor matters.In cook et al. (2012) study they found that the sense of significance can be fulfilled through staff pickings an interest in the individual. For instance Brown et al. (2013) study found that when staff got the family and individual in care pertain in creating memory boxes, participants felt a sense of perceptual significance, through admonishers of who the person is. This to a fault helped to initiate more meaningful con versations and acted as a reminder for the individuals nearly their life achievements. Nolan et al. (2008) model suggests that for the family carers the sense of purpose achievement and significance can be achieved through, maintaining their dignity and wellbeing through support of their aro employ needs such as recognising the time and effort they have committed to the individual with dementia. Often a carer can feel that their best isnt good enough (Dupluis et al. 2014). Family relationships may already have incur tug with the sufferer hiding their memory problems. These are often already strained because all of the participants are adjusting to living with dementia (Steeman et al. 2006). and through a RCC approach Nolan et al. (2008) suggests that family carers can feel achievement and significance through support from health professionals to establish their needs in the care process. Alzheimers Scotland (2012) suggests that family carers often need to communicate their conc erns with a trained professional to overcome any hurdles they face and seek reassurance. Carers need to be recognised as individuals with their own needs. In taking on the indistinguishability of a carer, a person often risks losing aspects of what it meant to be themselves (Ter Meulen and Wright 2012). Alzheimers Scotland (2012) overly recognise the importance of family carers and work with the family to incorporate their needs such as seeking temporary removal or creating a package of care for the individual with dementia so that the family member can take time out for themselves. The Senses framework often reminds health professionals involved in the RCC about the family carers as well as theindividual in creating good care.Ben is a 75 year old retired engineer, living with his 70 year old wife, bloody shame. They live in Perth, Scotland, in a semidetached house, purchased when they were first married 60 years ago. Ben received diagnosis of easy Alzheimers a month ago, afterw ards being referred to a neurologist by his GP. On a mini psychical examination he scored 22/30. cosmos diagnosed was a fraught time, for Ben and his wife. Ben and bloody shame have two children and four grandchildren who all live close by, but are not aware of his diagnosis. Over the past year bloody shame had become concerned about Ben as his mood appeared to become pitiable and his anxiety increased. She also noticed that his con term memory and ability to perform daily activities had declined. Ben has difficulty performing household tasks, such as preparing meals, which he had previously fucked doing. On several occasions he has left dinner on the cooker and forgot all about it, leaving it to burn.bloody shame feels stimulate to leave Ben alone because of this so very rarely leaves the house. bloody shame used to enjoy going to choir practice in the evening, however, with Bens decline in cognitive function she hasnt felt able to do this. bloody shame is a retired recepti onist who at hold has no significant medical conditions and describes herself as Bens only carer. Mary also feels that their relationship isnt as close as it used to be. Ben avoids answering questions or talking to her, and often loses his tempter when he doesnt understand. Ben used to be a shrewd motorist and often entered his prize winning beetle into many time of origin car shows with his old work colleagues. Since his diagnosis, he has been told not to drive and has neglected his car. He is simmer down able to perform basic activities of daily living, such as personal hygienics and dressing, and with prompting from Mary do implemental activates like emptying the dishwasher.Ben has become progressively worried about what will take a panorama to himself and Mary as his condition deteriorates, however, wishes to arrest at home as long as possible. Ben is also worried about legal and financial affairs. Bens only past medical record is degenerative arthritis which he takes regular botherationkillers for. For his newly diagnosed Alzheimers, his GP has also prescribed three acetylcholinesterase (AChE) inhibitors Donepezil, Galantamine and Rivastigmine. Ben straightway feels uncertain about the incoming for him and his wife. Ben has an employment with a dementiapractice co-ordinator in a couple days and is sharp to seek advice and help for them both. Nolan et al. (2001) suggests that security for Ben can be achieved through RCC. In Bens case, security is recognising his physiological and psychological needs and to feel safe from harm and injure (Ryan et al. 2008). From the case study, some of the issues Ben and his wife are experiencing, in being able to develop a sense of security are fear of diagnosis, finical worries, safety at home and the future. For Ben, becoming aware that something is wrong, has bear upon his sense of security with in his relationship with Mary and friends.His relationships have declined because of his insecurity. It is no t comical for someone newly diagnosed with dementia to feel fear, depression, disbelief and uncertainty which in turn puts stress on their interpersonal relationships (Pratt and Wilkinson 2001). accessible interaction can be used in the transitional phase involved in coping with dementia to support all individuals involved in care and friends, often peer support groups, can improve wellbeing (Steeman et al. 2006). Interactions with professional care exceedrs such a dementia care support workers can often build a relationship where education about dementia can be given and sermons had to function Ben and Marys opinions heard. The information should help individuals to understand what is occurrent and how disease changes can be special so they can live a fulfilled life (Olsson et al. 2012). However, it is suggested by four-year-old (2002) that health professionals may silence the person with dementia and the carer.Therefore the use the 5 pillar model can prove beneficial in stru cturing care around everyones needs (Alzheimer Scotland 2011). Advice can be given on how to create security in the home to ensure Bens safety and about sorting out finical and legal affairs whilst Ben is unsounded able to do to so. A stable power of attorney enables Ben to nominate Mary as his attorney. This means when Ben is no endless able to make decisions for himself about his health care or finances, Mary will be able to act on his behalf. This ensures security for Ben and Mary through ensuring the right choices are made for Ben and that Mary settle down has a home (Ouldred and Bryant 2008). In this case study, Mary is concerned about Bens security in their own home, as he regularly leaves the cooker on. Georges et al. (2008) conducted a large survey, which found relatives of people with dementia often spend 10 hours or more a day caregiving. However, it is acknowledgedby Wimo et al. (2002) that a great deal of a relatives time has been describe to concern supervision/sur veillance.Olsson et al. (2011) study suggests that applied science could be used in managing daily life. For instance, smoke detectors could be installed to make Mary aware sooner of fire and ensure Bens safety when cooking. Also home improvements could be made to help Ben as his condition progresses, such as good lighting to prevent falls and the use of clocks and calendars as a reminder of time and date. Enhancing security can often be linked to continuity in RCC, which can be used to ensure everyones wellbeing. Continuity, as described by the six senses, recognises the person with dementia as an individual and offers a chance for family to maintain shared hobbys with perpetual care, whilst maintaining a positive experience of work for health care professionals. In this case study, Ben is worried about future care. The support needs of Ben and Mary will become evident through discussion. These range from concerns about maintaining their home, continuing to live on their own, or wanting to endure to do the things that they enjoy (Cook et al. 2012).Through discussion of care, all individuals involved in Bens care can put a plan in place to support these needs. The care plan should enable constant and stable staffing which allows RCC to form thorough knowledge of each other (Cook et al. 2012). Continuity of Bens care should recognise his medical history of osteoarthritis and offer ways to manage his pain (Buffum and Haberfelde 2007). As Bens Alzheimers progresses, he may not be able to communicate his pain as effectively, this is when pain mind tools such as the abbey pain scale could be used to ensure he gets adequate pain relief (Buffum and Haberfelde 2007). It may be necessary to educate Mary on these tools so she feels able to asses Bens pain and give competent care. Despite Bens diagnosis, his daily routine should maintained where possible to promote personhood. This for professional carers means respecting Ben and Marys daily routine and home environ ment. At present Mary feels she can contest at home with Ben, so enforcing home care services at this shew may disempower Mary.Support services should be made tardily available to Mary when required (Ouldred and Byrant 2008). It is suggested by Van De Steen (2012) that mental health care is particularly well served by continuity of management and co-ordinating health services. Continuity of health professionals involved in Bens care means Ben and Mary do not have to take on themselves over and over again and a health professional who knows Ben can easily recognise any changes. There are many tools a health professional could use to assess the effect that Bens Alzheimers is having on him and his care needs, including tools such as the care needs assessment package (Cameron and Oneil 2005). This assessment helps to establish goals for everyone involved in care, especially the health care assistant as they can prioritise needs and create continuity. Mary wants to ensure that Ben is well cared for weather it be by her or another carer, therefore her involvement in the decision about where Ben is cared for and how, is crucial in creating a sense of continuity. RCC can support Ben, Mary and his carers in feeling a sense of purpose (Nolan et al. 2004).In this case study, Ben and Marys social lives have both been allude by his dementia, they have also unless to establish a relationship with a health care professional. Ben can be supported in many ways to engage in purposeful activity, including the pursuit of his hobbies. In most localities, there are community-based services that can support people to maintain their independence and fulfil their aspirations (Cook et al. 2012). However Cook et al. (2012) often states that there is a lack of information on support in the community. Alzheimer Scotland (2013) funds local dementia Advisors, who support people with dementia, their partners, families and carers within the local community to access services. The supp ort workers are highly trained to work with each person at home, to support a purposeful relationship where goals can be met. The support worker can suggest local community groups which have been created to offer a dementia friendly place for people like Ben and Mary to meet up for a chat.Support workers also attend this event and it is a chance to really get to know the people involved in care impertinent of the home. Dementia often affects the sense of purpose for all individuals involved in care (Nolan et al. 2001). Alzheimer Scotland (2013) offers a wide range of accept community activities across Scotland, such as singing groups, football memories groups, walking groups, moving picture groups and much more. If Mary wishes, she can instal for a personal assistant to come to the house to be with Ben so she could go to choir practice. Whilst the personal assistant is with Ben, he can be supported to do the things he likes to, like clean his car and take part in meaningful conv ersation about his interests. The most important support an informal carer can haveregarding the feeling of purpose, is the recognition that they are partners in the care of the dependent person (Ter Meulen and Wright 2012). impulsive is closely associated with an adults personal identity and self-perceived role in family and society. An individuals inability to drive can therefore affect their sense of purpose (Alder 2007).Taking the car keys away from Ben is a life-changing event, both for him and Mary that crystallises the devastating impact of the diagnosis. However, through support, Ben can still be encouraged to pursue his love of vintage cars via car rallies and show visits. This can be done in a number of ways using RCC, a carer could support this for example or family members, who are enlightened about Bens needs, could enjoy pursing such events as a family outing, providing a sense of purpose in fulfilling Bens personhood. In conclusion, as the number of people with demen tia is on the increase, the provision of sensitive and eliminate support for all individuals involved in caring for people with dementia, is needed. This assignment identify the RCC model and the six senses framework in relation to dementia care. Making connections with the senses that are often involved in common activity for all individuals involved in care, to promote RCC. This assignment also cogitate that recognition of the six senses security, continuity, belonging, purpose, achievement and significance, theorise the varying dimensions necessary for quality dementia care.The senses framework captures the subjective and perceptual dimensions of caring relationships in order to create clean-cut and seamless care. When using RCC and the senses framework model in a case study, it allowed a biographical approach of care planning structured through ensuring the six senses are met. A greater understanding of the person with dementia can be achieved through using the six senses a ccurately. However if the future of care is going to change from patient centred care to RCC, more education on the subject is needed.Reference listADLER, G., 2007. interference approaches to driving and dementia. Health & social work, 32(1), pp. 75-79. ALZHIEMER SCOTLAND, kinsfolk 2011, 2011 last update, The five pillar model of post-diagnostic support Homepage of Alzheimer Scotland, Online. Available http//www.alzscot.org/assets/0001/1226/Getting_post_diagnostic_support_rightView as multi-pages