A.C 1.2- Outline the benefits of working with an individual with dementia in a person-centred manner
It is important to work with an individual with dementia in a person-centred manner in other to meet the individual’s needs and to provide the best quality care service. The benefits include to ensure quality of life of the individual and to treat the individual as deem fit and necessary.
To place the individual at the centre values, individuality i.e. everyone’s differences must be recognized and respected. Choice, privacy, information and activities must be kept confidential. Individual must be empowered to do activities for themselves which means individual must be independent. It is vital for the social care worker to work using these precise methods to establish the needs and wishes of the individual. This will also mean that individuals will feel empowered and in control of their lives, be more confident about making decisions, will feel valued and respected. A.C. 1.3 – Why risk-taking can be part of a person-centred approach
Life itself is a risk. We take risk in our daily lives.
The person-centred approach to risk includes making an assessment with the people involved in the plan such as the individual, their relatives and other professionals. Risk taking is part of a person-centred approach as this empowers individuals to have choices about what they want to do in their lives as well as to be part of their community. Not allowing individuals to take risks can have a negative impact on an individual’s life which may negate the way they which to live. Taking risks means that you are able to decide and be in control of what you do. You need to ensure that a concern about taking risks is not stopping you living the way you want to. A.C. 2.1 – Describe the role that carers can have in the care and support of individuals with dementia
A.C.2.2 – Explain the value of developing a professional working relationship with carers Every day we make many choices. All choices are important, even though some of them are very small. Day-to day choices are often about the cloth we wear, the food we eat, how we spend our money and who we spend time with. Other choices we make include where to work and who to live with, where to live and where to go on holiday. We probably take the freedom to make these choices for granted, but these choices are often made for people with learning disabilities, without paying attention to their wishes. Choice is not only for people who can speak for themselves. People with severe or profound learning disabilities can make many choices for themselves. We will need to develop our observation skills to discover the way in which the person we support expresses their preferences. Over time we will be able to build up a more detailed understanding of how they communicate their likes and dislikes. We can then use this information to involve the person in making more choices. Having choice over a particular part of our life means we have control. This is good for our emotional and mental health, and helps us to feel a real part of the community.
Part of our task is ensuring that people with learning difficulties have choice in their lives. Privacy is a basic human need. We all need to do some things alone and to have time to ourselves to do as we please. Our need for privacy depends on our personality, interests and circumstances. We must respect people’s need for privacy whenever it arises. If our work involves supporting a person with their personal care, we will need to make particular efforts to ensure privacy for them. We are dependent on other people for all aspects of our daily life. Think about the supply of electricity and water to our homes, the food we eat and the transport we use, not to mention access to communication technology such as phones, Television and the internet. More importantly, we are dependent on those close to us for their love, support and affection. It is more accurate to say that we are all independent. We need other people in all areas of our life. There are, however, different types of independence. We can see this with children, as they grow from being totally dependent babies to much more independent teenagers.
Gradually, people with learning disabilities are taking more control of their lives. But even today, people with learning disabilities are often on the receiving end of other people’s decisions and planning. They may not have the power to decide on their own lifestyle. Other people, such as service providers, family or support workers, often make these decision for them. Others may be well supported, but lack the confidence or experience to take control of their lives. We have a vitally important role in the empowerment of people with learning disabilities to become independent. People with learning disabilities have the same rights as every other citizen in our society. The fundamental principle means that people with learning disabilities should never be treated in an inhuman or degrading way. They should always be treated politely, and as people of value in their own right. The way ourselves and our colleagues behave towards the people with learning disabilities we support affects the way that other people see them, and the way they see themselves. We should always show consideration to the people with learning disabilities that we work with.
Our actions and attitudes should show that everyone is worthy of respect. Every day in our work as a learning disabilities worker, we are a partner with a person with disability we support. We are working with them so that they can fulfill their dreams and ambitions, and so that we can assist them their particular needs. Partnership also involves other people working together, to meet the needs of people with learning disabilities as fully as possible. This may include partnership with other professionals such as social workers, GPs, Physiologists, Psychiatrists, and speech and language therapist. The families of the people with learning disabilities we support are often very important partners in our work. Most family carers have a wealth of knowledge and experience about their family member. They know their likes and dislikes, their personal history and any other particular medical needs. They are often more than happy to share what they know with new workers.
When asking family carers for information, it is important to remember that some families have seen many workers come and go in their relative’s life. They may have repeated the same information very many times. Some may feel disillusioned of past experiences when things have not changed as they had hoped. A major aspect of partnership working is bringing together in an atmosphere where this is simply the accepted way of doing things. In this type of working environment, training, attitudes, procedures and quality standards all have partnership as one of their goals. Successful partnership depend to a large extent upon the amount of effort put into creating an environment in which joint working is seen simply as the way things are done.
Discrimination against people with learning disabilities and their families often results in the unfair and unequal treatment of people just because of their learning disability. People with learning disabilities may not be allowed the freedom and opportunities which the Human Rights Act and other laws encourage. They often face prejudice and discrimination. They may be treated unequally and unjustly and denied the opportunities that should be available to them, just as they are to other citizens. Equal opportunities mean that people with learning disabilities should: No longer be marginalized and isolated within society
Have the same social statues as other people
No longer be subject to exploitation and abuse
Have their opinions taken seriously
Have their adult status recognized
Have the same citizenship right as other people.
Failure to give equal opportunities to people with learning disabilities denies our common humanity. It causes anger, frustration, despair, hopelessness and loneliness for the people involved, and keeps them powerless and dependent. The General Social Care Council (GSCC) is the organization set up by the government in 2001 to register and regulate all social care workers. It has produced a Code of Practice which states that social care workers should work in a certain way.
A.C 3.1 – Describe the roles of others in the care and support of individuals with dementia
It is fundamental ethical principle that every person has the right to determine what happens to his/her own body. This right is reflected in the Rules of professional Conduct and the Core Standards of Physiotherapy practice and is also protected by law. Touching a patient prior to obtaining valid consent may constitute battery under civil or criminal law, or in some circumstances, sexual assault. However, it is important to gain patient’s consent prior to assessment treatment. It is also a matter of common courtesy between the patient and the care assistant and helps to establish a relationship of trust and confidence. Evidence shows that where such a relationship exists, patients are less likely to take a legal action, and this could be why legal action against care assistants is rare. As a broad principle consent should be gained for all activities, even if we want to plump someone’s pillows. It is important that people not only give their consent but also fully understand what they are consenting to and the implications.
Consent can be implied, verbal, informal or written. Gaining consent protects both the carer and the person against legal challenges. A health care service consent document supports the rights of patients and families to be informed about the benefit and risk of a proposed treatment or procedure and to make a voluntary decision as to whether to proceed or not. The following must be considered when making a valid consent: i. the patient must have capacity to consent i.e. be mentally competent. ii. Consent must be voluntary i.e the patient must not be acting under duress. iii. The patients must have received sufficient information to make a decision about their treatment.
A.C 3.2 – Explain when it may be necessary to refer to others when supporting individuals with dementia To established consent for an activity or action we have to explain the activity or action to the other party so they have the correct information to make an inform decision. If the persons lacks the capacity to make informed decisions alone then we will need to establish who else need to be involved. This information is usually found in the person’s care of plan or in a communication chart established to cover a range of circumstances. To establish consent to an action or activity we need to:
Explain what it is using language familiar to the individual
Describe what the action or activity involves
Explain the benefits to the individual
Explain any potential or actual risks involved in doing it and not doing it
Listen to and observe the individual’s response
Encourage the individual to ask questions
Give the individual time to process the information
Confirm consent again immediately prior to any action or activity.
A.C 3.3 – Explain how to access the additional support of others when supporting individuals with dementia Consent (permission) must be given before care can be to a person. To even touch a person when forbidden, can be consider assault. If there is nobody available when an intoxicated, unconscious or impaired individual presents for care, consent is “implied”, as there is nobody to give that consent. It is assumed that consent would be given by family or that person, if they were able to communicate that. The only time that we cannot take saving measures, is when there is a Do Not Resuscitate (DNR) order on that patient. It is considered an emergency if a person is apparently experiencing severe suffering or is at risk of sustaining serious bodily harm.
The expectation for emergency treatment applies if: the patient is mentally incapable of making the treatment decision. The delay required to obtain consent will prolong the suffering or put the person at risk of sustaining serious bodily harm. The expectation for emergency treatment also applies if: the patient is apparently capable, but communication cannot occur because of a language barrier or a disability. Reasonable steps have been taken to find a practical means of communicating with the patient but such steps have been unsuccessful, and the delay required to find a practical means to communicate will prolong suffering or put the person at risk of sustaining serious bodily harm in addition, a health practitioner who believes that a person is mentally incapable, or where communication cannot take place after reasonable steps have been taken, may conduct an examination or diagnostic procedure without consent, if the examination or diagnostic procedure is reasonable necessary to determine whether there is emergency.
If a patient presents in an emergency situation, is unconscious, mentally incapable, and with no family available, and no advance directive in place, it is considered reasonable to treat the patient. It is assumed that under these conditions, the patient would consent to treat. If there is a language barrier, and the patient is otherwise capable of giving consent, a reasonable effort must be made to find an interpreter, which includes using the ones through the phone companies. If the patient’s life is in danger, and there is nobody who can communicate with them, then with careful documentation, treatment can be delivered.
A.C 4.1 – Demonstrate how to use a person-centred thinking tool in relation to own life to identify what is working and not working
People who use services and carers are becoming more active participants in social care provision, training and employment. They are no longer the passive recipients of service. Skills for care committed to ensuring people who use services and carers get an opportunity to have their say and participate in projects, to ensure that activities undertaken by Skills for Care reflect their need, wants and aspirations. Providing individual with empowerment is important. Empowerment is about enabling the individuals we support to contribute and have an influence over the issues which affect the way they live. When individuals make choices, they have more control and feel valued.
It is important that we support empowerment of the individuals we work with. Providing individuals with empowerment to make informed choices enables individuals to maintain their rights of choice, equality and opportunity. Active participation is ways of working that recognize an individual’s right to participate in the activities and relationship of their own care or support, rather than just a recipient. Being part of a community is particularly important to individuals who live on their and do not work. It does not matter what kind of something will give them a sense of belonging, a feeling of self-worth and independence.
A.C. 4.2 Describe own relationship circle
4.3 Describe how helpful using a person-centred thinking tool was to identify actions in relation to own life Putting active participation into practice means being able to recognize and reduce potential barriers to its implementation. Barriers to implementing an active participation approach can occur where the health and social practitioners: lack understanding of the individual’s personality, history, health and cognitive status and social abilities View the person as a passive recipient of care who is always dependent on others Have low expectations of the person’s ability to develop, change and achieve
We are not committed to making an active participation approach to work Lack creativity and flexibility and flexibility in thinking about ways of providing care or support Lack patience and tenacity when pursuing active participation goals Have inconsistent approach, and does not integrate active participation into our care practice to the extent that it becomes part and parcel of our daily care practice Changing attitudes is the key to reducing barriers to active participation. Improving society’s attitudes to, and expectations of, people with disabilities is an important part of this involving the individual and all those people who are significant to them is also crucial to success.
A.C. 5.1 – Use person-centred thinking to know and act on what is important to the individual In order to enable individual to make an informed choice, both us and the individual first need to think about what all of the available options are. We are then need to look at what are good and bad about each option. Health and safety are important factors and must be put first for us, the individual and anyone else involved. The Mental Capacity Act in other Standards provides the legal framework for capacity and decision making about health and social care and financial decisions which applies to everyone aged over 16. We will need to consider whether the person we are supporting has capacity to make informed decision s or we need a formal mental capacity review. It is important to note that a person is assumed to have capacity unless it is proved otherwise. There is a four-step way to test for capacity: a person must be able to: Understand the information relevant to a decision
Retain the information
Use the information as part of decision making process
Communicate their decision
In supporting a person to make a decision, we have a duty to assist the person in all four of these steps. For example, using appropriate communication methods to help the person to understand and communicate. Capacity is assessed specific to each decision and occasion. For example, a person may have capacity to make a decision in the Moring about what to wear, but not later day in deciding if they want to move home. If someone is assessed as lacking capacity, any decision taken on their behalf must be in their best interests and we must consider if there are less restrictive options. For example, if a decision can be delay until a person is less distressed this is the best course of action. However, if a person does have capacity this over-rides what we may consider as an unwise decision.
A.C. 5.2 Establish with the individual how they want to be supported
Each individual have a formal assessment as part of their care and support plan. The assessment should contain information about the individual and the type of care and support they need. It will provide the most appropriate options for keeping the individual and anyone else as safe as possible. It will also tell us how to do some tasks where these tasks have been risk assessed and the best option has been established. A particular way of moving and handling is recommended for Mr. X because he has health issues that mean he or she can only be moved another way. Mr. X does not like being moved this way and asks to be moved another way.
We should always follow the risk assessment. We should report Mr X’s request to our supervisor/manager. If we are appropriately trained in risk assessment and moving and handling and the change Mr X requires is minor, we may be able to make this change. We should never make changes unless we are trained or our supervisor or manager confirms we can make the change. We should always record any changes in Mr X’s wishes and in the way we perform tasks. Every effort should be made to support Mr X to be moved in the way he wants to be moved. He has the right to make this choice but an appropriately trained person will need to review the risk assessment first and work out if it is safe for all involved for Mr X to be moved in the way he wishes.
A.C. 5.3 – Use person-centred thinking to know and respond to how the individual communicates 5.4 – Be Responsive to how an individual makes decisions to support them to have maximum choice and control in their life When an individual has made decision which we feel is risky, we need to make the individual aware of any consequences involved in the decision; however we should not try to influence the individual with our view or opinions. It is the individual’s freedom of choice to make decisions about their own future and support. Providing they have the right information to make an informed choice and have the capacity to understand their choice; it is part of our duty of care to enable them to do so. Referring to Mr. X in 5.2 above, we might not approve of or like the choice he has made. We might need more moving and handling training, perhaps for a specialist piece of equipment. However, the choice is not ours and we are not allowed to influence Mr X. in supporting Mr X to make his decision, we need to listen to him and put his wishes and best interests first.
This means the service must be provided in the way Mr X would like, as long as it is safe and approved through care and support plans and risk assessment. This is because the choices belong to Mr x, not to us. He needs to make his own decisions in order to feel he is in control of what happens to him. This leads to positive feelings around dignity, pride and satisfaction. If relative or friend has made a decision about individual’s care, support or life that the individual is not happy or comfortable with, we may need to support the individual to question or challenge the decision. It is important that we obtain and understand the facts and reasons surrounding the decision so we can make sure the individual has a clear understanding
If the individual remains sure that he or she is not happy with the decision, once he or she has this information, we can work with the individual to support them to challenge the decision. Any changes that are made as a result of this change must be safe for us, the individual and anyone else involved. We should never make changes unless we are trained to do so or our supervisor or manager confirms we can make the change. We should always record any changes in individual’s wishes and in the way we perform tasks. It is essential that we understand the Mental Capacity Act and how to work within it’s requirements every day with every individual.
A.C. 6.1- Explain how individual identity and self-esteem are linked with wellbeing
Spiritual well being is an integral part of mental, emotional and physical health. It can be associated with a specific religion but does not have to be. It is about an individual’s own journey to discover things of importance in their lives and enabling them to find purpose and meaning in life. The effects and impact of spiritual well-being is determined by each individual and can make a huge impact on their lives. Through spiritual well-being, individual can become empowered and realize that even though they have issues, stressors, and challenges, they are not define by their circumstances. In realizing this individual’s gain greater peace, better freedom of self expression, increased manageable over the healing and support process and higher self-esteem. A few of the numerous benefits of spiritual well-being include: Feeling content with our life’s situation
Making time to spend alone and find inner peace
Taking time to reflect and resolve life’s issues
Finding satisfaction in a job well done.
Taking part in an active lifestyle rather than merely standing by and watching life as it passes
Maintaining balance and control of life
Feeling purpose and meaning in life
Accepting and growing from challenges of life
Emotional well-being is based on how individuals feel about themselves. Someone who is emotionally healthy:
Understands and adapt to changes
Copes with stress
Has a positive outlook on life and themselves
Has the ability to love and care for others
Can act independently to meet his or own needs
Everyone, including people who are emotionally healthy, have problems.
If something or someone threatens our happiness or well-being, we would feel uncomfortable emotions such as anger, sadness or fear. When we experience something that enhances our situation, we feel emotions such as joy, satisfaction or a sense of achievement. The way we are brought up and our culture have a great influence on how we feel. They help us to form ideas and decide what we care about. Everyone deals with situations in life differently. What may seem unimportant to our closest friend might be upsetting to us.
Sometimes an individual’s self-esteem (the way they feel about themselves) can become so low that everything seems a lot harder to cope with compared with when they are feeling confident. Being emotionally healthy does not mean that we feel happy all the time. Good emotional health is about having lots of different emotions, and being able to accept them and talk about them. Signs that Individuals are not coping well emotionally might include having a lack of self-confidence, having trouble with relationship or feeling unhappy a lot of the time.
A.C. – 6.2 Describe attitudes and approaches that are likely to promote an individual’s wellbeing Because we are so different and diverse, we have different and diverse views about every subject. We may not approve of or agree with the views of individual we support but our role is about working with them in ways that support their views. The best way to find out about an individual is to ask questions that are not threatening but show us have a genuine interest in the individual. By encouraging them to talk about themselves and listening to their views, as we will learn a great deal about the individuals we work with. Through this learning, we will be able to meet their needs in ways that are sensitive and supportive of their views making individual feel valued. Our role is to support individuals to feel emotional well-being and to feel emotional wellbeing, individuals need to feel: Appreciated, cared about and loved
Safe and secure
Extra supported when they feel sad, depressed or lonely
That they are not a burden but an important priority
Listened to and respected
Satisfied with relationships
Independent and in control of their lives
That they have a purpose and meaning to their lives
We will need good communication skills and be able to listen but also to encourage individuals and show understanding and support for what is important to them in life. We could suggest that the individual organizes for someone from their faith or community group. It might be possible for someone from the group to organize travel and support arrangements whilst the individual attend the group.
A.C. – 6.3 – Support an individual in a way that promotes a sense of identity and self-esteem Each individual’s spirituality is greatly impacted by the community they are a part of and the relationships they take part in. Spiritual wellbeing is not a practice of isolation but rather of affecting and involving the people around the individual. Spiritual well-being groups and sessions could provide an open and save environment to explore, learn, practice, support and heal. This safe-haven offered in such a group is important to individuals who experience difficulties in their lives. Individuals may be able to find spiritual well-being programs in their local areas. These may include group exploration and experimental practices on the topics of meditation, prayer, forgiveness, personal values, and purpose in life, the role of self-esteem in spiritual connection, healthy relationships and developing an authentic relationship with a higher Power, or God.
A.C. – 6.4 Demonstrate ways to contribute to an environment that promotes well-being By promoting an individual’s spiritual and emotional wellbeing, we can help improve their self esteem and make them valued and remain their own person. Building an individual’s self esteem is a first step towards the happiness and emotional well-being of the individuals we support. Focusing on what they can do rather than on what they cannot do, will encourage their independence and feeling of self worth. It is also important to help individuals to deal with stress. Changes in situations and in their ability to do things can cause stress. However, by providing encouragement and positive support we can improve their inner self and quality of life. By providing emotional support, understanding and good quality care, we can improve on individual’s confidence, promoting spiritual and emotional well-being.