Care of a Confused Parent

Care of a Confused Parent I N T R O D U C T I O N The first FETAC Level 5 Assignment in Care Skills module requires that learners produce an assignment on the care of a confused person. This confusion can be the result of any number of causes – from an illness such as dementia or Alzheimer’s disease or the long term use or an abuse of drugs and /or alcohol. The assignment must be completed answering very specific points (as outlined in the table of contents). This assignment was compiled using various methodologies including: Classroom lectures and feedback sessions Class notes and Manual, hard copy manuals and books One to one sessions with Work Experience Skills Coach Previous life experience of caring for an ill family member Online research and library research For the purpose of this assignment the author has decided to highlight one particular client who is in the Nursing Home in which the author is completing her work experience module. The clients name has been changed in order to respect her rights to privacy and dignity. The client in this example has been diagnosed with Stage 4 Lung Cancer (T4, N3) which denotes that she suffers from a malignant tumour which has invaded the oesophagus, epicardium, pleural cavity, T5 and T6 vertebrae with Metastasis to the supraclavicular lymph node. She also suffers from osteoarthritis of L2-L5 and S1-S5, Type 2 Diabetes and Psoriasis. She is currently on a variety of medications which are listed in her Care Plan, along with creams and ointments for the Psoriasis. Presently she suffers from severe bouts of confusion as a result of her pain medications and needs constant monitoring and care. In conjunction with her family, and a multi-disciplinary team Catherine has decided to move to a Nursing Home where she will receive the type of holistic care she requires. Catherine has also documented her specific wishes regarding her death and funeral arrangements and all of which has to be respected by all involved, the details are listed in her Care Plan along with the emergency contact details if her condition should suddenly decline. INDIVIDUAL NEEDS ASSESSMENT Initial assessment of Catherine’s needs using the Logan Roper Tierney model of assessment an individualised, client-centred holistic approach to Catherine’s care has been devised. Physical Catherine loves the outdoors and she should be encouraged to continue this through gardening – taking her out for walks, especially during spells of confusion. Ensure she has her walking stick and bring the wheelchair as she gets breathless very easily. Shower rails and chair must be available in her room and always ensure that the non-slip mat is on the ground. When she is confused she forgets how to wash herself properly and will need assistance. Intellectual Catherine loves to read and complete quizzes and cross words – these are very good for stimulation and they should be made available to her in her room and in the day room. The news and primetime are two of her favourite programs – ensure that they are on the TV in her room and the day room. Diversional therapy of card games and jigsaws are great for completing when she is confused. Emotional As a result of the illness and her pending death Catherine can become depressed – she must be encouraged, made feel wanted loved, needed and always try to support her decision to move into the nursing home Social/Spiritual Socially, Catherine has a lot of friends with whom she plays cards – they are going to come visit her once a week to continue this tradition, the other residents should be encouraged to join in also as it will help integrate her more. Her large family of 8 children and 63 grand-children/great-grand-children/great-great grand-children all visit her when she is at home and will continue to do so. It is amazing the Catherine remembers all their names and dates of birth – during spells of confusion though she does tend to forget them a little. Catherine is very religious and attends mass every Sunday when she is well – the angelus must be said at 12pm and 6pm and the rosary at 9pm. I D E N T I F Y T H E L E V E L O F A S S I S T A N C E R E Q U I R E D Catherine has very low level needs when she is not confused. She needs help sitting up in the bed and cannot use the remote control as her fingers are very badly damaged from the arthritis and as such will need assistance getting out of bed. She cannot manage small buttons when dressing and most days she just wears t-shirts but on Sundays she wishes to wear a blouse going to mass and will need assistance with that. Catherine dose not wear dentures and is on a chopped diet for now, she can manage to use cutlery but prefers to use a spoon. When she is confused she forgets when to eat and sometimes forgets that she has eaten so she will need monitoring when eating rather than assistance. MAINTAINING A SAFE ENVIRONMENT During confused spells Catherine likes to walk and as such walkways will have to be completely compliant with the Health and Safety Regulations for care as set out by the Health and Safety Authority. (HSA.ie, 2014) It would also be a good intervention to ensure that her walking aid is always within arm’s reach and that her shoes/slippers have rubber soles and are well maintained. For showering, the shower stool must be readily available and ensure that the hand rails are well maintained. The toilet in her room has a raised toilet seat and rail which must be cleaned and maintained regularly. Catherine will also use a commode, but when she is confused does not realise where she is when trying to urinate therefore she should be encouraged to go to the bathroom to protect her dignity. When going on outings with her family Catherine’s wheelchair must accompany her always and kept well maintained and ensure the wheels are pumped. PROMOTE CLIENT INVOLVEMENT IN SOCIAL EVENTS AND THERAPIES Catherine likes to play cards therefore she would enjoy it as part of the available diversional therapies. The HCA can have table quizzes added to the curriculum of activities by the activities co coordinator and help her participate by writing the answers to the questions and holding the cards – when she is confused one to one games such as Patience or Snap are very helpful. Catherine is quite a sociable person and will have loads of visitors – they will help to integrate her with the other residents and they play cards, tell stories, Irish dancing and play music some days she wishes not to have any visitors or participate in activities – in order to keep her from this depression the HCA could encourage her to attend the card game or maybe say some prayers with her as her strong beliefs will help to alleviate the depression. Catherine has refused to attend the Cuisle Centre in Portlaoise which has numerous activities and therapies available to cancer sufferers. The HCA could bring her more information on the services provided and explain what they are in detail and answer any questions she may have in order to encourage her to attend. They offer a Gardening Therapy workshop each week which would really benefit her along with the CranioSacral therapy and Holistic Massage would be beneficial for her also and she should be encouraged to go by bringing her down to the centre and having a talk with other clients that attend. (Cuisle Centre, Cancer Support Centre Laois, Cancer Support Portlaoise, 2014) MOBILITY INDLUDING FALLS AND PRESSURE AREA CARE FALLS The results from the Morse Falls Assessment in Catherine’s Care Plan show that on non-confused days she is at low risk, but during spells of confusion she is moderate risk and as such – should be encouraged to walk around more during lucid days and be accompanied outdoors for short walks if her breathing allows – allow her to push the wheelchair for a while will help and support her. The activities co-ordinator has a great curriculum for mobility and Catherine should be encouraged to participate in order to help keep her arms active. PRESURE AREA CARE As Catherine suffers from Psoriasis she is even more susceptible to pressure sore development. Her skin should be cared for as per her prescribed treatment – creams and lotions to be applied daily. At the moment she is fairly mobile and does not remain in the one spot for too long – if she suffers bad pain during the day she tends to stay in bed and will need assistance turning and should be encouraged to do so – a second HCA may be needed for this as she has had two hip replacements which have to be cared for also – a hoist may be needed on occasion. Gel cushions should be used when she is playing cards with friends as she could be in the one position for hours, to break this she should be encouraged to get up and walk around every hour – even if for a few minutes. EFFECTIVE VERBAL AND WRITTEN COMMUNICATION WITH CLIENT AND HEALTHCARE TEAM Catherine has to attend various appointments for scans and pain medication updates. Any new developments need to be explained in full to her so she can make an informed decision as to what course of action she wants to pursue. Catherine must be kept informed at all times of any changes in her condition and has requested that she be told first so she can decide whether to tell her family. She has stated during meetings regarding her funeral wishes but may want to change these so ensure any changes are documented. All daily charts are to be kept updated immediately and inform the staff nurse of any noted changes in her condition at handover. As her cancer is rapid and fast progressing Catherine’s condition can and will change on a daily basis therefore food and fluid charts are vital. At the moment she is normal on the M.U.S.T scale, but as she tends not to eat when in pain this has to be carefully monitored and reported if she is refusing food or fluids. ASSIST CLIENT WITH ACTIVITIES OF DAILY LIVING Mobility Assistance Catherine needs assistance when getting in and out of bed. She can sometimes sit up on her own but during spells of confusion she forgets how to stand up and should be encouraged and supported to do it herself as long as possible without the aid of a hoist. She may also need assistance getting in and out of the shower and needs her hair to be washed as she can no longer raise her arms above elbow height. If the weather if favourable Catherine likes to go outside – she should be accompanied and ensure her wheelchair is in good working order. Allow her to walk as much as she can pushing the wheelchair but ensure she does not get too tired – encourage her to get into the wheelchair and continue until she wishes to return. Catherine’s pain medication is prescribed by the GP and monitored by the Palliative Care team. She has certain pain killers that are available to her without the nurses supervision – please record when and what she is taking and report it back to the nurse for monitoring. At the moment Catherine is normal on the M.U.S.T scale and we have to endeavour to keep her that way – she is on a chopped diet but needs to be monitored as the tumour is pressing on her oesophagus – it could cause a choking hazard – any noted changes to her swallow must be reported back to the nurse for further investigation by the MDT. When she is confused Catherine needs assistance eating as she forgets how to use the cutlery. PROMOTE THE RIGHTS OF THE CLIENT TO DIGNITY, PRIVACY, INDEPENDENCE, POSITIVE SELF IMAGE As Catherine is very self-conscious about her body – every effort must be made to give her as much privacy as possible when dressing and showering. She will need assistance dressing on occasion especially when she is confused as she gets the order of clothing mixed up. The HCA can discuss her wishes with her and come to an arrangement regarding the assistance she requires. Catherine is very independent and likes to take her own medications and feed herself. She has expressed her wishes numerous times to all her family and multidisciplinary team regarding her funeral wishes and insists that she not be left alone from now on and even when she passes she does not want to be alone until she is buried with her husband. Catherine needs to feel in control of the disease and wants to be informed if there is any changes being made to her medications or if the multidisciplinary team think that she is declining in any way regardless of the news make sure she is kept informed and involved in all decisions – it is best practice to inform Catherine first and let her decide when and how much information he and the rest of the family is to be told. BIBLIOGRAPHY http://www.upledgerclinic.com/conditions_symptoms.html http://www.cuislecentre.com/therapies/ http://www.ahrq.gov/legacy/research/ltc/fallpxtoolkit/fallpxtool3h.htm http://www.clinicaloncologyonline.net/article/S0936-6555(08)00451-2/abstract http://www.nurse2nurse.ie/Upload/NA6762article.pdf http://www.ncbi.nlm.nih.gov/pubmed/19059769 http://www.patient.co.uk/doctor/end-of-life-care-pro REFERENCES Cuisle Centre, Cancer Support Centre Laois, Cancer Support Portlaoise, (2014). Therapies Cuisle Centre, Cancer Support Centre Laois, Cancer Support Portlaoise. [online] Available at: http://www.cuislecentre.com/therapies/ [Accessed 19 Dec. 2014]. Knott, D. (2014). End of Life Care | Doctor | Patient.co.uk. [online] Patient.co.uk. Available at: http://www.patient.co.uk/doctor/end-of-life-care-pro [Accessed 15 Dec. 2014]. 1

Commentary On The Road Not Tak :: essays research papers

The poem is basically about a person who has at some point in his life been posed with a question of which path to take. Obviously, there would be a dilemma on his part and the poem revolves around his decision. Frost’s narrative style has lent itself to a certain amount of ambiguity in what he is trying to convey. This ambiguity that Frost has left the reader to contemplate is basically divided into two schools of thought. The first is that Frost has a regret for the choice that he has made and he is relating the hardships of that choice to the reader. The alternative is that he is simply trying to make a statement about life and harbors no regret towards the choice that he has made. The first theme to be considered is that of Frost’s analogy of one’s life being put onto some sort of timeline and he has used roads to illustrate the idea of many possibilities. The use of nature in the same line â€Å"Two roads diverged in a yellow wood† gives an almost organic-like appeal. This helps us to integrate roads into the natural environment and it gives an impression that the decisions that we have to make are natural. The divergence of the two roads into the same place (a yellow wood) symbolises Frost’s departure into the real world (because of the singularity in â€Å"wood†). This could mean that the wood is being compared to the â€Å"unknown† world. Again, in the first stanza there is the start of the ambiguity in the very colour of the wood. A strong believer in the view that Frost has given a regretful tone to the poem will point out that there is a significance in the very colour of the wood. This is because yellow represe nts autumn time where the stigma is that everything around him is dying and because of life he still has to continue. Furthermore, there is the inclusion of the second line â€Å"And sorry I could not travel both†. This could mean that he is regretful because he will never know what the other path offered. On the other hand it could also be interpreted that it is plain curiosity which has led him to say this, not any regret for what he has failed to do. Frost has used a clever illustration of the continuance of these roads to depict the uncertainty that life holds.

Undefeated

Undefeated Being positive and a true believer in good things will always give you the best outcome in life. Johnny was always out in the court playing what he loved. Second on his team, he was the most recognized basketball player in the entire high school. Johnnys passion towards basketball began when he was Just 8 years old. Always dribbling the ball around and playing with his friends, and never lost a game. During the school year, Johnny was determined to be his best in school but also to compete in the state finals.So to do that, he would come to the gym court every morning to practice. He hardly every missed a practice. Every day he would try his best to be healthy so his bones could be strong on the court. Johnny lifelong goal is to be a professional basketball star one day. The final game was Just a day away. This was to determine who was going to compete in the district finals. Johnny was as nervous as can be but he couldn't stop from going out there. As soon as the game sta rted, Johnnys team was in the lead. They were trying really hard to play their best.When a foul was called, Johnny was up for a free throw. While he threw the ball, a massive pain in his knee prevented him from continuing. He was in major pain and the ambulance was called to take him to the ER. Later that day, Johnnys teammates and family were as worried as can be. When the x-rays came in, it was noticed that Johnnys ACL was ruptured very severely. Followed by the recovery time and the surgery, it really impacted Johnnys mood. Although Johnny was aware that he had to stay positive throughout all of this.Thinking about the surgery â€Å"Finds, and shall find, me unafraid† kept him going. After the successful surgery, Johnny had only 2 months remaining until he could go back out on the court and play again. As tough as the procedure was, Johnny kept his head up and got through it. Johnny knows, because of his positive attitude and dedication to get better, he will be playing ag ain Just like he used to. All the hard work pays off at the end somehow. One thing to know he said â€Å"I am the master of my fate; I am the captain of my soul. † By mt6nesscaaa

Gender Stereotypes in Advertising and the Media - 1940 Words

| Gender Stereotypes in Advertising and the Media | | | | | | According to Surviving for Thriving, a nonprofit organization that helps victims of rape and sexual assault, one out of every six American women has been the victim of an attempted or completed rape in their lifetimes. This means that a total of 17.7 million women have been victims of these crimes. While these numbers may or may not come as a shock to you, the real surprise is where they start (Surviving to Thriving, 2008). Due to rapid advances in technology and the effects of globalization we have facilitated the emergence of a media saturated world. While the media’s consistent presence has provided us with countless advantages, many negatives have also emerged.†¦show more content†¦Both of these perspectives provide a fundamental understanding of how and why gender stereotypes are so powerful in today’s society but they fail to explain how gender stereotypes started. In order to truly understand the power that stereotypes yield, we must first examine the historical context that gave rise to their existence. Gender stereotyping evolved with the emergence of a consumerist culture. It was vital for companies to exploit pre-existing stereotypes in attempts to attract new and loyal customers to their products (Browne, 1998). Today, gender stereotypes are visible in every form of media: in Hollywood movies, magazines, television commercials and advertising campaigns. Gender stereotypes are often used as a marketing tool because these values have been instilled in our society for centuries and consequently, consumers view these depictions as truthful (Bessenoff amp; Del Priore, 2007). While the obsession with female beauty began in the 1830s when women began to compete professionally with men, we cannot truly understand modern conceptions of beauty until we examine the historical roots of Western ideals. 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