Nursing Care Plan for Patients with Dementia

Dementia is identified by the client struggling with both cognitive and noncognitive symptoms, the Cognitive symptoms largely signify an impairment in communication, reasoning, visuospatial function, the lack of capacity to have a conversation, and related mental activities, leading to the decline in the brains function. Whereas, noncognitive effects a person’s temperament, behavior and are suggested dilutional (Vitaliano P, 1986). It is argued that to date research has been connected to the cognitive functional ability and it has been published with a focus on the client’s problem solving, performance and social interaction. (Ditter, Mirra 1986). They suggest in their research it is a correlation of intellectual decline and the impairment in the 12 activities of daily living. There are additional treatments although this does depend on the stage the dementia is at, for instance JJ is showing advanced dementia, therefore, Cognitive behavior therapy (CBT) would not be possible, due to a decline in her memory and low communication skills.

Care planning is an important method of gathering information on a client and is used across all care settings, this helps health care professionals establish all important fields of care required for a client or patient (Royal College of Nursing, 2015). It permits staff to gain access to a client’s past and existing health problems and determine how these are affecting their capability to perform the 12 Activities of Daily Living. It should comprise the actions, aims/goals and a full assessment of the client and the responsibilities within care, this may well be physical or mental health needs, the care plan should be holistic and cover all needs where applicable (NHS 2009). They should include information on treatments and therapies that have been conducted, along with an explanation as to why this was necessary, including details on who is responsible for these procedures (Barrett et al, 2012). This will comprise of health care professionals involved in the client’s care, A Multi-Disciplinary Team. psychiatrists, district nurse, mental health nurses, psychologists, social workers, specialists/community and occupational therapists.

Anyone filling in a care plan are responsible and must ensure that all information within a care plan is documented correctly, confidentially (Data Protection Act 2018). Ethically ensuring that care is highest in all mediations, value the clients right to make independent and informed decisions with dignity and respect, codes of conduct and safeguarding the most vulnerable (NHS, 2009).

The care plan should always be filled in regardless if the client is there for respite or permanent. A care plan should have client’s participation and cooperation to warrant it is person centered, focusing the care on the needs of the client (Social Care Act 2012). Think about the effect it can have on the client for example in the care plan above, JJ cannot get into a bath therefore she must take a shower. (Royal College of Nursing 2016). The advantage of client’s participation in their own care plan is that the content is individual and the client feels empowered within their care, this helps them to maintain their independence, also assisting the client in a better recovery response (World Health Organization 2015). In the case of a care plan for Mrs. J her deteriorating cognitive disorders implies that she will progressively suffer the loss of capacity as her disorder develops. Nevertheless, the realism is that for individuals with dementia, advance care planning would be an advantage but does present a problem as it is not certain when the decline in cognition will start (Sampson and Burns 2013). Families of the client likewise have the chance to be involved on all levels as they will be able to recall things the client is unable to remember, including care assessments, activities, and interventions in the goal to promote health (Berwick 2009). As the client’s requirements change the care plan must be adapted appropriately to keep the clients care process relevant and effective.

Many care plans will follow a medical model. The Roper Logan and Tierney model implements a holistic approach. (Roper et al 2000) indicate that the model consists of five theories, activities of daily living, independence- dependence continuum, Lifespan, factors influencing the activities of daily living and Individuality (Appendix 2). Most model’s emphasis is on characteristics of physiology, socio-environmental factors and behavioral affecting on health. In 2000 Aggleton and Chalmers indicated this takes away from the theory of individualism as techniques are established on expectations about peoples shared aims. When used in the care sector guidelines this should outline the experience of the individual’s health on their own perspective and not to be assumed, as identified by the department of health (2012).

Conclusions are based on the strengths of a care plan that the staff can acquire a vast amount of qualitative data quickly, although, there are criticisms expressing that this is very time consuming and that client may choose or forget vital information leading to the wrong kind of intervention, thus, putting the client at further harm. Nevertheless, data has indicated that the good care results are reached when the individuals participate in their own care plan aims and goals, as it improves the ability of the client’s conformity throughout their care plan (Wagner et al, 1996).