Critical Review of Dementia Service User's Experience of Care

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Title: A 3000 words essay critically reviewing a service user’s journey through their experience of care

In this essay I will critically evaluate a resident by the name of Tom Journey with dementia. He suffers from Alzheimer's dementia and lives in sheltered housing. I will explore issues surrounding nutrition intake, wandering, communication, incontinence and the environment that affect the client, family and staff. I will then look at the assessment process, care planning, implementing and evaluation. I will explore patient safety, intervention and the processes that managers and professionals have to undertake when managing patients with dementia. These interventions and approaches adopted are vital when planning person centred care. In addition, due to the policy of confidentiality I would not mention the name of the organisation and persons involved. The essay will end with a conclusion and a summary.

According to Mathers and Leanardi (2000), “Dementia is a syndrome caused by a range of illnesses and currently many are incurable, and cause progressive, irreversible brain damage. They include Alzheimer's disease (the most common cause), vascular disease, frontal lobe dementia and Lewy Body disease. Symptoms of dementia can include memory loss, difficulties with language, judgement, insight and failure to recognise people, disorientation, mood changes, hallucinations, delusions, and the gradual loss of ability to perform all tasks of daily living”,( Mathers and Leanardi, 2000). Mace and Rabin (1999) highlighted that, “the word dementia originated from two Latin words which mean “away and mind”. This can indicate a loss of memory inability to function effectively, which can result in mental confusion”. Jack is a seventy year old man with dementia. He lives in sheltered housing. He has four children two sons and two daughters. He was moved from his home into sheltered accommodation after the death of his wife Mary. His condition deteriorated very rapidly and he needed extra support to live at home safely. The family was unable to adequately provide for Jack’s needs, so they decided to re-house him. The family brought Jack with them to view the flat before he was moved in. This allowed Jack the opportunity to meet the staff and get familiar with the new environment. He was brought in by his son and daughter, but his son stayed with him in the guest room for a few days to get him settled and feel comfortable. Jack was showing early signs of dementia as his communication was not clear at times and often his speech was muddled. Furthermore, his memory was poor at first as he kept asking for his wife repeatedly for examples, ” where am I”, “whose house is this”, and “why am I here”. Also his nutrition was an issue as he was not eating his meals and often said he was not hungry or he would eat later. He would sometimes say take it away and feed the pigeon. Food would turn up in various places like bins, in drawers and even in his bed. Mace and Rabins (1999) mentioned that eating alone can contribute to or worsen their confusion.

Incontinence was also a big concern for staff as he was constantly wet and soiled with faeces. He would choose places not suitable to use for toileting, removing his protective clothing. He was also hiding dirty soiled clothes in inappropriate places. Moreover, getting his personal care done was a big task as he was not cooperative. Beatie et al, (2005) stated that people with dementia do not know that they are not being cooperative with certain basic tasks. This could be related to my client as I observed these issues on many occasions. All these conditions have been highlighted by (Kitwood, 1997). With regard to incontinence, Parker (2000) supported that because of the dying of the brain cells, a person like Jack will not be able to independently identify the message the brain is conveying about the bowel. This problem was identified with Jack. Jack, as supported by Parker (2000)...
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