Person Centred Care

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The Importance of Using an Individualised Person Centred Approach to Nursing Care with and for Older People

This essay explores the idea of Person Centred Care and the significance it has in caring for an older patient. Issues related to patients incapable of taking part in their care will also be discussed. Each and every patient should be treated holistically and individually to their own personal needs as part of any nursing care plan. This essay will show this is especially evident in the person centred approach to caring for the older patient.

What is person centred care?
Originally developed by Dr. Carl Rogers in the 1960s as an approach to psychotherapy, person centred care is an approach to nursing care which involves the patient’s participation in their own care. (Cited by Cox, 2011) It requires a therapeutic relationship between nurse and patient in order for the best outcome for the patient. The nurse’s role in this situation is to recognise the patient as a partner in their care, to provide a network of personal support and practical expertise without directing; only advising and facilitating the patient down their own path to recovery. (McCormack, 2003)

Why consider treating older patients differently?
Science has taught us of the physiological changes in the body with age. These ageing changes include: the way sickness presents itself in the older body, the response of the human body to the treatment given and even some treatments that may no longer be suitable. Psychological changes affect memory as a result of ageing. There can be a lesser understanding due to the change in technology and medicine over time with more modern procedures and equipment. (Lippincott, 2011) It is common sense that because the patient is older their patient history could be more extensive than a younger patient. They may have been exposed to contagious illnesses that lay dormant in their bodies until now. Extra consideration to all aspects of the patient’s assessment is significant when treating older patients.

Older patients incapable of participating in their care
The key element in the person centred approach to nursing care is ensuring your patient’s capability to participate in their own care provision and to cooperate with the multi-disciplinary team (Cox, 2011). There are a few different issues to consider when treating the older patient. Their mental status must be taken into account; are they capable of understanding and following instructions regarding their medication, physiotherapy and diet? Are they independent in their activities of daily living or do they require assistance? If so, does the patient have a preference to the gender of their carer? The patient could be confused as a result of their illness or medication. A further explanation for confusion in the older patient is dementia. The Mental Health Foundation (2006) defines Dementia as “...a decline in mental ability which effects, memory, thinking, problem solving, concentration and perception... Dementia is almost invariably a disease of ageing” If an elderly patient is incapable of making rationale decisions for their self and unable to cooperate in the participation of their care, the next of kin’s involvement is very important. We as healthcare professionals can only do so much for the patient but it is the next of kin’s decision as what is best for the patient. This student must point out that in this situation the upmost importance of including the patient in any conversations rather than speaking over them to their next of kin. It may seem obvious, is best practice and is common courtesy but unfortunately it does happen. No matter what the mental status of the patient is, showing them respect and maintaining their dignity is still top priority. As nurses, best practice is ‘promoting the understanding of residents and family members of the nature of dementia.’ (HIQA, 2009) People suffering with dementia often feel confused and...
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