In my conclusion, I shall include recommendation in relating to reducing a fall in older people with dementia. During my clinical placement, I had the chance to realise the complexity surrounding the assesses of falls in older people with dementia. Reducing a fall is a major concern of health promotion that is familiar to all formal and informal carer. (Hainswoth, 2004). The rational behind this topic is that, there is a growing concern in current progress in prevention and management of falls in older people as outlined in a key government target in standard six of the national service framework (NSF) for older people (Department of health, 2001) Falls are major cause of disabilities and the leading cause of mortality in older people and preventing falls in older people with save lives (DOH, 2001)
In my discussion also, I shall use reflective the cycles of Gibbs’s as a framework to reflect upon my own experience in reducing falls. Gibbs’s reflective cycle consist of descriptions, feelings, evaluation analysis, conclusion and action plan (Bulma, 2000). With regard to confidentiality procedures in code of professional conduct as per Nursing and Midwifery Council (NMC 2002), I have decided to camouflage the patient’s name as Tom. During my placement, tom was assigned to me as a primary nurse in collaboration with my mentor.
Tom a 74 year-old Spanish man was suffering from vascular dementia and subsequently remained on an EMI –elderly mentally infirm (illness) ward for five years. There were typical signs and progressions of memory impairment movement disorder typical of mild Parkinson with possible falls and was even nursed on close observation level. On one of my shift s, I observed that, he was sitting on an armchair with belt tied to his bed to prevent him from falling.
Further more after going through his medical charts; he has been prescribed with groups of sedative medication. As a practice nurse, Tom’ issue became a prime concern to me and I discussed it with my mentor. I observed that it is more appropriate to use preventive strategies for Tom than to physically restrain him against his human rights freedom. The most common use of the restrain is to prevent falls and injuries (hammers et al, 2003)
It is recommended that, the use of restrain should be critically re-evaluated, as physical restrains are defined as limitation on an individual freedom of movement (hantikaipen, 1998) This action is being consider unethical, totally against the code of professional conduct and violating human rights. The National Health Service plan (DOH, 2000) “ emphasises the role of nurses as advance”. It is the business of advocate to facilitate the views and rights of the service user. It is the corners stone of European policy to improve the quality of older people in the European Union even when very frail (European Community, 1999).
I believe human freedom and dignity must be maximised. Tom’s care should have been taken cognisance of holistic care. The care plan should have consisted of alternative interventions rather than more primitive methods of preventing falls. As a primary nurse on this placement, I established a good therapeutic relationship with Tom, based on trust and honesty, a risk assessment was carried out, and I discovered studies have demonstrated various prevention strategies as ways of reducing falls in older people with dementia.
During Tom’s care review, I presented...