Support For Older People With Memory Loss: Observational Report And Recommendations

Introducing the Client: A Case Study

This assignment presents support for older people. In order to complete this task, memory loss is chosen as the topic. This paper divides into two parts. Part A consists of the observational report where the findings are discussed and recommended some better actions that can improve the client's quality of life. Part B reflects my practice and experience working in healthcare.

Client profile

A is 68 years old and has been living in a care home for one and half a year.  His wife died seven years ago, and his two middle-aged children live abroad. He is a retired secondary school teacher. Presently his children send him money and the authority of the care home to take care of their father. However, the client cannot detect people properly and cannot remember any sequence of tasks.

Moreover, the client has mobility issues after sitting on the chairs; he faces difficulty getting up from the chair. The client had hypertension and diabetes in his medical history. In recent times he has had Alzheimer's disease that may cause his cognitive impairment. It may cause some safety issues and issues of self-care. He is looking upset as his children are not living with him, and he is feeling alone. In the past, he had used medications for hypertension and diabetes. Now he is on medication for Alzheimer's disease.

Challenges experienced by the client

It is noticed that during talking with people, the client has asked their names repeatedly. However, those people are living with him and the staff of the home care. However, after recalling the names, he can recognize them. He is looking confused about the people and place. In the following situation, it is identified that he has asked people about the washroom or restroom, but he has been living here for one and half years. As he has been living many times, he needs to know these places in his care home.

Facing issues in daily activities: The major issue is that the patient has to face the fact that he cannot do his daily activities as he tends to forget things. He cannot maintain his hygiene level and eat poorly. He is not bathing every day and behaving unsafely after drinking water. He has not covered the bottle, and people can fall accidentally. The person can do something that can be vulnerable to an accident (Lingler et al. 2016). There are many things that the person has lost that are required in his daily life. He looks lost while talking with someone and forgets the details of the conversation that he had one day ago.

Communication issues: He is also facing difficulty in communication and losing words. It makes barriers in communication with others for the client. However, Mr A uses the lists of a few names and places, things that he has to do every day. He is trying to manage the changes in his memory. Aging is already a risk factor for memory loss (Lingler et al., 2016). The client already had Alzheimer's disease, which makes this illness more fatal.

Issues Faced by the Client and Possible Interventions

Difficulty in medication management: The patient cannot maintain his medication schedule. He is not taking the medicines for Alzheimer's disease, making this memory loss illness more complicated. On the other hand, there is also the possibility that the patient can take a double dose of the same medicines, which can draw some side effects on his body. The patient has fallen to manage his medications. However, the carers help him to take his medicines on time.

Emotional disorder: Mr A has gone through different emotional disorders. The client has to give stress to remember something that develops anxiety. He is facing difficulty concentrating and other issues that can disrupt daily activities.

Competence and confidence of the older adult

Socially active and cheerful: The client can work in a team, and he has enough enthusiasm to be involved in social activities. He is physically fit compared to other older adults from that living home. Every day at their ground play, the carers do different activities that encourage the older adults to be active (Kinsella et al. 2016). The client has not denied participating in regular exercises during the day and evening. He loves to walk with his friends, who live with him in the same care home.

On the other hand, Mr A is not that person who wants to withdraw himself from society. He is kind and humble. He has flexibility as he has managed and adjusted in this care home after admission. However, he loves to make his own decisions, and he knows how to manage any difficult situation. Moreover, he has enough knowledge as he was a teacher in his profession, and he loves to share his experiences of teaching with others in normal times.

Describing the interventions that are presently employed

Pharmacological medication and therapies: The client was under pharmacological treatment. The patient has Alzheimer's disease, under the therapy and medication procedure. However, there is no possibility that the development of new cells in the brain or the development of cognition ability can be prevented from getting fatal. In the present condition, the patient has been encouraged to join in activities. In social and cultural events, the client needs to remember things to do sequentially.

Exercise and different activities: The carers also used the crossword puzzles or played games that affect the mind and make the mind active. These activities help the client prevent memory loss by increasing connections between the cells in the brain that can support the memory (Li et al., 2021). It can control blood pressure. Mr A needs to take the medications adequately and needs to participate in the therapies that have been used in Alzheimer's disease.

Realistic suggestions for improving the quality of life

Involvement of multidisciplinary team in the treatment

A multidisciplinary team can effectively offer both efficient and effective care for memory loss issues by reducing the ineffective services and can maintain the optimum health of the patient (Zhao et al. 2018). In order to treat this client, a multidisciplinary approach needs to be engaged. It is collaborative care for the patient through a blend of services. In this multidisciplinary team, the neuropsychologists, nurse practitioners, geriatricians, physical therapists, neurologists, social workers and nutritionists are engaged.

Involvement of Multidisciplinary Team in the Treatment

The nurse's main role is to examine and manage the client, and their caregivers can respond to the progress of the disease. The nurse helps the client by monitoring the symptoms, responding to the issues of medication, giving education and reliable information to the family members and may assisting the client in preparation for the progress of the disease (Small et al. 2018). Memory loss frequently gives outcomes in immobility and also decreases physical conditioning. It has affected the muscle tone and strength and also impacts the poor coordination. Physical therapists can assist the client in optimizing the physical conditioning and can maintain safe mobility (Youn et al. 2020). It can help to prolong independent living and the requirement for institutionalization. An occupational therapist can help the client, and their caregivers adapt to the diminished ability of the patient with challenges faced in the daily activities. Using of devices for assisting with dressing, eating, and toileting can be suggested and also demonstrated by the occupational therapist (Rotenberg Shpigelman et al., 2019).

 There is a need to establish daily schedules for the client who can gradually succumb to the mild type of memory impairment that requires little effort. In this scenario, daily or weekly tasks must be set for the same time or days. In order to prevent the memory loss of the patient, there is a need to prioritize the client's diet plan. Proper diet plans and nutrition can help older adults prevent cognitive impairment (Belleville et al., 2018). For making a proper diet according to the requirement of calories and nutrition, the dietitian is involved. The dietitian can help the patient to prevent dehydration and malnutrition during treatment. Dietary intake has been considered as per the dosages of medicines and also helps the client in the management of weight.

The social worker can help the client get access to social services such as financial services, counselling the client and management of the crisis. In this scenario, the social worker is enabled to help anticipate future requirements, facilitate the acquisition of the services and can navigate the caregivers and patients through the extended type of healthcare system. The caregivers can fulfil the needs of developing skills and give more assistance (Clough Shehabi and Morgan 2016). They can promote the community-based type of services and can help the client in the prevention of disconnection from society. They can support her in functional, social domains and cognitive levels of their lives (Weiss et al., 2021). They are mainly aimed to make the client independent or helping maintain independence.

Pharmacological intervention:

The pharmacologic intervention involved in providing the medications and pharmacotherapies. Pharmacotherapy or drugs can stabilize the patient and delay the subsequent decline (Li et al., 2021).

Non-pharmacological intervention:

In this type of intervention, there is a need to involve psychosocial therapies, physical therapies and therapies of the sensory. The strategies may be implemented in the care home and the treatment modalities. The clinical efficiency of the nonpharmacologic treatments may remain to be fully analyzed. Still, it is reliable that the primary goal of the approaches can improve the quality of life for individuals with memory loss (Featherstone 2021).  There is a need to use cognitive-based interventions for memory loss that rely on the plasticity hypothesis that can theorize that the brain is enabled for achieving the functional and neural improvements by the reorganization of the consistent components and the connectivity of the internal network as per the constraints of the environment (Avgerinou et al. 2020).

Cognitive Rehabilitation and cognition training is the most effective nonpharmacologic strategies for implementation in the early stages of memory loss. These interventions also addressed Alzheimer's disease. These interventions engage the targeted training and practice of the particular cognitive domains with the primary emphasis on the attention, memory and executive functions (Higgins et al., 2019). Rehabilitation based on cognitive level differs from cognitive training, which is an individualized type of therapeutic approach. The main goal of this intervention is to improve functioning in each day's life instead of improving performance on cognitive tasks.

As an individual, I can help the client keep a proper routine such as dressing, bathing and eating. I can help the client in his daily activities. I can help the client write down the to-do lists, events in the notebook and appointments. I can plan activities that the client can enjoy, and I can try to do them simultaneously every day. However, I can provide advice on how he can improve his situation and can share different things or tactics that help the client.

Learning from a personal and professional perspective

After evaluating the assessment from a personal perspective, I have gained that memory loss or cognitive impairment is associated with aging, but it can be prevented through a supportive approach. A family has a great role in aging as members can support older adults. It can be said that the family is the only source of financial and economic support for older adults. From a professional perspective, caregivers need to develop more new strategies that can help them to improve their health. However, the caregivers have played a major role in support of older adults and can help them to reduce their feeling of isolation and depression.

Reflect on the practice as a care worker 

This section contains the reflection on the practice of the care worker. The Gibbs cycle has been used to reflect the experiences of working in healthcare (Adeani Febriani and Syafryadin 2020).

Description of the events

I would like to share my experience of working in a healthcare facility as a care worker where I had to work with the different patients, relatives and members of the healthcare team. I need to support people with physical and social activities. I had to work under the guidance of a supervisor who was a medical professional and administered medication. My main responsibility was giving medications to the client by maintaining a schedule, and I had to monitor the client's condition and need to report my supervisor or client manager.

Review

While doing this job, I am quite satisfied as I have made therapeutic relationships with people effectively. I have shown mutual trust, respect and caring with the patient, family of the patient and team members.  I have a wide range of scope to learn other personal and professional skills. My overall experience is good as my supervisor. Client managers are very cooperative. The staff and the patients, and their family members are also cooperative. Although in certain cases, I had to give more effort to communicate with the family members of the patients who have come from the rural areas.

Evaluation

Most of the patients have a positive emotional connection to the therapist. There is a need to make therapeutic relationships through four stages such as commitment, change, process and termination. I have learned to implement effective problem-solving skills and flexibility skills as I can adjust in any department when the shift time changes.  However, sometimes I have felt difficulty in communicating with the rural people or family members of the patients and sometimes I could not respond to the queries of the family members due to pressure of workload due to lack of time management skills. This may affect my relationship with the patient or family members.

Analysis

After analyzing my experience working with the client, their families and the team members, I can say I had a great experience. I had a great journey as a roller coaster because of the ups and downs in the relationship. I have completed my journey with the support of team members, cooperative patients and their family members.

Conclusion

He was a good communicator, empathetic, emotionally strong and calm to understand the needs of the patients and their families. Not only with the patients, but I have also listened to all instructions from my supervisor carefully. On the other hand, If I had the time management capability, I could communicate with the patient's family members in a better way. Therefore, I need to develop my time management skill and problem-solving skills to give responses to the family members of the patients as it is one of my responsibilities.

If it happens again, I need to make sure I will be able to give a response to the queries of the family members. For this reason, I need to focus on those skills that can help me manage this critical situation. I have learned about myself that I am capable of working in new places, although I need to sharpen some skills.

Objectives	Specific	Measurable	Achievable	Relevant	Time Limit
To develop my time management skills	Making short time goals	It can be measured by reviewing achieving the short goals	It will be achieved by regular practice	It will be  reliable as it increases my skills	2 months
To improve my communication skills	Taking different language classes and researching different communication strategies that have been used before to solve the issues	It is measured by analyzing the capabilities of communication	It will be met through using different language and communication strategies with patients and family members	It will be relevant as it helps to improve my skills	3 months

Table 1: SMART GOALS WITH ACTION PLAN

(Source: self-created)

Description of the events

Interpersonal issues are related to value conflicts, ego, value conflicts and policy conflicts. In this section, I would like to share the most interpersonal issue that I have faced in my practice is that behavioural issues and ego. Normally, people have their values, and I have my own. However, at initial times, in my team, few people have an ego as they joined this healthcare 4 or 5 years ago. I have seen that three people have separated them, and they may possess the stereotypical belief that those people who are new joiners have a lack knowledge and talent. Sometimes their ego and my ego get conflicted. They are underestimating other team members or new joiners. It is a barrier to forming a positive communication strategy with my team members.

Review

In the initial stages, I got upset and lacked the motivation to work in this workplace. I could not implement a positive communication strategy as the behaviours of my team members have influenced me. However, my supervisor was supportive and cooperative. He encouraged me to communicate with people and try to maintain eye contact. There is a need to be aware of the body language of those team members and listen to them actively. I can join in the different activities or workshops with them and present my capabilities in my work.

Evaluation

From this situation, I have learned how to resolve interpersonal issues in order to implement a better communication strategy. It might be possible that I have to face different people with different backgrounds but accepting diversity and small types of activities can increase inclusive practice. I have developed interpersonal skills through this situation. However, in the initial stages, I had issues communicating with the team members because of ego conflicts. Still, after participating in the activities, the misunderstanding or ego clashes have been reduced. At First, it decreased my morality and motivation, but after some time, I was motivated on my own. It helps to develop self-motivation skills.

Analysis

After analyzing the situation, I have understood that I can be better at handling the situation if I accept diversity. However, there is also the need for the cooperation of those team members. However, I can handle this type of situation in future to eradicate the issues through small types of communication workshops where we can share views. I need to acquire my teamwork skill to help me work collaboratively. I need to use different communication strategies to implement effective communication. However, I need to use email and other communication tools for effective communication.

Conclusion

I can say that after this situation, I can use different communication strategies and accept and implement diversity for inclusive practice. On the other hand, I need to develop my teamwork skills, and I need to develop my diversity skills.

The action plan can help me to improve the skills that can help me in future to manage the above critical situations.

Objectives	Specific	Measurable	Achievable	Relevant	Time Limit
To improve teamwork skill	Working with teams for any goal	It c an be measured by checking the capability of working with a team	It can be achieved through cooperation	It is reliable as it addressed my objective	3 months
To improve my diversity skills in my practice	Reading stories or news about how the cultural or other diversity has been implemented	It can be measured by evaluating the progression	It will be achieved by application of the different training and workshops on the diversity	It is reliable as it addresses the objective of developing communication skill	4 months

Table 2: SMART GOALS with Action Plan

(Source: self-created)

I would like to present my effectiveness as a care worker in my practice. I was supportive and encouraged clients throughout my entire practice via my leadership quality. As a care worker, I need to book and approve people's requests for appointments. I have helped with personal care, such as I have helped the patients with dressing and showering. I have supported people by helping them in drinking and eat. I have used my leadership skill to do the different levels or areas of responsibility. I have fulfilled all aspects of my role and helped to increase the efficiency of the organization. The patients are also satisfied with my service.  I have shared stories and given them time to understand their needs. I have been practised as sensitive and respectful. I have respected my supervisor, team members, patients and their families. I had the flexibility approach for adopting new approaches for each new client. It can enable me to shift with my caseload for carrying out the best work. I have used a friendly approach for the client that gives them scope to express any kind of concern. I had to handle different regular cases of health issues where I needed to make different decisions.  In this situation, I have felt stressed because of an overload of work because I have not planned or organized the work regularly. In addition, I could not take care of my health and safety.

Review

I was happy that I had properly carried out my responsibilities as I have served my service as the linker or connector between the health professionals and the patient. I had felt that I had. During work, initially, I was getting frustrated as I felt overloaded. Initially, I could not arrange the work sequentially. In real terms, I could not understand that I have felt overloaded or pressured by work due to illogical orders of my tasks. It reflects that I was lacking in the arrangement or organizing skills. In addition, because of this overload of work, I have felt stressed and getting frustrated.

Evaluation

Although from this situation, I have understood and learned that planning is a vital aspect to maintain daily activities in a schedule. It has influenced my actions, and I am getting more serious about organizing the tasks in daily life. After evaluation, it can be said that leadership quality and communication skills are my strength, and I was weak in the planning or organizing skills. I could not make the plan properly. How should I design the tasks in the schedule that helps me to eliminate the overload or pressure of work. The improper organization of the work has given extra stress or overload of work.

Analysis

There is a need to improve my planning skills to help me arrange my work one by one. It will give me scope to take care of myself, and I can maintain safety in my workplace.

Conclusion

It can be concluded that I have acquired leadership skills properly. However, there is a need to improve my overall planning skill. Leadership skill enhances my capability, but they cannot contribute to reducing the overload of work. In order to deliver time to time care to each one within the time, planning is a crucial component.

In order to reduce extra baggage or unorganized workload in future, there is a need to develop my organizing skill. In order to improve my organizational skill, I need to make a to-do list where I need to arrange my tasks sequentially. I can make short goals that I can easily achieve that I need to include at the top of the list. It helps to maintain a healthy work-life balance in my future practice.

Description of the events

In the workplace, there is a need to give and receive feedback that can help people to change behaviours and can improve their level of productivity. Moreover, I have been guided by my supervisor appropriately. The supervisor has helped me and allocated my jobs. The supervisor has given a list of the clients under my monitoring process. I also have to follow up with the clients and need to take admissions or readmissions of the patients. It was clear to me that I have to monitor clients and be responsible for arranging the appointments for the clients. However, I have received feedback from the supervisor and client manager about giving care to the patients. I have gotten positive feedback from both of them. I also have given feedback about my experience in the workplace.

The feedback has been given in the format of verbal discussion in a session. However, one aspect where I am weak, according to the feedback, is that I am independent of the supervisor or others. I need to work alone without any assistance. There is a need to assess the situations and need to make decisions by myself so that can help me to be confident in my practice. It is also stated that I need assistance making plans for work where I need to work. Otherwise, I have all the qualities that a care worker needs to be carried out. I need to develop flexibility, respect, professionalism

Review

I was glad that I had gotten positive feedback from the supervisor and client manager. However, I could not get any feedback from the clients. It is not good that I have disagreed with the patient directly. It is quite disappointing as their feedback can encourage my capability of work.

Evaluation

  Through giving feedback, I have gained knowledge on how to give feedback, and it helps me convey my experience to the supervisor about working here. This process can give details about the changes required in the organization according to my perspective, and it also helps to know the views or progress of my practice.

Analysis

I have given feedback that I am happy, but there is a little issue regarding the job allocation. I have found that I have to do many tasks in one day, and on the other days, I have fewer clients to manage. It hampers the continuation of my work and affects my capability. The feedback has influenced me. I have utilized this feedback to improve my skills which I could not apply properly.

Conclusion

It can be concluded that I have to develop my organizational skills. Otherwise, I have all the professional and personal skills needed for the caregiver profession.

I need to develop my organizational skills by setting short goals. After completing the target, I need to make another one. I need to use a list of works or a to-do list that helps me to improve my planning skill.

Description of the events

During my work in healthcare, I have used this opportunity to learn new things. I have understood how to report the changes in patient health and the keeping of records. I need to use critical thinking skills and also contribute unique ideas. However, I was not so familiar with the advanced usage of computer applications for keeping records which is causing a delay in reporting.

Review

Firstly I have struggled to develop my advanced computer skills, but I have learned them. I am happy that during this responsibility, I have developed record-keeping skills. It is the way of having a well-maintained, organized and written process, personal growth and can accomplish and encourage participation.

Evaluation

I have learned about the way of recording and reporting the legal requirement. I learned the importance of the report and recording the documents for occupational health and safety. However, if I had advanced computer skills, I could manage the process and maybe report within the correct time.  

Analysis

Initially, I was late in the reporting procedure, which was disappointing for the team members. As I have not acquired proper management skills, a few days after getting accustomed, I have reported each record, such as policies, procedures, indexing, accessibility, and disposal of the obsolete records.

Conclusion

It is clear that I have developed my record-keeping skill, but I need to learn about the advanced skills. For future practice, I need to develop my advanced computer skills to manage this kind of situation.

I will take a 6-month course on advanced computer skills in the upcoming days.

Description of the events

At my practice, I was aware of maintaining dignity. Dignity refers to the individual maintaining self-respect and being valued by other people. In order to maintain dignity, I have listened to the needs or any point of view of the patients. Most of the time, I have to handle the older adults. I have understood their values and their traditional cultural approach. I have respected their opinions and politely answered them. For example, I have always given a choice to the client to wear their clothes and always given priority to their decisions. However, I need to deny some clients' decisions, such as ignoring or not wanting to take baths for two or three days. At this time, I do not agree with the patient. In this situation, one older adult has felt that I have not maintained dignity in his care.

Review

I felt confused about handling those situations when a patient does not agree to take a bath. After taking advice from the supervisor, I have understood how to manage this situation. I have maintained the dignity of the patient via talking to him in a polite voice and explaining to him what consequences can be raised if he is not taking a bath. I also have asked the family members to encourage the patient to take a bath.

Evaluation

I have developed the creativity skill in my practice that I can strategize to manage critical situations. I have developed negotiation skills as I have negotiated with the patients about doing something to get a reward. These types of difficult or critical situations have influenced my skills. If I could not manage the situation, the other staff had to be involved in the conversation. Then it can be considered as my failure to manage a client and promote dignity for him.

Analysis

I need to be more familiar with the term dignity. Firstly, I have denied and disagreed with the patient that is not maintaining the patient's dignity. It can increase anxiety levels among the patients. For this reason, I need to learn how to critically think and manage this type of situation.

Conclusion

I lack knowledge on how to manage critical situations.  I need to learn how to manage critical situations to maintain the client's dignity. However, I need to learn the monitoring skill that helps me understand the actions behind this action.

It has been identified that I was lacking in handling critical situations. In order to manage critical situations in future, I need to develop my monitoring and critical thinking skills.

Objectives	Specific	Measurable	Achievable	Relevant	Timebound
To improve critical thinking skill	? Question assumptions ? Reason through the logic ? Diversify thought	It can be measured via managing different situations	It will be achieved through practising	It can be relevant as it addresses the goal	4 months
To improve monitoring skill	? Observing patients within	It will be measured through the evaluation of observing skills	It can be achieved by reporting the results of the observation	It will be reliable as it addresses the goal	6 months

Table 3: SMART GOALS with Action Plan

(Source: self-created)

Description of the events

I have the responsibility to help the patient in daily work and report to the client manager about the patient's health. I have managed the admission and appointments of the patients. My values refer to giving the same and equal priority to all patients without any discrimination. I have open-minded beliefs regarding culture or any other things.

Review

I am happy that I have given care to all patients equally. I have not assumed the decisions or cultural beliefs of the patients. I have asked and understood the beliefs and values of the patients first; then, according to need, I have given priority.

Evaluation

I have not never discussed my values or beliefs with the clients and have always given them the right information to make my practice inclusive.

Analysis

I have maintained the boundary while having an open discussion with the patients. I have always given preference to the interests of the patients with consent.

Conclusion

It can be concluded that I have developed my skills and continuously fulfilled my responsibilities. However, I need to make new strategies to improve my way of giving care.

I need to be more professional and learn more new things that can help me be properly supported in the future.

References 

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