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Complete the following short answer questions

1. Why was the carer’s recognition act 2010 implemented?

2. List 3 legal or ethical considerations included in the 10 key principles in the Carers recognition Act 2010?

3. What organisational policies and procedures do you need to pay attention to when caring for a deceased client?

4. What specific standard precautions do you need to apply when caring for a deceased body.

5. Part of your role is to provide support and comfort for the grieving family or carer. Within your scope as an Enrolled Nurse, list 2 ways you can achieve this.

Introduction to the Carers Recognition Act 2010

1. The Carers Recognition Act 2010 was implemented to increase recognition and awareness of the functions of carers in providing care to people with disability, mental illness and aged patient. The objective was to identify the contribution of carers in the well-being of the community. The act mainly gives insight into the definition of carer and their obligations for public sector agencies and human service agencies. The 10 key principles covered by this act give information regarding the considerations for carers. This was mainly related to same rights, choices and opportunities of carers, same rights for children and young carers. It also emphasized that valuable contribution of carers should be recognised and they must be acknowledged and supported for their own needs and optimum health and social well-being.  The Act gave all provisions for respect and dignity of carers and enabling economic well-being and sustainability for them in employment and education (Carer Recognition Act 2010, 2017).

2. There are many ethical and legal implications listed in the 10 key principles in the Carers recognition Act 2010. These are as follows:

  • Ethical implication is seen as the principle mentions providing equal opportunities to all carers and not discriminating them on the basis of age, race, sex, disability and political beliefs.
  • Another ethical implication was related to providing the same rights to all child carers.
  • It also recognized the fact as carers are responsible for well-being of the community, they should also be equally paid by promoting optimum health and social well-being in them.
  • Another priority according to the Act was related to giving own space to carers and acknowledging them to engage beyond caring roles to meet their own personal needs.

The Act also recognised the unique knowledge and experience of carers by giving them the opportunity to engage with other care providers (Carer Recognition Act 2010, 2017).

3. The following organisational policies and procedures are needed for caring for deceased individual:

  • Firstly, complying with legal requirements related to handling death patient and postmortem examination is necessary (Wilson, 2017).

Another responsibility for organisation is to have a certifying doctor available so they can examine the deceased person and prepare relevant death certificates. In doing so, the doctors must follow current legal procedure for certification process (Wilson, 2017).

  • In addition, the staffs involved in care of such patients must be made aware of their responsibilities while caring for death people. Registered nurse particularly has this responsibility of correctly identifying deceased person and conveying respect to such person.ID tag is also placed on foot of patient. This has ethical implications because conveying respect is important because once they were a living person. The deceased body needs to be washed and positioned before rigor mortis begins. Both modesty and privacy must be maintained throughout this procedure. Religious and/or cultural preferences may demand specific steps in the care of the body after death, which should be followed as per the client’s, family’s or next of kin’s wishes (Crisp et al. 2013).

Another important responsibility is to preserve dignity, appearance and condition of patient within two to four hours after death (Wilson, 2017). 

4. The standard precautions needed for caring for dead person includes the following:

  • It is the responsibility of the staff to preserve the dignity of patient after deaths (, 2017)
  • Staff must inform all health care professionals regarding the death of the person (, 2017).
  • In case of deceased individual who have been referred to the coroner, it is the responsibility of the staff to leave all catheters insitu and follow universal infection measures to avoid any contamination in the area (, 2017).
  • In case of death without coronial involvement, staff must inform the family members regarding the changes to the body after death. They should also be aware about the procedures for manual handing and infection control process (, 2017).
  • Staffs must respect the spiritual or cultural wishes of the deceased person. However, if they have died because of infection risk, staff must take all precaution to handle patient in sensible manner (, 2017).  
  • Staffs must also adhere to some standard precautions at all times such as hand hygiene, use of protective clothing, body fluid spillage management, cleaning environment and inoculations management (, 2017).

5. According to the scope of practice of Enrolled Nurse, they have the responsibility to provide support and comfort to patient and their family member (Ruth Jacob et al., 2013).  Within this scope of practice of Enrolled nurse, can provide support to grieving families in two ways:

i. They can give emotional support to family members by stating that death was better for the patient considering the long suffering of patient due to terminal illness. The explanation regarding the sufferings due to illness might give comfort to family members that death was better for them  (Ruth Jacob et al., 2013)

ii. It is also necessary to acknowledge them that enrolled nurse understand their feelings and ask them if there are any ways  the nurse could support them at this very difficult time (Ruth Jacob et al., 2013). 

Legal and Ethical Considerations related to Carers Recognition Act 2010

Reference

Ackley, B. J., Ladwig, G. B., & Makic, M. B. F. (2016). Nursing diagnosis handbook: an evidence-based guide to planning care. Elsevier Health Sciences. UK

Boltz, M., Capezuti, E., Fulmer, T. T., & Zwicker, D. (Eds.). (2016). Evidence-based geriatric nursing protocols for best practice. Springer Publishing Company. UK

Brinkman-Stoppelenburg, A., Rietjens, J. A., & van der Heide, A. (2014). The effects of advance care planning on end-of-life care: a systematic review. Palliative medicine, 28(8), 1000-1025, SAGE

Carer Recognition Act 2010 (2017).Care Recognition Act Retrieved 22 June 2017, from https://www.dss.gov.au/sites/default/files/documents/05_2016/carer_recognition_act_2010_guidelines_april_2016.pdf

Cole, R. (2014). Reducing restraint use in a trauma center emergency room. Nursing Clinics of North America, 49(3), 371-381.DOI: I: https://dx.doi.org/10.1016/j.cnur.2014.05.010. Elsevier. Netherlands.

Cress, C. J. (2015). Handbook of geriatric care management. Jones & Bartlett Publishers. New York

Dains, J. E., Baumann, L. C., & Scheibel, P. (2015). Advanced Health Assessment & Clinical Diagnosis in Primary Care. Elsevier Health Sciences.  UK

Giebel, C.M., Sutcliffe, C., Stolt, M., Karlsson, S., Renom-Guiteras, A., Soto, M., Verbeek, H., Zabalegui, A. and Challis, D., 2014. Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study. International psychogeriatrics, 26(08), pp.1283-1293. Elsevier

Gitlin, L. N., Hodgson, N., Piersol, C. V., Hess, E., & Hauck, W. W. (2014). Correlates of quality of life for individuals with dementia living at home: The role of home environment, caregiver, and patient-related characteristics. The American Journal of Geriatric Psychiatry, 22(6), 587-597. Elsevier

Kuys, S. S., Peel, N. M., Klein, K., Slater, A., & Hubbard, R. E. (2014). Gait speed in ambulant older people in long term care: a systematic review and meta-analysis. Journal of the American Medical Directors Association, 15(3), 194-200. Elsevier

Marquardt, G., Bueter, K., & Motzek, T. (2014). Impact of the design of the built environment on people with dementia: an evidence-based review. HERD: Health Environments Research & Design Journal, 8(1), 127-157, Elseveir

Netting, F. E., & Williams, F. G. (2014). Enhancing primary care of elderly people. Routledge. Publication. UK

Nursing and Midwifery Board of Australia - Fact sheet: Enrolled nurse standards for practice. (2016). Nursingmidwiferyboard.gov.au. Retrieved 1 November 2017, from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/Enrolled-nurse-standards-for-practice.aspx

Pierre, J. S., & Conley, D. M. (2017). Chapter 1. Introduction to gerontological nursing. Gerontological Nursing Competencies for Care. Jones & Bartlett Learnng. New York. 

Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri, C. P. (2013). The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & Dementia, 9(1), 63-75.  Elseivier

Ruth Jacob, E., Barnett, A., Sellick, K., & McKenna, L. (2013). Scope of practice for Australian enrolled nurses: Evolution and practice issues. Contemporary nurse, 45(2), 155-163.

Ryu, M., Izumi, S., Ueda, T., Oda, S., & Sakurai, K. (2015). Association between frequency of oral and denture cleaning and personality in edentulous older adults. Geriatrics & gerontology international, 15(12), 1258-1263.  DOI: 10.1111/ggi.12423. Japan Geriatrics Society. Japan.

Serrano-Pozo, A., Frosch, M. P., Masliah, E., & Hyman, B. T. (2011). Neuropathological alterations in Alzheimer disease. Cold Spring Harbor perspectives in medicine, 1(1), PMC

Stanley, M. A., Calleo, J., Bush, A. L., Wilson, N., Snow, A. L., Kraus-Schuman, C., Paukert, A.L., Petersen, N.J., Brenes, G.A., Schulz, P. E,. Kunik, M.E. & Williams, S. P. (2013). The peaceful mind program: a pilot test of a cognitive–behavioral therapy–based intervention for anxious patients with dementia. The American Journal of Geriatric Psychiatry, 21(7), 696-708. Elsevier

Wilson, J., (2017). Guidance for staff responsible for care after death. Retrieved 22 June 2017, from https://www.leedspalliativecare.co.uk/wp-content/uploads/2014/08/Care-After-Death-Guidance.pdf

Wilson, K. G., Dalgleish, T. L., Chochinov, H. M., Chary, S., Gagnon, P. R., Macmillan, K., ... & Fainsinger, R. L. (2016). Mental disorders and the desire for death in patients receiving palliative care for cancer. BMJ supportive & palliative care, 6(2), 170-177. BMJ.

Wold, G. H. (2013). Basic geriatric nursing. Elsevier Health Sciences. UK.

World Health Organization.  (2017).  Dementia. Retrieved 1 November 2017, from https://www.who.int/mediacentre/factsheets/fs362/en/

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