Reflective Essay On Personal Values And Beliefs For Caring As A Nurse In Aged Care. (70 Characters)

The difficulties encountered in attempting to describe and define it” (eds Brykczynska & Jolley 1997, p.1).Considering the quote above and your current understanding of the art of caring, undertake a reflection on your personal values and beliefs on caring as a nurse. This should include consideration of an example of where you have experienced or observed ordinary practice that was perceived as extraordinary.

Undertake a creative reflection of your values and beliefs on caring as nurse considering the above quote, person-centredness within your practice and the Synthesised Model of the Communication of Caring in Nursing (Knowlden 1998, p. 60). This creative reflection is to be presented in the form of a visual representation; this can be in any form except for a PowerPoint presentation. You are to participate to the discussion forum with a short overview of your creative work and provide feedback for one other student.

Write a reflection using a recognised model to demonstrate how the exploration of the creative representation will enable your future practice to be authentic to your values and beliefs.

Overview of aged care

In the health care sector, nursing is a key profession that focuses upon care of families, individuals and communities to keep and recover public health and optimal quality of life, thereby making the society healthy. One of the key domain in nursing sector is the aged care nursing. This field of nursing is mainly concerned with the provision o adequate nursing care and health care facilities to the elderly people in care homes, residential facilities, hospitals or in community care services. In the current era, in the developed countries, with advanced heath care facilities, the life expectancy of the population is being increased, making the population to be aged faster.

With increasing aged population, the prevalence of age-related health issues is also increasing, which is enhancing the importance and need for establishing advanced stage of aged care system. One of the key solutions of promoting appropriate and efficient aged care facility is ‘person-centred care approach’, the potential of which has been demonstrated in several evidences (Pulvirenti et al. 2014, p. 303). The key focus of this report is to demonstrate and analyze the current culture of aged care nursing, especially on person-centred care along with the recommendations for improving the current situation.

Overview of aged care

Aged care facilities focus upon taking advanced care to the elderly population. In this context, the aged care population focusing upon not only the physical care of the elderly people, rather aged care in developed countries are focusing more on holistic care of the care users. It helps to promote the overall health of care users, instead of focusing upon a single domain of the care facilities. Additionally, the aged care facility is also focusing upon enhancing the quality of life of the elderly care users, through holistic and client centred approach. The holistic well being helps to promote the overall health of the care users, by promoting physical, mental, social, emotional and cognitive well being (Ageing and Aged Care 2016). For this, the nursing care givers need to align the care approach with the aged care principles.

Considering the Australian perspective of aged care, it has been revealed that wide range of care options are becoming available for the aged care, which is promoting the quality of overall aged care services of Australian health care framework. In this context, Australian elderly care includes two key types of care facilities in wider concept. These include residential aged care system and community based aged care system (AIHW 2016). The residential care homes focuses upon providing health care support to the elderly service users along with the accommodation facilities, for those people, who cannot be provided with adequate elderly support at their home.

In turn, the residential facility is provided in two forms, i.e. permanent aged care facility and respite care facility. The permanent facility include care provision for the patient in a permanent manner, whereas respite care facility provides short term residential care, where patient need to stay in the care facility for a short period to deal with a short term health issues. However, with advanced care and innovation in aged care; since 2014, the system has become superseded. In July 2014 the Federal Government started changing the aged care system; home care is being facilitated, instead of focusing more on residential care.

Current culture of aged care nursing

The Australian aged care facility has undergone significant evolution, as the aged care needs are being changed day by day and these changes are significantly affecting the nursing care to improve the quality of care facilities and improving the health as well as lifestyle outcomes of aged care users. In several previous evidences, the impact of evolution in nursing care is visible in the nursing care facility. The recent standard of Australian aged care system is significantly high in respect to the care facility worldwide and it is continuously evolving, going through several stages of change.

Through the continuous evolution, the aged care system in Australia have gained more sustainability and have successfully made the aged care system in an affordable system that can be accessed by all types of care users. The continuous transformation of the aged care system though the past 10 years have made the system more attractive towards the investors, which is enhancing the potential of the system to provide higher quality service, thereby promoting the sustainability of the system. During the last 5 years, with the advancement of aged care and nursing responsibilities, the career option has also been promoted significantly (Australian Aged Care Quality Agency 2014).

While reviewing the evidences from the existing literature regarding the trends of nursing care to the aged care facility, in the developed countries, Australia and US have shown the transformation of the elderly care priorities from the care provider’s perspective to consumer’s perspective. For instance, the entire sector has been evolved from a care provider oriented system to consumer-directed system.

With the rise of more complex health care issues, as a result of increased life expectancy of aged population, the need for reviewing and focusing on each health care client’s issues have became crucial (Grol et al. 2013). It is no longer remain possible to treat a disorder in a similar way for all the elderly patients, as there are several different factors associated with each client’s case and analysis of these factors are vital for leading towards the achievement of high quality patient outcomes. Thus, the evolution or transformation of the aged care sector from care giver oriented to client directed has helped to focus more complex care issues in each client.

The approach enhanced the opportunity for the clients to understand and choose their own care facilities that should be included in the care plan. It in one hand promote patient’s awareness regarding the health issues, on other hand, enhance patient’s adherence to the care plan, thereby ensuring the improvement of the maximized health outcomes of the patient. Moreover, a thorough health care reform has been seen to be adopted by Australia (Australian Government Department of Health 2016). For instance, federal government has introduced new home care approaches and supplements to the home care as well as residential care facilities, in 2013-2014 sessions, thereby promoting the quality of the aged care facilities continuously.

Throughout the world, the aged care facilities have been evolved with the reform of the policies and introduction of strict regulation of the quality of care provided to the service users. While discussing the policy implementation, it should be mentioned that Australian government have launched the Aged Care Pricing Commission for improving the quality of health care service provided to elderly service users in affordable price. In this context, it can be said that the global acceptance of the person-centred care approach have led to a significant positive change in the quality and accessibility of aged care facilities, which have also been reflected in the Australian aged care facility.

Recommendations for improving current situation

The transformation and evolution helped the society by eliminating the barriers among in-group and out-group patients, which contributed in hindering the efficiency of aged care facilities in Australia (Michael et al. 2014, p. 1099). With the emergence of rare psychological issues, researchers and psychologists are focusing more on behavioural and communication based therapies in psychological care, instead of relying upon only the pharmacological therapies. In case of aged care, the implementation of holistic care facilities have promote the inclusion of palliative care in the aged care, which have improved the quality of health outcomes of the aged patient, by enhancing their satisfaction, therapeutic alliance and trust towards the health care system of Australia.

Person-centred perspective in aged care

According to Mackenzie et al. (2013, p. 1265) the person centred care is defined as the care approach that promotes the values, choices and perception of the health care service user to be placed at the centre of care planning, giving the care user equally importance for participating in patient care planning, developing and monitoring like the other members of the multidisciplinary team. To promote the human rights and dignity of the aged health care service users, several aged care facilities have been implemented this approach in the aged care practices. This approach provides the patient and their family to take decisions regarding their care plan according to their own choice and represent their choices to the health care team member, to get the best outcome (Laplante-Lévesque et al. 2014, p. 80).

In a person-centred approach, communication is the most important tool, which ensures a positive therapeutic alliance with the health care staff, which promote patient’s adherence. Additionally, the person-centred care approach promote the holistic assessment of patient’s needs, including physiological, psychological, emotional and social needs of the patient, by thoroughly reviewing and analyzing the medical, social and personal history of the patient. For instance, palliative care is a special domain of aged care, where the older patients are provided with special care, which are at the end stage of their life (Bradley and Mott 2014, p. 1927).

In this context, emotional support is key element of their care plan. On the other hand, with aging ability of completing activity of daily living without support becomes difficult, thus, the aged care facilities also include support to the daily activities and attempt to improve patient’s independence.

In the current context, evidences are suggesting that the existing aged care sector is accepting the person-centred care approach as one of the key element of quality service provision. However, to achieve success, the collaboration between care users, care giver and the care providing environment is crucial, along with the focus towards the patient’s holistic care needs. However, the perspectives regarding person-centred care in previous era and the current era needed to be distinguished by the practitioners (Kaltoft et al. 2014, p. 111).

It is because, the new approach promotes the fact that the care user should be valued, respected and empathized, which are required for building trust and satisfaction of the care users towards the practitioners as well as the system. Several previous and current research studies have suggested that the practitioners and administrators have significantly understood the importance of integrating person centred care approach within the aged care sector. Therefore, the standards of quality service are being met by implementing this approach within the aged care services (Ferguson et al. 2013, p. 285).

Evolution of aged care in Australia

In Australia, the person-centred approach have received significant acceptance in the aged care sector along with community care approach. A significant success is being achieved through the integration of person-centred perspective in the Australian community, at the centre of care giving process. Community practitioners are infusing the person-centred perspective with the community care to maximize the success of their practices, showing the potential of this practice in the health care industry.

Evidence of findings and stories of person-centred culture in Aged care

In Australia, person-centred care has become an important principle that underpins the stipulation of quality health care. From several evidences, it is found that person-centred care can positively affect health outcomes and job satisfaction of the nurses. Principles of person-centred care include knowing the patient or client as person, sharing power and responsibility, accessibility and flexibility, coordination and integration and environment (AIHW 2016). These principles have mane the concept of person-centred care so important that care centres in Australia are frequently adapting this method.

According to Grenness et al. (2014, 70) the Australian College of Nursing (ACN) strongly believes that principles of person-centred care are a central belief that helps to deliver appropriate nursing care and health care. Uniting Care located in the South Eastern Region of Australia is providing a range of care services for more than 14,000 people. This organization is known as the largest provider of aged services in New South Wales. This organization has also implemented person-centred care by fostering and nourishing vibrant relationships, appointment and by providing holistic care.

Several other health care providers in New South Wales have also implemented several other patient-centred initiatives such as motivating participation of patients, focusing on the requirements of the patients and their experiences, assisting the ongoing review and establishment of practice and using proper research and evidence that is generated from practice and care settings. Besides, a clinical leadership program has also implemented in NSW that is helping the healthcare professionals to establish leadership strategies to introduce more patient-centred principles into their practices.

Queensland health is also following a strategy to enhancing experiences of the patients by collecting feedback through surveys. They are also using computer-based information system that is helping to manage complaints and compliments of the patients. This information is helping the Queensland Health to evaluate performance of their patient-centred program. In Queensland, the productive ward and transforming care programs are key quality and safety enhancement strategies which are sponsored by the Patient Safety and Quality Enhancement Service (Reeve et al. 2014, p. 740). Both the programs are implemented only to put more focus on patient-centred care.

The Victorian Department of Health has also adopted patient-centred care in their health care centres. The Ministerial Advisory Council on Safety and Quality along with the Victorian Quality Council has introduced have implemented a proposal to improve the journey of the patients. This proposal or initiative will promote the principles of patient-centred care in the Victorian health sector by enhancing and standardizing information flow and by delivering decision assistance tools to support inter-facility transfer of non-critical patients. Consumer leadership program is also initiated in the Victorian Quality Council with an aim to establish patient-centred programs (Phillips et al. 2015, p. 2616).

Transformation of elderly care priorities from care provider’s to consumer’s perspective

WA health has also introduced a patient first program that places patients and their careers at the forefront of method by improving patients’ understanding of their situation that provided better decision making through informed consent. This program includes a unique volunteer consumer (Patient First Ambassadors) who distribute Patient First Booklets directly to the patients. This booklet includes several things such as informed consent, problems to consider when making decisions about treatment and understanding the probable issues that can occur at the time of treatment (Thomson et al. 2015, p. 635).

Analysis of current caring culture in Aged care

A thorough evolution of the aged care facility related culture has been observed in Australian health care setting. However, to analyze the current caring culture in Australia, a suitable analyzing tool needs to be selected. Here, in this context, the “15 steps challenge” tool has been used. For this, 15 steps are being followed to oversee the care through the client’s perception and promote the exploration of their first impression. The analysis tool helps to focus on both patients’ well as their carer’s concern, understanding the positive and negative aspects of the care procedure and the areas need improvement (Kitson et al. 2013, p. 15).

The key aim of using this tool is to improve the care procedure by offering a better understanding of patients’ impression regarding the health care process and the way of improving the processes. Analyzing these steps of the tool in Australian aged care context, it has been revealed from the patient’s perspectives that most of the older patients are able to access their aged care facilities within the community easily. On the other hand, analyzing the government contribution, it has been revealed that the assessment of current needs of the older patient is crucial for the people accessing the Australian Government subsidised aged care services; which are conducted by government aged care agencies, including Aged care assessment team under the Aged care assessment program (AIHW, 2016).

These mandatory assessments eliminate the complication of the older care service users to get inappropriate health care service from inappropriate service users and promote older adults to get into the right aged care program at the right time. Moreover, these assessments helped in providing information regarding older patient’s holistic care needs, thereby specifying the actual care needs for the patient (Callard 2013).

However, in spite of successful integration of person-centred perspective and understanding the need for the specialized care services, some issues have also been found with the help of the analysis tool. In this regard, the failure of several organizations in maintaining the accreditation standards through the past three years have been found, which has been reported by (Kollmorgen 2016). These significant failure indicated lack of compliance of those organizations with the current rules, standards and legislative framework. Moreover, a lack of qualified staffs in the residential aged care with advanced knowledge in aged care service has also been observed.

Recommendations

Reviewing the current culture of the aged care culture, it has been revealed that there are scopes; where the health care service can be improved further to meet the future demands of aged care sector. Some issues have been identified with the help of the ’15 steps challenge’ tool. For instance, it has been revealed that several organizations are not meeting the accreditation standards, thereby reducing the quality of overall Australian aged care service quality. For this, proper assessment of the organizational quality of care is needed on regular basis, to enhance the efficacy of care (Fox and Reeves 2015, p. 115). This would help the authorities to ensure that aged people are continuously receiving their government subsidy.

Person-centred care approach in nursing

In addition, the organization can employ the 15 steps analysis tool for the purpose of auditing the current organizational system of care provision, which would significantly identify the flaws, providing the chance to improve those particular areas. It would also help the organization to adhere to the CQI, i.e. continuous quality improvement, which is an essential element of accreditation system, thereby promoting the organizations towards achieving their accreditation standards (Ranasighe and Miller 2016, 27). Finally, career opportunities for advance aged care practices should be enhanced, to gain more potential staffs for efficient care of aged population.

Conclusion

The report focused on reviewing the evidenced regarding the aged care nursing and current culture of the same practice. In this context, initially the current and previous trends of the aged care worldwide, with a special focus on Australia have been demonstrated. A significant positive transformation of the aged care facilities have been observed through the past few years, which have positively impacted upon both the nursing care and the quality of aged population’s lifestyle. The report focused on evidence based care approach, person-centred care approach, which has potentially accepted by the aged care sector. With the analysis of the evidences and an analysis tool, the report then demonstrated some recommendations for meeting the future demand of aged care services.  

Reference List

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