Care Plan For People With High Dependency Needs
In this assignment, a distinct client group with a range of healthcare needs will be identified and profiled and it will be demonstrated how people with high dependency needs can be cared for by me as the Carer.
Needs of a Specific Client Group
The client is 68-year-old woman named Samantha Matthews. Samantha is suffering from an advanced lung cancer and is currently residing in Seafront Nursing Home. Below, the main healthcare needs will be identified and elaborated and how people like Samantha with high dependency needs can be cared for by me as the Carer will be elaborated in detail.
Physical Needs
In the past, most cancer patients were suggested to move as little as possible and rest. Which means, the level of physical activity was minimal. In general, it is a good advice if “…movement causes pain, rapid heart rate, or shortness of breath. ” However, according to American Cancer Society, recent research has revealed that exercise is “…not only safe and possible during cancer treatment, but it can improve how well you function physically and your quality of life. ” The argument goes that “Too much rest can lead to loss of body function, muscle weakness, and reduced range of motion. ” Therefore, although Samantha isn’t young anymore and her physical movement is restricted, she is advised to attend physical classes that are encouraging her to move, even if it means lifting her hands or moving legs slightly – these classes will have a positive impact on Samantha’s well-being and cancer treatment in general. Some of the advantages of these physical classes are that it will maintain and improve Samantha’s physical abilities, improve her balance – which means the risk of falling and breaking her bones will be reduced, keep her muscles from wasting due to restricted movement, lower the risk of anxiety and depression and more. However, all Carers shall regularly observe Samantha and her physical health during classes and in general. If Samantha feels distressed or tired or in extreme cases pain, the Carer should immediately stop what she is doing, give her prescribed medication and lead Samantha to her private room where she takes some rest.
Emotional Needs
Providing emotional care is typically the hardest part of caring for a patient with advanced cancer. When dealing with advanced cancer patients most Carers make a mistake of trying to solve their problems – it is impossible to do, the fact that they have a cancer cannot be changed nor solved by a Carer. The best thing what the Carer can do is by simply listening and hearing out their concerns. Most Carers overlook the fact that listening is such a powerful tool in helping cancer patients deal with their emotions – it is a simple yet powerful communication technique. To put it simply, active listening is all about concentrating on a client and focusing what he or she is saying. In Samantha’s case one of the things that may help her cope with her emotions is if a Carer sits down with her somewhere quiet, in a private place where Samantha feels comfortable – for instance at her private room. The Carer should make sure that he/she has plenty of time for active listening – the Carer must let Samantha know and feel that he/she is there for as long as Samantha needs.
Another critical element of active listening is to maintain as much eye contact as possible – the Carer should regularly look in Samantha’s eyes while listening to her and gently smile and nod – confirming he/she is actively listening and engaging in conversation. In addition, the Carer should only ask open questions – such as “How are you feeling this morning, Samantha?” – because closed questions typically lead to yes/no answer and don’t encourage the patient to engage in a conversation properly. Everyone deals with cancer differently and cancer patient’s mood regularly fluctuate. To put it simply, people have various coping mechanisms. It can result in sadness, anger, anxiety and denial – as mentioned above, the fact that patient has a cancer cannot be changed nor how the patient feels. The only thing that can be done is to support the client and let her/him know that she/he is being loved and cared for. By simply listening and trying to accept how cancer patients feel will show that the Carer really supports them and therefore make them feel at ease and comfortable while living with a cancer.
Social Needs
When it comes to social needs, many cancer patients, including Samantha have difficulty in interacting with others due to fluctuating mood and prolonged periods of sadness. In such case, the Carer should closely observe the patient and make sure he/she is constantly in touch with people and talk to someone they know and trust. In Samantha’s case, she should be encouraged to maintain contact with her circle of friends, even if it is one or two friends, talk to them and open up about how she feels. In addition, as mentioned above, the Carer should spend a significant amount of time actively listening to Samantha and showing love and support. The Carer should organize community education and activities on a regular basis, so cancer patients occupy themselves with something positive while also interacting with other community members at the same time. In addition, the Carer should also try to organize cultural and traditional activities and various family activities, so to keep the family fire burning strong and as a result helping cancer patient feel loved and cared for by not only Carers, but community and family members as well.
Psychological Needs
This is a sensitive topic that has already been touched upon above. As mentioned above, most cancer patients feel sad and distressed most of the time. So, in addition to active listening and support, the Carer should do all he/she can to surround cancer patient with supportive friends, family and other health professionals. In addition, the Carer should regularly plan enjoyable activities and try to keep doing normal activities – the ones that don’t remind a cancer patient that she/he has a cancer. Also, many psychological issues, such as depression and anxiety are linked to improper nutrition – therefore the Carer should closely monitor what cancer patient is eating and that he/she receives enough of sleep. The Carer should organize activities and help cancer patient do little things that make them feel better, such as wearing preferred makeup or dressing as they wish. Another critical thing is that the cancer patient gets involved in some sort of support group, or a meeting with other people that also have a cancer – it would have a positive social and psychological impact. The Carer cannot change how the patient feels such as Samantha, but it can make cancer patient feel safe, loved and cared for, by organizing abovementioned activities and actively listening on a regular basis.
Spiritual Needs
Spirituality and religion are important elements for people dealing with cancer – it typically enables them to better cope with the cancer and feel good as a result. Spirituality and religion, “…may help patients and families find deeper meaning and experience a sense of personal growth during cancer treatment, while living with cancer, and as a cancer survivor. ” Therefore, each Carer should identify cancer patient’s spiritual needs and religion and help him/her practice it as often as possible. Many patients are Christians, therefore going to church should be organized on a regular basis and wearing religious symbols should be allowed.
Safety and Security
Falls
Samantha is 68-year-old. So, the risk of falling is highly possible – the older the patient, the greater the risk. In addition, due to her sickness, Samantha and others suffering from cancer usually are unsteady and unstable on their feet and are more vulnerable to falling/slipping and hurting themselves. If a patient falls, it can cause minor and major skin abrasions, joint dislocation, fractures, head injuries and much more. To avoid falls and slips, the Carer should make sure that the patient’s personal items and emergency call button are within reach and don’t require standing up and walking to them. Also, the patients should be encouraged to ask for help to get out of bed to use the bathroom if they feel dizzy or unsteady. It might sound less important, but making sure pyjamas and other clothing is the right length is also important – because there is a risk of tripping over. In addition, the Carer should make sure that the patient’s slippers and other footwear isn’t slippery. In cases when a patient has to wear pressure stocking – he/she should be advised to wear slippers over them, so the patient doesn’t slip and hurt him/herself. In case of Samantha and others suffering from advanced cancer, each person should have an appropriate walking aid, such as walking stick or a rollator.
Pressure Injuries
Pressure sore prevention is a critical element of a proper care provision. Pressure injuries, “…may cause pain and discomfort, resulting in a slower recovery and longer hospital stay. ” Most advanced cancer patients, such as Samantha are categorized as high-risk or with a high-dependency. Therefore, they are much more likely to develop a pressure injury – so, the Carer should follow a strict care plan to minimise the risk of developing a pressure injury. The Carer should frequently inspect the skin of a patient for any possible signs of pressure sores and keep client’s skin clean and dry at all times. In addition, each Carer should make sure that nutrition and fluids are suitable for a patient and help a patient change sleeping or sitting position frequently if needed. There are many pressure-relieving devices Caring specialists should utilize, such as supportive pads or special mattresses.
Electrical Appliance Checks
The Carer should make sure that each client’s electrical item, such as hair dryer, docking station or a mobile phone charger, radio and other are fully tested by an electrician for its safety. The Carer should explain each patient that any appliances brought to nursing/care centre by them or their relatives should be presented to staff and that the staff will arrange the electrical testing of electrical items presented. d) Medication Checks Typically, hospitals have “…procedures to minimise the risk of patients being given the wrong medication or wrong dose. ” So, each Carer should carefully check relevant patient files and the dosage instructions before giving any medication. Also, although it doesn’t sound serious, other remedies and supplements might interfere with general treatment process and even cause negative side-effects, so the Carer should inform each cancer patient that he/she should not take any addition medication while being treated, including herbal supplements or remedies, without the consent of a Carer or other medical/healthcare professional.
Keeping Valuables Safe
Theft is possible anywhere. So, the Carer should inform each patient to be safe with their jewellery and money as it can get lost or stolen if not taken care of properly. The patient should be explained that carrying small amounts of cash for necessities such as newspapers and food is ok, but any bigger sum of money should be instead stored somewhere safe and out of public’s reach.
Safe and Hygienic Work Practices
Infections
All care/nursing homes and centres have infection control policies and procedures in place, so each Carer should take all precautions to avoid any potential infection. However, it doesn’t matter how a Carer tries to eliminate the risk of infection, some people have a higher tendency of acquiring them than others. Infections such as lung, wound, urinary tract and bloodstream infections can be picked up at any stage in a care/nursing home. Nonetheless, Carers should inform each patient that the risk can be mitigated if a client washes hands properly – especially after toileting, telling Carer if patient’s dressings are not clean and dry and/or attached to any wounds and asking relatives or friends who are sick not to visit them until they get well. Another critical part of infection-prevention is doing deep breathing exercises – the Carer should organize them regularly, as it can help prevent a chest infection.
Food
Similarly, like above, all care/nursing homes are legally obliged to have food and safety regulations in place in order to “…prevent food contamination and to keep patients safe from food poisoning. ” The Carer should be cautious of the food visitors bring from outside the care/nursing home that needs to be heated. It is particularly important considering the fact that most elderly patients “…have a chronic disease, or take medications that compromise their immune system, making it harder for them to fight an infection if they consume contaminated food”, says Sharon McDonald, Med, RD, LDN, Senior Extension Educator/Food Safety Specialist from Penn State Extension, University Park, Pa.
Linen
Used linen “…may become contaminated with micro-organisms from patients or when soiled by blood or other body fluids. ” Health Service Executive continues, “If not segregated, microbial transfer will occur. ” Therefore, each Carer should make sure that all linen is safely decontaminated by complete and professional laundry process. In addition, the Carer should also segregate linen using proper linen bags – most linen can be categorized in 3 groups: Clean or unused linen, foul or infected or contaminated linen and dirty or used linen.
Relevant Records and Reports that Must Be Maintained
The nursing/care home should carefully document changes in patient’s health condition and keep appropriate records safe and out of public reach. The patient’s health condition should be documented on handwritten notes that are safely deposited in a store-room or re-written into computerized database where all files are secure and require password in order to access it. All other electronic records should be accurate and safe as well – so to protect patient’s identity and rights. All other personal correspondence, such as text messages and e-mails, faxes, letters and other documents related to clinical matters should be stored safely and require a password in order to access them. Scanned records, laboratory results or any visual documents should also be stored in a secure database that is protected by a strong password. Also, all consent forms and videos and audio recordings should be stored safely and be out of public’s reach.
Factors That Will Enhance the Quality of Life for the Client
The Carer must explain to a patient that there are all sorts of counsellors that can help him/her cope with the advanced cancer and how it affects his/her life. There are many specialists, such as Psychologist, Psychiatrist and others and the Carer should observe a patient and suggest the most suitable one. In addition, the Carer should organize regular friend and family member activities and gatherings – talking to family members and friends can be healing and comforting for cancer patients. As mentioned above, another good idea is to organize talk sessions with other patients suffering from similar or same diseases – most patients find it helpful and relaxing speaking to other people who are in the same situation and it is much easier to engage in a conversation with someone that has so many similarities, especially for patients who are somewhat shy. It will help a patient know that they are not alone coping with this. Solid support can also be found in “…one-to-one programs (also called buddy programs) that put you in touch with another person very similar to you in terms of age, sex, type and possibly stage of cancer. This may be done by phone, in person or online, depending on the program. ” Having a cancer is a very stressful experience. However, “…support groups help many people cope with the emotional aspects of cancer by providing a safe place to share their feelings and challenges. They also allow people to learn from others facing similar situations. ”
One of the major organizations available to support the cancer patient and their family in Ireland is Irish Cancer Society. It is “…the national charity in the Republic of Ireland dedicated to eliminating cancer as a major health problem, and improving the lives of those who have cancer. ” Another great organization is ARC Cancer Support Centre – it is “Providing a range of support services to people affected by cancer in Ireland. ” There are many more organizations and support groups aimed at supporting cancer patients and their family members on a regular basis.
Comprehensive Evaluation, Conclusion and Recommendations
In overall, although living with advanced cancer is a challenging experience for patient and for those caring for them, such as a Carer, it can be turned into a much more positive experience. In Samantha’s case it is vital that the Carer spends enough time actively listening to her and making her feel cared for. Active listening is a critical part and Carer should look at it seriously – while having a conversation, a Carer should focus on listening and asking open-ended questions instead of constantly talking and ignoring the patient. Another important thing is support groups – a Carer should do everything he/she can in order to organize group meetings with people suffering from cancer. Such groups are a great way for people with cancer to socialize, make friends and feel normal.
Also, interacting with like-minded people might eventually reduce the level of anxiety and depression that haunts most cancer patients. In terms of spirituality and religion, some patients aren’t religious, so they shouldn’t be forced to accept any religion. But those who are religious, should be given an opportunity to practice it on a regular basis as it would positively impact their mood and well-being and help deal with negative thoughts regarding cancer. When it comes to family members, a Carer should encourage family members to make regular visits. If a patient isn’t visited by family members it might add more pressure and contribute to depression and anxiety, because it could invoke feelings of loneliness and worthiness due to abandonment by family members.
In overall, there are many measures and options available that can turn a devastating experience of living with a cancer into a positive experience where a patient feels loved and cared for by a Carer, family members and a circle of friends he/she regularly visits and opens up to.
