Reflection Regarding Dementia Care

Artefact

In the workplace, I was responsible in delivering care to dementia patients to ensure their enhanced health outcome. It was mentioned by the physicians and experienced nurse to me as a student nurse that dementia symptom does not include forgetfulness at the initial stage and confusion, hindered speech and communication ability, hindered thinking and others signs of dementia that are present in patients with early dementia. Thus, the focus of the care required to holistically resolve all the symptoms and avoid focussing on one specific sign to deliver dementia care to patients. In the care environment, I was engaged to actively communicate with dementia patients by use of verbal and no-verbal cues along with simple communication as I was alerted that the patients due to hindered thinking capability caused by damaged brain cells are unable to understand and engage in complex conversation. Moreover, multi-disciplinary care was asked to be implemented in delivering care to dementia patients as helps in quality care delivery. As a student nurse, the supervisor at the workplace mentioned urgent situation such as wandering patients getting lost and others may be raised in care during which adaptive actions are to be taken with confidence for the enhanced well-being of the individual. However, I failed to work with effective adaptability and expressed low confidence on delivering care as I was confused due to lack of practical experience of he way dementia care is to be managed and delivered to patients. In dementia care, I was asked to follow NMC Code of Practice to mention professionalism and Beauchamp and Childress Theory of Ethics along with Care Act 2014, Safeguarding Act 2004, Data Protection Act 1998 and others in delivering enhanced care to dementia patients.

Introduction

In nursing practice, reflection is important as it allows the nurses to recognize their personal strength and weakness of skills and knowledge that is used as a guide to promote continuous learning and development (Reljić et al., 2019). The current refection is regarding dementia care provided in the workplace and Rolfe’s reflective model is to be used. This is because the model is simple and clarified to be used in reflecting any situation to determine immediate correct action to be taken for improving it (Dressler et al., 2018).

Step 1: What?

The topic regarding dementia care in the workplace is chosen to be reflected. This is because in the UK, nearly 850,000 people are suffering from dementia who are mostly above the age of 65 years (england.nhs.uk, 2018). Moreover, in 2020, the nearly 12 million people in the UK are found to be above 65 years which is 29.4% of the population (lginform.local.gov.uk, 2020). Since dementia mostly affect the early, the growing aged population with concerned rise in dementia affected people number indicates discussion regarding the nature of care for the disease is essential. Thus, the dementia care in the workplace is been reflected to understand strength and weakness present that are to be improved for better dementia care deliver in the present as well as in future.

The dementia patients are often found show behaviour problems, depression, wandering, emotional outburst and inappropriate behaviour. It has led me to develop poor confidence and attitude to deliver quality care as I struggle to cope with resolving the problems. However, dementia care allowed me to determine the way verbal and non-verbal communication is to be used for interacting with the patients as they suffer hindered speech delivery due to the disease. Thereafter, dementia care allows critical thinking as nurses require to determine varied care to be provided to each patient based on their different needs and demands so that their safety and enhanced health outcome is ensured. Thus, delivery of dementia care met my learning needs of the way to develop effective communication and critical thinking in care.

The good thing about the experience is that I understood I have strong communication, ethics, professionalism and critical thinking skills to deliver care to dementia patients. Moreover, I understood I have poor confidence, conflict resolution and adaptability skills. This is because I expressed hindrance in adapting to use assistive technology for dementia patients which would improve their care and expressed involvement in increased conflict at work. However, the bad thing about the experience is that I was unable to determine my extent of ability to maintain team working and networking in care which are one of the key components in dementia care as it supports multi-disciplinary care to be implemented. In the care experience, the most challenging was retaining confidence and clam attitude to deliver care.

Step 2: So What?

The learning experience regarding dementia care created impact on me to understand the cause and factors responsible for dementia in patients as well as resolved one of my belief that forgetfulness is related with dementia. This is because I identified from dementia care experience that forgetfulness is late symptom of dementia and there are signs like confused thinking, hindered concentration, struggling to communicate and others which are early indication of dementia in patients (Wiels et al., 2020). As a nursing student, the learning experience regarding dementia care was significant for me because it helped me to determine way verbal and non-verbal communication is to be used for dementia patients who have hindered speech ability. It is evident as I understood from providing care to dementia patients that they understand short, simplified sentences and face hindrance with complex vocabularies. This is because of the damaged brain cells that make them unable to have enhanced sensory stimulation for complex words due to which they express hindrance with making and understanding complex speech or language (Seo et al., 2018). Moreover, maintaining steady eye contact during communication and active listening are non-verbal cues that makes the dementia patients feel valued during interaction as they feel being heard by the nurses in care (Kimura et al., 2021). It was realised after involvement in current care which I was not previously known to me.

The learning experience was also significant to me because it helped me understand the way ethical dilemma in care is to be managed while maintaining ethics. This is evident as ethical dilemma is raised in decision-making of treatment for the dementia patients when the patients preferred less effective care over another due to lack of previous experience and hindered understanding of the care. However, I understood that through enhanced discussion and information sharing the dilemma could be resolved. The experience was significant because it led me to known that I have poor confidence and attitude in delivering care. This is evident as I often doubt my care process even if it is effective for the patients due to lack of effective practical experience in delivering certain care. However, after the experience I understood that confidence in care could be raised with discussion of care with experienced nurses and accessing assistance from them.

The current learning experience regarding dementia care was significant to make me understand that I fail to show enhanced adaptability and conflict resolution skills. Before the experience, I thought I have enhanced adaptability skills because I could verbally understand the way changes are to be made in complex situation but after the experience I feel I have hindered practical ability to be adaptable in complex situation. Thus, the learning experience made me realise I have to improve my adaptability skill in dementia care. This is because lack of adaptability skill led me to face hindrance in taking immediate care actions for some of the vital needs of the patients in the care environment. In healthcare, adaptability skill is currently important as it led to allow nurses get accustomed in the current changing care environment and deliver quality care with efficient use of advanced treatment to patients (Callahan et al., 2018). Moreover, before the experience, I was confident of resolving conflict but after the experience I understood I require more effective conflict resolution skills. This is because during the dementia care delivery I faced unnecessary conflict and quarrelling with my supervisor as there was clash of ideals and I was unable to calmly manage the matter with enhanced conflict resolution strategies.

The experience also led me understand that I have enhanced professionalism skills. This is significant as enhanced professionalism skill in dementia care among the nurses makes them face lesser ethical violation of patient’s rights and effective use of policy along with legislation in delivering professionally competent care that enhances safety and satisfaction of care for the patient (Grace, 2017). The learning experience related to the coursework because I found my most challenging action that was asked to be identified in the course is team working and networking. It is evident as I express hindered ability to resolve conflict, reach mutual decision in care, fail to understand interchange of information and skills to be made between multi-disciplinary team and others in framing enhanced teamwork and networking. The team working and networking in dementia care is important to include diverse healthcare professionals from different expertise and discipline to deliver collaborative and quality care to the patient (Bale and Jenkins, 2018). Thus, the learning experience led me to develop interest in updating my team working and networking skill so that I can overcome the challenge with implementation of the skills that is essential in dementia care.

Step 3: Now What?

The thing learned from the experience is that I have enhanced communication, ethical, professionalism and critical thinking skills. These skills are to be further applied in future care delivery of dementia patients in providing them person-centred support and ethically approved care that is delivered by following proper policy guidance. The learning also mentioned I have poor confidence, adaptability and conflict resolution skills. These skills are to be improved for future care by involving in training of advanced dementia care and actively accessing support from experienced nursing professionals in understand the way conflict is to be avoided at work along with adaptation with change is to be made without hindrance.

In case the same task is provided again, I would initially involve in multi-disciplinary care arrangement for the dementia patients compared to acting alone in delivering care. This is because multi-disciplinary care for dementia patients help them to access best quality care from different expert professionals in managing their varied symptoms and needs along with it that lower error in care as well as raises quality of care (Smith et al., 2018) The effort on this task of delivering dementia care contributed to my career by providing me initial practical experience to tackle dementia patients and the signs of early dementia. It also contributed towards my career by making me understand the weak skills to be improved to become more professionally efficient in future care thus creating opportunity for me to make professional improvement.

Conclusion

The above discussion mentions that I have enhanced professionalism, ethics and communication skill but experience challenges with team working and networking. However, my weakness includes confidence, adaptability and conflict resolution skills that are to be improved for future care delivery in enhanced way to dementia patients.

References

Bale, L. and Jenkins, C., 2018. Nursing students’ experiences of delivering dementia friends sessions to peers. Nursing older people, 30(6).pp.34-67.

Callahan, C.M., Bateman, D.R., Wang, S. and Boustani, M.A., 2018. State of science: bridging the science‐practice gap in aging, dementia and mental health. Journal of the American Geriatrics Society, 66, pp.S28-S35.

Dressler, R., Becker, S., Kawalilak, C. and Arthur, N., 2018. The cross-cultural reflective model for post-sojourn debriefing. Reflective Practice, 19(4), pp.490-504.

Grace, P.J. ed., 2017. Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Kimura, N.R., Simões, J.P., Santos, R.L., Baptista, M.A.T., Portugal, M.D.G., Johannessen, A., Barca, M.L., Engedal, K., Laks, J., Rodrigues, V.M. and Dourado, M.C., 2021. Young-and late-onset dementia: a comparative study of quality of life, burden, and depressive symptoms in caregivers. Journal of geriatric psychiatry and neurology, 34(5), pp.434-444.

Reljić, N.M., Pajnkihar, M. and Fekonja, Z., 2019. Self-reflection during first clinical practice: The experiences of nursing students. Nurse education today, 72, pp.61-66.

Seo, S.W., Thibodeau, M.P., Perry, D.C., Hua, A., Sidhu, M., Sible, I., Vargas, J.N.S., Gaus, S.E., Rabinovici, G.D., Rankin, K.D. and Boxer, A.L., 2018. Early vs late age at onset frontotemporal dementia and frontotemporal lobar degeneration. Neurology, 90(12), pp.e1047-e1056.

Smith, T., Cross, J., Poland, F., Clay, F., Brookes, A., Maidment, I., Penhale, B., Laidlaw, K. and Fox, C., 2018. Systematic review investigating multi-disciplinary team approaches to screening and early diagnosis of dementia in primary care–what are the positive and negative effects and who should deliver it?. Current Alzheimer Research, 15(1), pp.5-17.

Wiels, W., Baeken, C. and Engelborghs, S., 2020. Depressive symptoms in the elderly—An early symptom of dementia? A systematic review. Frontiers in pharmacology, 11, p.34.

Take a deeper dive into Reflecting on the Journey: A Three-Year Nursing Degree Experience with our additional resources.