Individual Patient Care in Dementia

Individual Patient Care in Dementia A nurse’s role focuses on the help, care and support given to their patients whilst treating people as individuals and upholding their dignity (The NMC code, 2015). In this essay I will discuss the ways in which nurses can ensure that patients with dementia receive individualised patient care. The aim of this essay is to demonstrate how care is implemented to patients with dementia and how nurses ensure care is individualised to meet the patients’ needs and wants. Nurses can identify the individual needs of the patient by following the nursing process.   The nursing process is a series of stages intended for nurses to demonstrate excellent care. It consists of five phases: Assessing, diagnosing, planning, implementing and evaluating.   This process is client centred. These stages mean that nurses should individualise what is needed for one patient.   A patient needs, and problems is identified through these steps. The Assessment phase is the first step in which it allows nurses to identify what the patient’s needs are. The nurse collects information from the patient by asking them questions and running physical examinations. They dissect the information that is gathered in this stage in which it is further analysed which requires in dept thinking. The Diagnosing Phase is the next phase in which the nurses make an overall diagnosis about the information that was collected in the assessment phase (Gardner, 2003). It is stated that patients tackle a medical diagnosis with what mental health professionals name an anticipatory anxiety. They are nervous and scared as to what they are told and how it may change their day to day life for them and their close ones (McClain and Buchman, 2011).   The diagnosis of dementia entails of examination, cognitive testing and assessment. Nurses informing patients that their memory and cognitive function is beginning to change can be challenging and difficult to hear hence it is crucial that nurses should uphold their dignity and inform them of the treatment that will be applied and to give them the help and support they need. (Prince and Martin, 2016). The planning phase lets the nurses create a plan of action in which ongoing treatment will be discussed. This phase allows the nurses to address patient’s needs. The implementing phase is when nurses carry out the plan of action. For dementia patients their symptoms tend to go worse. It is vital that nurses demonstrate great care in which they can them support with daily activities e.g. washing and dressing them. They should also monitor the patient and focus on the improvements made by the patients. It is vital that the nurses care, monitor and support that is given to the patients is continuous. The care that is received by the patients with dementia is much lower as to those patients without dementia hence it is fundamental that the nurses ensure that care is individualised to the patients’ needs and wants.   For the last evaluation phase, it is crucial that nurses complete an evaluation to see if the treatment that was carried out is working and if any changes happen. If the treatment isn’t working nurses can support the client, analyse and understand as to why it didn’t work (Gardner, 2003). Nurses should respect the patient’s beliefs and prevent making assumptions mainly grounded on their appearance or other personal quality. They must listen and consider patient concerns. It is vital that the nurse is non-judgmental and open minded towards the patient. Nurses can ensure care is individualised when it comes to fulfilling the nutrition, pain management and personal needs of the patient. If the patient cannot manage or is unable to regulate their nutrition, then the nurse should support and encourage the patient by placing food within their reach (Kaplan, 1996). Providing care to a patient who suffers from dementia is vital as the patient does not have the ability fully understand their diagnosis. As a nurse, it is encouraged to introduce yourself to the patient to create a therapeutic relationship during treatment. Patients who have dementia are no longer able to maintain their individuality and personhood hence why it is important that nurses can try and uphold and preserve it for them. Patients value nurses recognizing their individuality. Nurses reassure patients that one is not living a horrible and unhappy life by implementing the worth and value to their life by trying to get to know the person behind the patient. Nurses can ensure that care is individualised as they could get to know the individual, their values, likes and dislikes and hobbies as this gives the patient an individuality whilst always showing compassion and respect (Collins and Hughes, 2014). This is most valued and appreciated by patients as it allows the nurses to know the characteristic and the personality of the patient.   Nurses can show recognition to the patient by acknowledging their needs and wants and providing care that is customized and adapted to it. It is important that nurses try and build an insight of the patient’s world and how to bond with them. When communicating and engaging with them they must always say their name unless the patient wishes a different way of being addressed.   Nurses can consider the patients perspective when demonstrating care that is exclusively personalised to their needs.   Giving recognition to the patient allows the relationship to build much stronger as you are giving your attention and time to them.   Nurses would give the patients the choice and responsibility to make their own decisions when it comes to their choice of food, clothes they want to wear, getting involved in activities etc. Allowing the patients to make decision like this lets them know that they are comfortable. It also gives them a sense of involvement and participation to express their qualities and personality. However, when the discussion of making clinical discussions arises and the patient is unable to make the decisions due to cognitive abilities declining, the family and doctors will be more involved. Nurses should allow the patients to create their own pace in which you shouldn’t push the patients over their limits. It would be much of a benefit to focus on the improvements made by the patients even if it’s something small. This would motivate and drive the patient building their self-esteem. When a nurse is caring for a patient who has dementia it is important that you do not patronise them. Respect for the patient is a main aspect nurses must implement in their duty of care. Nurses can ensure that the care and treatment given to the patients is with both respect and compassion (The NMC code, 2015). Socialisation and interaction is fundamental for patients as it allows the patients to maintain a social life and form relationships. Allowing the patients to experience and be around company will progress their communication skills. Nurses should recognise that all patients including people with dementia is built in relationships and that dementia patients require a healthy social environment to promote opportunities for personal and mental progress.   Dementia affects the way a patient communicates. People suffering from dementia can find difficulties responding back to question (NICE, 2012).   When conversing with patient with dementia they may also find problems to maintain the information during a discussion.  Nurses must validate and shouldn’t dismiss what is said by the patient. They must try to understand and take notice of what the patient expresses to them.   Nurses can communicate in a calm and respectful way in which they should speak directly to the patient. It can be frustrating for a patient with dementia to communicate their needs and wants hence it is vital that nurses are supposed to remain calm and patient if the patient becomes agitated (Ellis and Astell, 2017).   When a patient’s conditions begin to deteriorate, health and social care needs begin to increase causing them to require more help and personal care. When nurses are relaying information to a patient they should give the patient both oral and written information, so it can be fully understood and so it can encourage and boost their communication skills in their care and treatment. When released from hospital, people with dementia are likely to suffer a serious loss of individuality, and increased needs for help and support. So, it is important that the care is demonstrated to patients not only during hospital but when they arrive home.   Nurses can try and view the world from the viewpoint of the person with dementia, distinguishing that everyone’s experience has its own psychological validity, that people with dementia act from this outlook (Brooker, 2007). The ageing population is exponentially increasing resulting in challenges to nurses in coping and treating the conditions and health needs that arise with old age (Bhardwa, 2015). These barriers that I will be explaining are obstacles that prevent the pace of excellent care being demonstrated by nurses. The barriers to demonstrating care to dementia patients is that they receive poor quality in which nurses tend to focus on other patients with severe illness and diseases.   Another barrier would be ineffective advance care planning. Some people with dementia receive a delayed diagnosis which can result in them not having the mental capacity to attain decisions. A lot of patients find it difficult to vision their self-getting better due to their current state. Nurses can ensure that the care that is provided to people with dementia is quality care during the duration of their treatment. Hospice use is incredibly low for dementia patients. The people with dementia that get transferred to a hospice can result in confusion and distress at a state in which the person is unable to handle change. Also, they have completely different needs compared to cancer patience’s. It is crucial that both staff and nurses have the training required to deliver care to individuals with dementia. Age discrimination is also a barrier that elderly patients face in which the symptoms demonstrated to doctors and nurses is referred to a getting old. Nurses are failing to spot and notice the symptoms of dementia in a lot of patients which creates a poor rate of diagnosis (Collins and Hughes, 2014). The organization like the National Health Service also create barriers resulting in patients not receiving the care they need. They have limited access to resources, lack of time, heavy patient workloads and insufficient staffing. Nurses have a contribution when it comes to the barriers of providing care to patients. Some nurses have a lack of interest, lack of confidence in critical appraisal skills, lack of knowledge and them feeling overwhelmed (CAN, 2018). Dementia patients experience behavioural and personality changes. Patients that specifically have advances dementia tend to be physically aggressive, have hallucination and get agitated. These symptoms can result physical and emotional distress to both the patient and the nurse. There is also hostile treatment for dementia patients that is very familiar in which it consists of tube feeding and antibiotic treatment for infections. This treatment is known to be wrong and does not improve survival. Families of the patient shows great dissatisfaction against the aggressive treatment that is demonstrated to the patients. Nurses can implement excellent care by concentrating on improving patients comfort and increase in advance care planning (Collins and Hughes, 2014). The points I explained in this essay show how providing and offering care to people with dementia can be complex and there can be a lot of boundaries that come along with it however when the when the needs, wants, choices and problems is focused and centred around the patient that’s when care is at its best. Nurses should always put the patient first. Nurses can value patients with dementia by promoting their self -worth and treating them as individuals. References The Code, 2015) Your Bibliography: The Code. (2015). [ebook] Nursing and Midwifery Council. Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed 26 Apr. 2018].(McClain and Buchman, 2011) McClain, G. and Buchman, M. (2011). After the diagnosis. [Clifton Park, N.Y.]: Delmar Cengage Learning. Gardner, P. (2003). Nursing process in action. Australia: Thomson, Delmar Learning. Prince, Martin, Comas-Herrera, Adelina, Knapp, Martin, Guerchet, Maà «lenn and Karagiannidou, Maria (2016) World Alzheimer report 2016: improving healthcare for people living with dementia: coverage, quality and costs now and in the future. Alzheimer’s Disease International (ADI), London, UK (Kaplan, 1996)   Kaplan, M. (1996). Clinical practice with caregivers of dementia patients. Washington, D.C.: Taylor & Francis.    (Patient experience in adult NHS services: improving the experience of care for people using adult NHS services, 2012) Patient experience in adult NHS services: improving the experience of care for people using adult NHS services. (2012). NICE. Ellis, M. and Astell, A. (2017). Adaptive interaction and dementia. Brooker, D. (2007). Person-centred dementia care. London: Jessica Kingsley Publishers. (Bhardwa, 2015) Bhardwa, S. (2015). Barriers to dementia care. Independent Nurse. (Cna-aiic.ca, 2018)Cna-aiic.ca. (2018). Barriers to Nursing. [online] Available at: https://cna-aiic.ca/en/nursing-practice/evidence-based-practice/barriers-to-nursing [Accessed 26 Apr. 2018]. Collins, J. and Hughes, J. (2014). Living and dying with dementia in England: Barriers to care. London.

Play and Game Essay

According to Merriam Webster â€Å"a hobby is a pursuit outside one’s regular occupation engaged in especially for relaxation†. Most of us have hobby because having a specific interest on something facilitates a balance between our physical and mental state. They can be either physical activities or mental activities. For me, cricket is my hobby because it has become part of my life. I often engage in playing both at the club level and for recreation. Cricket is a team sport for two teams of eleven players each. The objective of each team is to score more runs than the other team and to completely dismiss the other team. I enjoy this game because it’s fun and exciting, it has enabled me to adopt the teambuilding skills in my everyday life and it gives me an opportunity to be a role model to younger cricketers. The game of cricket evokes many emotions, mostly because of the fun and excitement involved. Cricket is played at a professional level all over the world. I regularly go the various ovals to follow my favourite team, and avidly watch the game on television. The sheer pleasure of winning a game and exhilaration of conquering this game of high and difficult technique brings nothing but delight to me. During a match we not only have to contend with the rules of the game, but also have to contend with different playing conditions that can have a dramatic affect on the game. The nail biting ending where your team mates are depending on you to score the winning runs of a game all contribute to this game being truly gratifying to me. In the end we all know how fun it is to smash the ball down the ground or to rip off the middle stump of the batsman. Another reason I enjoy playing cricket is for the teambuilding aspect. I learnt teambuilding, discipline as well as teamwork through playing cricket. The game is very challenging in some regard and it required teamwork to win a game. When playing cricket, one has to be cognizant of what your teammates are doing because each player is dependent on each other. Thus good communication skills are mandatory. This sport also filters into my everyday life as it translates into how I address work related issues as well. It has allowed me to have self regulating strategies, identify and utilize strengths of co-workers in completing projects and practice effective collaboration with team members. True role models and mentors are those who possess the qualities that we would like to have and those who have affected us in a way that makes us want to be better people. I believe through this game I can impact on younger minds and facilitate me being a mentor and role model. Recently I was been privileged to be the coach and mentor of a cricket camp. The positive influences I was able to instill to this young group will definitely redound to their benefit. To be able to promote the vitality and passion of this game and impart what role sport can play in our life was very rewarding to me. It was an invaluable avenue for me to develop as a coach, to share my knowledge and skills and be able to mold younger minds. In summary, cricket is my favourite hobby as there is no end to the element of surprise the game gives and benefits I gain from playing. As far as I can remember cricket has always been my favourite past time and part of my life. The pleasure of watching and playing is truly amazing. It’s a hot topic in many social circles because of the thrills and anticipation of the game. Likewise one also benefits from playing as it promotes and facilitates teambuilding. The camaraderie it fosters between team members is additionally rewarding. What is truly gratifying however, it allows me to be a role model and mentor to others as it allows me to convey what role cricket plays in my life and share my knowledge. In a few words, it has contributed to me physically and mentally as it helps me relax, keep fit and relieve stress. Bibliography James, C. L. R. (1963). Beyond a Boundary. London: Stanley Paul/Hutchinson Merriam Webster (n. d. ) Hobby Retrieved October 20th, 2011 from http://www. merriam-webster. com/dictionary/hobby.

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Defining and Implementing Interfaces in Delphi

In Delphi, interface has two distinct meanings. In OOP jargon, you can think of an interface as a class with no implementation. In Delphi unit definition interface section is used to declare any public sections of code that appear in a unit. This article will explain interfaces from an OOP perspective. If you are up to creating a rock-solid application in a way that your code is maintainable, reusable, and flexible the OOP nature of Delphi will help you drive the first 70% of your route. Defining interfaces and implementing them will help with the remaining 30%. Abstract Classes You can think of an interface as an abstract class with all the implementation stripped out and everything that is not public removed. An abstract class in Delphi is a class that cannot be instantiated—you cannot create an object from a class marked as abstract. Lets take a look at an example interface declaration: typeIConfigChanged interface[{0D57624C-CDDE-458B-A36C-436AE465B477}]procedure ApplyConfigChange;end; The IConfigChanged is an interface. An interface is defined much like a class, the keyword interface is used instead of class. The Guid value that follows the interface keyword is used by the compiler to uniquely identify the interface. To generate a new GUID value, just press CtrlShiftG in the Delphi IDE. Each interface you define needs a unique Guid value. An interface in OOP defines an abstraction—a template for an actual class that will implement the interface—that will implement the methods defined by the interface. An interface does not actually do anything, it only has a signature for interaction with other (implementing) classes or interfaces. The implementation of the methods (functions, procedures, and property Get/Set methods) is done in the class that implements the interface. In the interface definition, there are no scope sections (private, public, published, etc.) everything is public. An interface type can define functions, procedures (that will eventually become methods of the class that implements the interface) and properties. When an interface defines a property it must define the get/set methods - interfaces cannot define variables. As with classes, an interface can inherit from other interfaces. typeIConfigChangedMore interface(IConfigChanged)procedure ApplyMoreChanges;end; Programming Most Delphi developers when they think of interfaces they think of COM programming. However, interfaces are just an OOP feature of the language—they are not tied to COM specifically. Interfaces can be defined and implemented in a Delphi application without touching COM at all. Implementation To implement an interface you need to add the name of the interface to the class statement, as in: typeTMainForm class(TForm, IConfigChanged)publicprocedure ApplyConfigChange;end; In the above code a Delphi form named MainForm implements the IConfigChanged interface. Warning: when a class implements an interface it must implement all its methods and properties. If you fail/forget to implement a method (for example: ApplyConfigChange) a compile time error E2003 Undeclared identifier: ApplyConfigChange will occur.Warning: if you try to specify the interface without the GUID value you will receive: E2086 Type IConfigChanged is not yet completely defined. Example Consider an MDI application where several forms can be displayed to the user at one time. When the user changes the application configuration, most forms need to update their display—show/hide some buttons, update label captions, etc. You would need a simple way to notify all open forms that a change in the application configuration has happened. The ideal tool for the job was an interface. Every form that needs to be updated when the configuration changes will implement IConfigChanged. Since the configuration screen in displayed modally, when it closes the next code ensures all IConfigChanged implementing forms are notified and ApplyConfigChange is called: procedure DoConfigChange() ;varcnt : integer;icc : IConfigChanged;beginfor cnt : 0 to -1 Screen.FormCount dobeginif Supports(Screen.Forms[cnt], IConfigChanged, icc) thenicc.ApplyConfigChange;end;end; The Supports function (defined in Sysutils.pas) indicates whether a given object or interface supports a specified interface. The code iterates through the Screen.Forms collection (of the TScreen object)—all the forms currently displayed in the application. If a form Screen.Forms[cnt] supports the interface, Supports returns the interface for the last parameter parameter and returns true. Therefore, if the form implements the IConfigChanged, the icc variable can be used to call the methods of the interface as implemented by the form. Note, of course, that every form can have its own different implementation of the ApplyConfigChange procedure. Ancestors Any class you define in Delphi needs to have an ancestor. TObject is the ultimate ancestor of all objects and components. The above idea applies to interfaces also, the IInterface is the base class for all interfaces. IInterface defines 3 methods: QueryInterface, _AddRef and _Release. This means that our IConfigChanged also has those 3 methods, but we have not implemented those. This is because TForm inherits from TComponent that already implements the IInterface for you! When you want to implement an interface in a class that inherits from TObject, make sure your class inherits from TInterfacedObject instead. Since TInterfacedObject is a TObject implementing IInterface. For example: TMyClass class(TInterfacedObject, IConfigChanged)procedure ApplyConfigChange;end; In conclusion, IUnknown IInterface. IUnknown is for COM.