Meeting Essential Care Needs Essay

Mrs Gale is a 70 year old widow and retired unskilled worker. The longanimous lives alone and relies on her son to provide raw material c atomic number 18, medicinal drug and meals. Mrs Gale has a history of burden fluctuation owing to life style but is currently at risk of mal sustenance due to Parkinsons malady. Mrs Gale shows signs of early dementia and suffers from poor mobility and aggravator cause by arthritis. Mrs Gale to a fault has barmy depression triggered by loss and has become socially isolated. All names book been changed as per the treat and Midwifery Council confidentiality guidelines (2008).Mrs Gale is a 70 year old widow and retired unskilled worker. The diligent of lives alone and relies on her son to provide basic c be, medication and meals. Mrs Gale has a history of weight fluctuation owing to lifestyle but is currently at risk of malnutrition due to Parkinsons disease. Mrs Gale shows signs of early dementia and suffers from poor mobility and pain ca apply by arthritis. Mrs Gale excessively has mild depression triggered by loss and has become socially isolated. All names tolerate been changed as per the Nursing and Midwifery Council confidentiality guidelines (2008).Introducing the nature of essential cope adopts Daily activities of sprightliness such as eating, breathing, and mobilising were seen by Roper (1976) as a method of laying the motivations of a patient. By visiting what a patient requires in revise to function normally, a suck in arse compensate what is missing and produce a fretting plan accordingly. The Roper, Logan and Tierneys model of nursing place the activities that are deemed essential and suggests that it is non important to treat all the activities at once (Roper et al. 2000).Yura & Walsh (1983) believed that it is impossible to separate a person into their needs and on that pointfore you washbowlnot treat one without treating the another(prenominal)s. Newton (1991) concluded that in order to convey a holistic advance, all factors need to be considered. Along with the essential needs there are also the physical, psychological, sociocultural, politico-economic, and environmental factors that en devote need friendship. Factoring these into patient charge produces a person centred approach (Steinbach 2009). This means that a patient go away experience care that is individually tailored to them.In order to meet the needs of Mrs Gale, the care give be assessed according to differences in her homo needs, her social subprogram, her expectations of care and her lifestyle behaviours. This is because as an older adult, Mrs Gales needs are different to those of younger adults and children (Copeman 1999 Yura & Walsh 1983). There leave alone be particular focus on Mrs Gales nutritional needs as this is an area of adjoin due to her Parkinsons and the risk of malnutrition associated with it. The involuntary shaky movements associated with Parkinsons disease causes an pr ofit of energy expense which can consort to weight loss.Other symptoms and her medication can also decrease food in birth. fortunately medication such as levodopa contains medication that minimises these side effects (Green n. d. ). Mrs Gales poor mobility and pain levels will also affect her ability to consume nourishment as well as the ability to prepare, man develop and purchase food and drink. Roper et al. (1996 cited Bloomfield & Pegram 2012) stated that when addressing psychological needs it is important to understand that Mrs Gales inclination will be affected by her emotional state. Mrs Gales cognitive impairment may also lead to her forgetting to eat or consuming too much (Beardsley 2000).The environmental factors to consider for Mrs Gale are the layout of her home, having a suit competent eating area, available food storage and how is Mrs Gale able to purchase food (Copeman1999 NICE 2006). Mrs Gale has been identified as being from a working class family this means sh e has learnt behaviours which may impact on her wellness such as not buying suitable foods (Browne 2005). The financial costs of healthy foods, available funding, benefits and local anaesthetic care provisions via the social care system or local government schemes will also need deliberation (Copeman1999 Age UK 2012).Changes due to the aging process also need to be addressed. atomic number 20 reabsorption increases especially in women after the menopause, this decreases bone density. Lean tissue decreases as fat increases with age there is also a decline in the percentage of tree trunk water meaning that body temperature is more difficult to control. Thirst decline and decreased renal function means that older nation can become dehydrated (Copeman 1999). The function of the bowel reduces, meaning that the elderly are more nonimmune to indigestion and constipation.The risk of constipation is also increased with Parkinsons disease (Parkinsons UK 2011). The final consideration is the deterioration of the sensory system. Taste, smell, vison, pain and touch all decline meaning that food may not be as appealing (Copeman 1999). Exploration of the evidence underpinning the delivery of care In order to seek on the nutritional care of Mrs Gale the nursing process will be used. Nursing was described as a problem-solving process with 4 stages termed assessment, planning, implementation and evaluation by Yura & Walsh (1967) (cited Aggleton & Chalmers 2000).This principle is still used in clinical practice today and is considered to be best practice (Bloomfield & Pegram 2012). By carrying out an assessment nurses can identify the causes of problems that require medical involvement. Nettina (2006) described assessment as the pullion of data that will identify real(a) or potential health problems. This means that a health assessment is carried out to determine what care is currently required or care that will be required in the upcoming. sagacity begins with a comp lete nursing history and finishes with a nursing diagnosis which is based on facts and evidence (Yura & Walsh 1983). Assessment is carried out by observing the patient as a whole and includes making notes on the patients dress, expression, non-verbal cues, deformities, and absence of parts such as teeth (Yura & Walsh 1983). Data collection is done by using various assessment tools such as measuring weight and height, calculating body pile index (BMI) and screening tools such as the Malnutrition Universal Screening Tool (MUST) (Copeman1999 Stratton et al. 006). The use of BMI alone has increase questions due to people falling outside of the normal range and still being healthy (McWilliams 2008). picture for the use of the MUST was concluded from research that was bear oned by Stratton et al (2006). However, the MUST is recommended by NICE and is used regularly to identify those at risk of malnutrition (McWilliams 2008). In order to plan care effectively there are three phases tha t essential be considered. The first investigates the main concerns of the practitioner and patient.Subsequently the goals of the practitioner and guest are determined. Finally the required nursing interventions are recorded (Carpenito-Moyet 2006). Planning can be used to design strategies to instigateance the patients, for case diet plans and calorie acceptance (Copeman 1999). With Mrs Gale the simplest and inexpensive intervention will be to promote a healthy diet and encourage foods with high-nutrient content (Holmes 2012). During planning, goals are determined that will lead to ultimate health and wellness (Yura & Walsh 1983).These goals are developed by open dialogue between patient and practitioner and are assigned a time scale to be completed by (Carpenito-Moyet 2006). For example Mrs Gale has poor nutritional intake as a diagnosis and a goal could be to meliorate this. However, if the poor nutrition is due to money, so a time scale of a few weeks would allow time to s ort out benefits and buy the class nutrition. If the poor nutrition was due to behaviour issues, then a longer time period would be assigned in order to assist with religious wait on in changing that behaviour (Carpenito-Moyet 2006).The Orem model of nursing (2001) states that the nurse must act for the patient to increase their learning and awareness of their condition. However, in order for care to be implemented effectively a nurse must accommodate intelligence, interpersonal and technical skills (Yura & Walsh 1983). The ability to build relationships with clients and other practitioners is important to form trust and identify where a multi-disciplined approach can be used (Aggleton & Chalmers 2000). Communication plays a huge role in the implementation of care due to continued discussion and wondering(a) with the patient.The nurse must look for verbal and non-verbal cues from the patient and continue to collect data (Aggleton & Chalmers 2000). By doing this the nurse will b e able to use their clinical judgement and have an adaptive approach to care (Yura & Walsh 1983). A nurse must also be realistic and recognise their strengths and weaknesses. This will allow recognition of assistance and possible referrals to other practitioners that maybe required (Siviter 2008). This sharing of information and asking for help is part of the NMCs code of conduct (2008).A nurse must also have the knowledge to recognise normal and abnormal human functioning and the evidenced based interventions that can be used (Brooker & Nicol 2011). The care should also be safe, have the patients best interests, involve the multi-disciplinary team (MDT) and the patient, and informed consent should be obtained (NMC 2008). Evaluation of action is conducted to see if the best action or intervention has been used. Reflection will indicate if current goals should be maintained or if new goals are required for the patient (Siviter 2008).However, the achievement of the goals can be cong enital and difficult to measure. To evaluate if the goals have been achieved, listening and observation needs to be conducted and it is important to remember that non-achievement is not failure. It is possible that new more achievable goals are needed or that the current intervention is not effective for the patient (Brooker & Nicol 2011). Short term an appropriate goal will be the achievement of weight maintenance or gain and long term will be the changing of negative health related behaviours (Siviter 2008).This will be educated via referral to a dietician and via information guides such as the Parkinsons and Diet leaflet, designed by the Parkinsons Disease Society (2008). Diet can also be supplemented with high energy and protein drinks such as Fresubin and are prescribed via a dietician or world(a) Practitioner (Holmes 2012). Mrs Gales weight can be monitored every 4-6 weeks, if there are changes in her medication or every 3 months if stable (Green n. d. ). Mrs Gale can also be directed to age UK who can provide details of benefits, home and shopping assistance (Age UK 2012).All of Mrs Gales nutritional needs have been assessed, planned and evaluated. The implementation of this care will depend on the cooperation by Mrs Gale. Practitioners have to remember that patients have the right to refuse treatment. After all the evidence is presented and all questions and concerns are addressed the patient will have an informed choice (NICE 2007). Personal development plan (University of Southampton 2012) Identified areas for further development midsection Intrinsic motivation (Developing compassionate care)On refection I believe I need to develop my conversation skills, especially when dealing with older people and cognitive impairment. This will make sure my care be person centred (Steinbach 2009). I must also develop my understanding of how and when to use the available assessment tools so that I can complete the nursing process (Yura & Walsh 1983). I must al so improve my questioning techniques so that when I am faced with a client, such as Mrs Gale, I can collect all the relevant information I will need to plan her care (Aggleton & Chalmers 2000). Suggested activities and experiences that will assist in future developmentIn order to facilitate my development I will need to nurse patients with a variety of medical and cognitive conditions this can be achieved while on placement. This will improve my communication skills and my confidence (NMC 2008). Furthermore I need to observe nurses in a hospital ward or community setting while they implement the most appropriate assessment tool for their patient. This can be done while on placement and by contacting the community care team and organisation to shadow a community nurse. While completing practice experience one, I was able to take part in the planning process.I will need to continue with this so that I am confident in planning essential care. Identified areas for further development Nerve Self-belief and self-efficacy (Developing themselves and advocating for the service substance abuser or carer) To develop my self-belief and to be an advocate for my patient I will need to work on my confidence (NMC 2008). I will need confidence in applying the best nursing practice (Yura & Walsh 1983). I will need confidence in speaking up and making sure my patients receive the correct care and any available funding that they might need.If I am unable to provide this service I must have the ability to refer my patients or to ask questions so that this can be achieved. Suggested activities and experiences that will assist in future development To develop this confidence, I must work on base mentoring staff and observe dieticians, community nurses and general practitioners. By doing this I will appreciate how other professions care for my patient. Similarly I will gain understanding of which profession I would refer my patient to for future treatment.Working as part of a mult i-disciplinary team will improve my confidence and allow for questioning (NMC 2008). Identified areas for further development Brain Critical and analytical skills (Application of appropriate theory/research to practice) In order for me to apply theory into practise, I must research the care of various conditions and begin to understand the theoretical knowledge behind that care. This process has begun with the research I have conducted on Parkinsons disease and also on my research into the use of BMI and MUST (Eknoyan 2008 MAG 2003).I will also need to visit other areas of practice to see the nursing process being applied (NMC 2008). Suggested activities and experiences that will assist in future development I must attend any available courses, workshops and meetings that deal with patient care and conditions. While on practice experience two, I would like to attend a nutrition workshop and discover the benefit of supplementary foods and drinks available. I will arrange to work with and observe dieticians in spite of appearance a hospital setting and question them on transferring this knowledge to community settings.