I have many clients that I would be able to meet with regularly for the sake of this assignment. However, I am limited in choosing which clients to work with because most of them suffer from severe dementia. As a result of the dementia, most residents either exhibit either extremely repetitive or random behaviors. Very few of my residents can have a normal conversation and even less know what year it is or where they are.
However, two of my residents were only placed on my unit because there were no other open rooms at the time that they were admitted. One of my clients has chosen to stay on the floor because she is only her for a short term stay. Since she may leave in the near future, I cannot use her as the subject of this assignment. As a result, there is only one client that I could realistically work with in this assignment.
When I began working with my chosen client (who will hereafter be referred to as Mr. X), he exhibited no signs of memory loss that I noticed. However, his roommate was exhibiting very loud and disturbing behavior on a constant basis. This irritated Mr. X to the point that he had a nervous breakdown and was hospitalized for a few days until he calmed down.
A few weeks ago, Mr. X moved to another unit with higher functioning residents. Mr. X told me that he enjoys solitude because he is an artist and he can express himself creatively in a more personal way when he is free from the influence of other people. So, I thought that the best part about Mr. X’s transfer was that I was able to get him a private single resident room.
Since his hospitalization, Mr. X has been exhibiting both short term and long term memory loss. At my current field placement, we use a standardized test (Bloom, Fischer & Orme, 2009) in order to assess the mental status residents. The test is known as a mini-mental exam and consists of a few questions. The client is told three words at the beginning of the exam. The first word is a piece of furniture the second is an item of clothing and the third is a color. After answering a series of questions, which assess cognitive functioning (Bloom, Fischer & Orme, 2009), the resident is asked how many of the three words, which they were told at the beginning of the exam, they can remember.
In the few sessions that I have has with my client, I have developed quite a rapport with Mr. X. My conceptualization (Bloom, Fischer & Orme, 2009) is that my Mr. X has quickly become very fond of me. He enjoys any excuse to spend time in my company. As a result, my client was more than willing to participate with me in any study or project I undertake. For the same reasons, and also because my client has no family or friends, my field instructor is also glad that I will now have another reason to spend more time with Mr. X.
I would like to use both nominal and ordinal levels of measurement (Bloom, Fischer & Orme, 2009). This will allow me to gauge how often my client retains memories and how much of those memories he can retain.
Works Cited
Bloom, M., Fischer, J., & Orme, J., (2009). Evaluating Practice: Guidelines for the Accountable Professional. Boston, MA: Allyn & Bacon.
Wednesday, February 23, 2011
Monday, February 7, 2011
My Agency
My agency is a geriatric center. Both conceptually and practically, a geriatric center is not to be confused with a nursing home. Conceptually, the vastly different title serves to avoid the stigma associated with nursing homes. Practiacally, the geriatric center that I work for is much greater than any mere nursing home because it also includes assisted living as well as private apartments. My agency has the ability to provide housing and care for over 700 residents. Furthermore, there are specialized units, capable of providing care for residents with intense needs such as ventricular respiration and dementia.
The unit that I work in is the Alzheimer's/Dementia unit. One of the floors that I work on is entirely popultaed by residents who are incapable of ambulating. The other floor that I work on is entirely populated by residents who can ambulate, albeit some do so rather poorly. Each floor has a supervisor who manages all of the staff and residents on the floor. The floor supervisor's title is the 'neighborhood coordinator'. The neighbor hood coordinator also serves as an advocate for their 'neighborhood' (aka floor), who can appeal to the higher ups in the bearacratic administration when necessary. There is also a head nurse on each floor, who supervises and coordinates the nursing care being administered on that floor.
My agency promotes interdisciplinary participation in the implementation of resident care. The nursing staff, social worker, dietician and neighborhood coordinator work together in order to devise, adjust and rewrite the care plans of every resident in their charge, every three months. Furthermore, all of the aforementioned employees also work with the medical doctor in charge of that resident, as well as the recreational therapist, physical therapist, speech and hearing therapists, in coordinating the care being provided for each resident.
The best aspect of my agency is the result of a policy which requires employees to maintain a positive friendly demeanor. Everyone says hello to one another in the hallways. Athough the friendliness may be mandated and in some cases superficial, it does seem to facilitate respect between employees. This respect, while it may merely be superficial, does make the work enviornment more comfortable and effective. Having such a comfortable enviorment both allows employees to do their best work and provide the best possible care for the residents.
I have the ability to choose from any resident on either of my floors and meet specifically with them for any reason. Furthermore, I have a multitude of residents who exhibit bad behaviors and the behaviors are extremely well documented. As a result, it would be really easy to choose from any resident, meet with them every week and moniter their behaviour. However, I am not sure if it is possible, meaningful or effective for me to try and change the behavior of an individual who suffers from dementia.
Every time a bad behavior is exhibited and nopticed by the staff, it is documented. At the quarterly review, each bad behavior is addressed and discussed. After looking at the behavior from the perspective of each discipline, a plan is decided on and implemented in response to the incicdent. It is often the case that a resident will change or the behavior will subside for a period of time, sometimes longer than others. However, it has never once been clear to me that the change in behavior was a result of the plan that was implemented in response to the behavior and not just random coincidence. In fact, it is often the case that the bad behavior appears to be a random occurence more than a response to the context in which it occured, or specific enviormental stimuli.
The unit that I work in is the Alzheimer's/Dementia unit. One of the floors that I work on is entirely popultaed by residents who are incapable of ambulating. The other floor that I work on is entirely populated by residents who can ambulate, albeit some do so rather poorly. Each floor has a supervisor who manages all of the staff and residents on the floor. The floor supervisor's title is the 'neighborhood coordinator'. The neighbor hood coordinator also serves as an advocate for their 'neighborhood' (aka floor), who can appeal to the higher ups in the bearacratic administration when necessary. There is also a head nurse on each floor, who supervises and coordinates the nursing care being administered on that floor.
My agency promotes interdisciplinary participation in the implementation of resident care. The nursing staff, social worker, dietician and neighborhood coordinator work together in order to devise, adjust and rewrite the care plans of every resident in their charge, every three months. Furthermore, all of the aforementioned employees also work with the medical doctor in charge of that resident, as well as the recreational therapist, physical therapist, speech and hearing therapists, in coordinating the care being provided for each resident.
The best aspect of my agency is the result of a policy which requires employees to maintain a positive friendly demeanor. Everyone says hello to one another in the hallways. Athough the friendliness may be mandated and in some cases superficial, it does seem to facilitate respect between employees. This respect, while it may merely be superficial, does make the work enviornment more comfortable and effective. Having such a comfortable enviorment both allows employees to do their best work and provide the best possible care for the residents.
I have the ability to choose from any resident on either of my floors and meet specifically with them for any reason. Furthermore, I have a multitude of residents who exhibit bad behaviors and the behaviors are extremely well documented. As a result, it would be really easy to choose from any resident, meet with them every week and moniter their behaviour. However, I am not sure if it is possible, meaningful or effective for me to try and change the behavior of an individual who suffers from dementia.
Every time a bad behavior is exhibited and nopticed by the staff, it is documented. At the quarterly review, each bad behavior is addressed and discussed. After looking at the behavior from the perspective of each discipline, a plan is decided on and implemented in response to the incicdent. It is often the case that a resident will change or the behavior will subside for a period of time, sometimes longer than others. However, it has never once been clear to me that the change in behavior was a result of the plan that was implemented in response to the behavior and not just random coincidence. In fact, it is often the case that the bad behavior appears to be a random occurence more than a response to the context in which it occured, or specific enviormental stimuli.
Subscribe to:
Posts (Atom)