Safeguarding Dementia Patients - Free Essay Example

Sample details Pages: 8 Words: 2354 Downloads: 8 Date added: 2017/06/26 Category Medicine Essay Type Research paper Level High school Did you like this example? Introduction All nurses have a duty of care to their patients (Brooker and Waugh, 2013). Nurses are expected to play a safeguarding role, recognising vulnerable patients and protecting them from harm, abuse and neglect. Elderly patients are at especial risk due to their poor health, disabilities and increased frailty (de Chesnay and Anderson, 2008). Don’t waste time! Our writers will create an original "Safeguarding Dementia Patients" essay for you Create order Of concern here, is the higher than average incidence of abuse in elderly people with dementia (Cooper et al., 2008). Nurses play an important role in recognising signs of abuse and acting as advocates for their dementia patients. Here, the principles of safeguarding and how they are applied in dementia nursing are presented. Dementia: Cause of Vulnerability Dementia is a group of symptoms that are associated with declining functionality and physical health of the brain (NHS Choices, 2015). This decline in mental function makes a person increasingly vulnerable (de Chesnay and Anderson, 2008). Dementia is typically seen in elderly people with one in every three people over 65 having dementia, and two-thirds of these will be women (Alzheimers Society, 2014). The signs and symptoms of dementia demonstrate how this condition makes someone vulnerable to harm, abuse or neglect (Hudson, 2003) as they include: memory loss, reduced thinking speed, reduced mental agility, language difficulties, lower levels of understanding and reduced judgement. Furthermore, as dementia develops people become more apathetic and isolated as they lose interest in socialising, putting them at increased risk. Dementia can alter a persons personality (Hudson, 2003). They may find it difficult to control their emotions and hard to empathise. They may appear more s elf-centred, suffer from hallucinations and even make false claims or statements. All of these factors make it difficult for relatives and carers to interact with the dementia patient especially when offering very personal care (Adams and Manthorpe, 2003). Dementia reduces a persons ability to live independently and, as the condition progresses, they will increasingly need support and assistance. Their lack of mental capacity makes dementia patients vulnerable to the actions of others (Hudson, 2003). They will require assistance with decisions and gradually lose their autonomy as the dementia progresses, eventually relying on others for even the most simplistic decisions. Depending upon the stage and severity of their dementia, they may be living at home with support from relatives, or they may be in residential care. Safeguarding: Duties and Expectations Safeguarding adult patients means to protect those at risk of harm from suffering any abuse or neglect (Tidy, 2013). The CQC (2015) defines safeguarding people as protecting peoples health, wellbeing and human rights, and enabling them to live free from harm, abuse and neglect. Safeguarding is seen as an essential component of high quality health and social care. The healthcare provider is expected to minimise the risk of any abuse or neglect befalling a patient, identifying any potential causes and taking steps to mitigate them. A patients right to live safely and free from abuse or neglect must be protected, and their wellbeing promoted with ample consideration for their own views and beliefs. The overall responsibility for safeguarding vulnerable adults lies with Adult Social Care (Dementia Partnerships, 2015). They receive and process and safeguarding issues from their partner agencies. However, each partner agency is expected to have its own procedures and practices to reco gnise and respond to any safeguarding alerts. This means that all staff employed by a health or social care provider has a duty to identify and report any safeguarding issues. Nurses caring for patients with dementia therefore have a duty to identify and report any signs of abuse or neglect (Hudson, 2003). Furthermore, they must have the knowledge and skills necessary to provide quality care to these patients with reduced mental capacity. Abuse of a vulnerable adult can occur anywhere: at their home, in a hospital or a residential care setting (Tidy, 2013). Abuse can include physical actions, sexual abuse, mental or emotional abuse, neglect and also financial abuse. Often, the abuser is well known to the victim (de Chesnay and Anderson, 2008). They could be a neighbour, relative or friend, carer, nurse or social worker, a fellow resident or service user. The adults most at risk of abuse are the frail elderly people who either live alone, or live in residential care, but without a ny family support (Mandelstam, 2008). In terms of suffering physical harm, the most at risk are those adults with mental or physical disabilities. Dementia Specific Issues Dementia patients are vulnerable adults, their degree of vulnerability dependant on the stage and severity of their condition (Tidy, 2013). The Department of Health describes vulnerable adults as those who are unable to take care of themselves, or who are unable to protect themselves from harm (DH, 2000). People with care and support needs require help and assistance from both the nursing and social care disciplines. Part of the nurses duty is to safeguard their vulnerable patient from abuse and neglect (SCIE, 2015). The Care Act (HM Government, 2014) requires local authorities to perform safeguarding duties. This stipulates a multiagency approach where any safeguarding concerns are recognised, acknowledged and addressed. Dementia patients are especially vulnerable as they increasingly lack the mental capacity to participate in the decision-making process that will ultimately protect and promote their own interests (BMA, 2011). This means that any decisions made regarding their car e or treatment are made on their behalf. This loss of autonomy disempowers them and makes them subject to others will. Coupled with the ageing process, declining physical health and increased frailty, this puts dementia patients in a highly vulnerable position. Steps a Nurse Can Take: Identification Safeguarding adults with dementia is a difficult task. It is widely acknowledged that it is difficult for the nurse to spot signs of abuse in dementia patients due to similarities between signs of abuse and symptoms of their underlying condition. General signs of abuse can include frequent arguments between the caregiver and the patient, and changes in the dementia patients personality or behaviour (Tidy, 2013). Yet, as noted above, these are also signs and symptoms of the progressive disease. Furthermore, spotting such trends requires the nurse to have good knowledge of both patient and carer. Recognised signs of emotional abuse such as rocking, sucking and/or mumbling to themselves are also dementia-like (Tidy, 2013). Often professionals can only detect the signs of physical abuse and neglect by way of a detailed physical examination. The nurse should look for signs of physical and sexual abuse such as physical injury, bruising and bleeding. These may seem more easily detectable, but can be concealed or explained away as accidents. Signs of neglect, including weight loss, dirty living conditions, poor personal hygiene and untreated physical problems, should be identified by the nurse. Again, factors associated with dementia such as increasing apathy, reduced taste / appetite may be the underlying cause and will need to be explored. Effective safeguarding requires the nurse needs to get to know their patient, discussing all aspects of their well being with them and/or their carer. People with dementia are especially vulnerable to abuse being less able to remember or describe what has occurred (Alzheimers Society, 2014). Victims, whether they have dementia or not, find it difficult to tell anyone what has happened. Added to this general reluctance, are issues specific to dementia: patients may feel that they will not be believed, have difficulties recalling and communicating events. The distress caused by the abuse may exacerbate these difficulties. Dement ia patient are often not believed, being discredited and thought of as confused and unreliable. Therefore, to protect their patients and best represent their interests it is essential that the nurse understands them and establishes a good trusting relationship. Dementia patients are also at increased risk of financial abuse. This can include sales-people taking advantage of them, relatives or carers accessing their bank details or causing them to alter their will and/or gain power of attorney (Adams and Manthorpe, 2003). Yet, the nurse should remember that some of these actions may be necessary steps so as to provide care to elderly dementia sufferers. For example, a carer may need to pay for some goods or services for the patient, and, in cases of significant reductions in mental capacity, power of attorney has to be awarded to ensure that all aspects of the dementia patients life are managed. Nurses should be aware of the Mental Capacity Act (HM Government, 2005). This was intr oduced to help protect the rights and wellbeing of those who lack capacity. It governs the responsibilities and jurisdiction of those making decisions on anothers behalf. It aims to ensure that peoples autonomy is protected, but where they cannot make a decision, they are not ignored and any actions are in their best interest (Adams and Manthorpe, 2003). The demanding care needs of dementia patients can result in high levels of carer stress to be experienced by relatives and friends. This may cause that individual to do abusive things and behave out-of-character. Nurses should recognise that carers of dementia patients experience greater strain and distress compared to carers of other elderly people (Alzheimers Society, 2014). The enforced change of lifestyle resulting from caring full time can manifest as resentment and dislike. External pressures and stress can make people abuse others, as can a history of being abused themselves, previous violent or antisocial behaviour. Nurse s should endeavour to develop a good relationship with both patient and carer(s). They should seek to establish trust and empathy and learn about the people behind the condition. This will enable the nurse to offer high quality care as described in the next section. Steps a Nurse Can Take: Prevention Nurses should recognise that abuse can take place in all settings and be performed by all people (Tidy, 2013). Abuse of dementia patients in formal residential or hospital care settings is usually a sign of an overall poor quality of care. It signifies that staff are not appropriately trained and skilled in dementia care. They do not understand the complex needs of these patients and therefore cannot adequately address them. Thus, where a nurse identifies abuse at an organisational level, the situation should be reported so the necessary systems and training can be put in place. Remedial action on this scale is outside the scope of this essay, but where a colleague or individual carer acts inappropriately, the nurse can intervene to educate and train them. The communication difficulties posed by dementia patients does mean that it is more difficult to offer person-centred care. This results in an individuals needs not being met. This is further exacerbated where the dementia pat ient exhibits behavioural and psychological symptoms such as restlessness, shouting and aggression. These can result in the patient being restrained or medicated inappropriately. Therefore, nurses should ensure that they have the knowledge and skill to work with dementia patients so as to act in their best interests. On occasion, the requirements of the Mental Capacity Act are not followed appropriately: Staff assume that all dementia patients lack capacity and therefore dont involve them in decisions. Nurses should be aware of, and understand, the Act. They should know how to implement it and where to gain advice if necessary. Ideally, there should be continuity of care. The same nurse should work with the patient and their carer(s) throughout the progression of the condition. By knowing the patient well, they will be better able to facilitate person-centred care, upholding the patients interests and best representing their views. The nurse also has safeguarding duties with rega rds to home-based care. Improving the emotional and practical support given to family carers of dementia patients is recognised as key to safeguarding patients. These carers have little or no training and often do not feel adequately prepared (Alzheimers Society, 2014). They often find the situation stressful and demanding: circumstances that could lead to abuse or neglect. The nurse should therefore ensure that they are approachable and inspire confidence in the patient and carer. They should provide education and advice to carers and ensure that back-up support and resources are available to those who need it at all times. Developing a good relationship between all parties is essential in preventing abuse from occurring, ensuring the patients needs are met and their interests respected. Conclusion Nurses play a key role in protecting dementia patients from abuse. In order to effectively safeguard their patients, it is essential for nurses to understand the types of abuse, how and why it may occur. Dementia patients are at especial risk due to their declining mental capacity and reliance on others. Nurses are well placed to identify and prevent abuse through establishing close, open and trusting relationships with both patient and carer. Nurses can act as advocates for their patients, representing their best interests and facilitating person-centred care. Through providing education and support for carers, nurses can ensure that all the dementia patients needs are met. References Adams, T., Manthorpe, J., (2003). Dementia Care: An evidence based textbook. Boston, CRC Press Alzheimers Society, (2014). Dementia 2014 Infographic [on-line]. London, Alzheimers Society via: https://www.alzheimers.org.uk/infographic BMA, (2011). Safeguarding Vulnerable Adults à ¢Ã¢â€š ¬Ã¢â‚¬Å" A toolkit for general practitioners. London, British Medical Association Brooker, C., Waugh, A., (2013). Fundamentals of Nursing Practice: Fundamentals of Holistic Care. New York, Elsevier Cooper, C., Selwood, A., Livingstone, G., (2008). The prevalence of elder abuse and neglect: A systematic review. Age and Ageing, 37(2): 151-160 CQC, (2015). Safeguarding People [on-line]. London, Care Quality Commission https://www.cqc.org.uk/content/safeguarding-people de Chesnay, M., Anderson, B.A., (2008). Caring for the Vulnerable: Perspectives in Nursing Theory, Practice and Research. London, Jones and Bartlett Learning Dementia Partnerships, (2015). Safeguarding vulnerable adul ts [on-line]. Ashburton, Dementia Partnerships https://www.dementiapartnershipd.org.uk/archive/primary-care/primarycaretoolkit/1-dementia-care/managing-a-long-term-condition/safeguarding/ DH, (2000). No Secrets: guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse. London, Department of Health HM Government, (2014). The Care Act. London, The stationary office HM Government, (2005). The Mental Capacity Act. London, The stationary office Hudson, R., (2003). Dementia Nursing: A guide to practice. Oxford, Radcliffe Publishing Mandelstam, M., (2008). Safeguarding Vulnerable Adults and the Law. London, Jessica Kingsley Publishers NHS Choices, (2015). Dementia [on-line]. London, Department of Health https://www.nhs.uk/Conditions/dementia-guide/Pages/about-dementia.aspx SCIE, (2015). Adult Safeguarding [on-line]. London, Social Care Institute for Excellence https://www.scie.org.uk/adults/safeguarding Tid y, C., (2013). Safeguarding Adults. Leeds, Emergency Medical Information Service

Sympathy for Jane Charlotte Brontes Jane Eyre Essay

Sympathy for Jane Charlotte Brontes Jane Eyre In the first two chapters of Jane Eyre, Charlotte Bronte creates sympathy for Jane from the settings she uses like the red room, which comes up later in chapter two. Also with all the metaphors of Janes true feelings under the surface and the ways that the chapters are structured. Charlotte Bronte starts off the book straight to the point as if we just enter Janes mind at this moment in time, it is meant to draw the reader in and at once create the atmosphere of this time when we have joined her. With the clouds so sombre and the rain so penetrating we get a glimpse inside Jane knowing that she must be so cold inside like the winter. 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International Economic Development

Question: Write an essay on "International Economic Development". Answer: Introduction In this reflective essay I will be applying various foreign policy ideas implement them in democracy and then be able to see which policy is best able to improve the economic welfare of the country which will then be able to provide me with the Necessary number of voters to be elected in the country. Some of the areas that need to be revamped include foreign policy which includes international trade, foreign aid, immigration, welfare which includes poverty, equality, housing (public and private), pensions (public and private), unemployment benefit, economy includes GDP, tourism, competitiveness, currency, wages, unemployment, agriculture, recycling, energy, technology,. tax includes company, income, sales, property, public services includes healthcare (public and private), education (public and private), research funding, law and order includes crime, police, guns, prisons, transportation includes rail, road, air, oil (Jomo K. S. and Chowdhury, 2012). outcomes Since this was a developing country there are a lot of areas that still want policies to generate growth. I realized that the main problem in this country is high unemployment rate which if tackled would be able to give me more than 70% of the votes. This is due to the presence of a youthful population in the country that make up almost 60% of the total population. Hence I realized that policies should be focused on how generate and create employment for the youth who have no jobs. This can be tackled by improving the competitiveness of the country to attract foreign direct investments in the country and by doing so I will also be able to see that there is growth in the GDP. In recent years, the international economy has undergone significant changes that Our country has not been able to stay away, given its high degree of integration into the world economy on the one hand, and the important proximity to the main engine of this in recent times, the United States on the other. I will sign Free Trade Agreements with countries such as United States and Canada (NAFTA), to make Our country became an attractive destination for foreign investment for many transnational corporations and focused development model oriented abroad. Subsequently, as part of a trade policy with a clear liberalization objective, the country signed new trade agreements with other nations in the region in Central and South America, as well as with the European Union, Israel, the European Free Trade Association and Japan. This will definitely guarantee that there is creation of employment for the youth (Jomo K. S. and Chowdhury, 2012). implementation of a trade policy without a clear openness and liberalization objective, whose central axes are: to increase foreign trade and attracting foreign direct investment as driving forces of economic growth, it is time to make an assessment of process.Foreign trade, which has traditionally been the engine of growth in many economies, will also be to Our country, which is currently considered one of the most open economies.Trade liberalization, which started from mid nineties , when the country decides to face a new deregulatory step by seeking new business in the international market, yields high export figures for as well as increased foreign direct investment. Our country needs of global markets to maintain its foreign trade strategy, but the way of bilateral negotiations has not yielded the expected results, since exposed to competition in many sectors today reveal neglected, especially in agriculture as It shows in the well-documented case of rice the food chain, in which production losses, it has to add her job losses. It must support the local companies to export, since the revenue generated by sales abroad allow creation of employment both directly and indirectly. Winners in foreign trade sectors were those related to foreign investment, ie they have optimized their benefits on the basis of exploiting the main comparative advantage of transnationals Our country:In our country, foreign trade represents an essential instrument for achieving economic growth. It is for this that the relief has come close to the ceiling and still signing new trade agreements with other countries which are analyzed (Munshi and Abraham, 2004). An alternative would be the extension of that exportable offer based on knowledge and adding value, ie attributable to local businesses endogenous growth and focused on foreign trade, especially small and medium enterprises, key stakeholders in a strategy production development and weigh the existence of national networks between companies and between sectors. This policy gave me about 60% of the votes which will guarantee me the outright victory to be voted in. Investment in health, a priority of the package of social investment, and as an area that is so dear in peoples hearts healthcare investment should be able to bring in a substantial number of votes. About 40% of the people feel that health care in the country should be improved.Investment in health is a key package of social investment, where the contribution is recognized element health to a job-rich recovery. policies in this field and reforms of national health systems are essential for my election bid. Health is a value in itself, but also a precondition for economic prosperity. Health expenditure is conducive to growth. And the more effective use of the social and health budgets through advice and encouragement of good practice. I will unsure smart investment in sustainable health systems that are responsible for the organization and functioning of the health care services. To increase the efficiency of these services, it is not always necessary to spend more, but do it smarter. And ensure that the cost of healthcare for the people is at a minimum and is also quality (Singh, 2013). It is essential to put reforms and investments to achieve greater performance .Efficiency gains can be achieved in several ways, reducing hospitalizations and specialist consultations that are not necessary, strengthening primary care, encouraging the use of less expensive drugs equivalent (generic),evaluating the profitability of health technologies as a basis for decision making. and Investing in the health of people. The health status of individuals determines their degree of participation in social life and work, conditioning their productivity at work. On a larger scale, affects the financial impact on national health systems. Investments in the health sector can support economic growth by allowing people to remain healthy and active at work for longer.Another policy in this area is the investment in health promotion among children and youth, contributing to their physical and social development and, ultimately, their preparation to participate fully in society. Investment in health workers is another course of action..Investments to reduce health inequalities. Preventable diseases and deaths due to health inequalities represent a drain on human capital and should be reduced. Universal access to safe, effective and quality health services, greater cooperation between social services and health care and action on risk factors can combine to break the vicious circle of poor health, poverty and ex clusion. I recognize that implementation of this policy may require a long period to have real effect on the people (Arbuckle, 2012). The third problem to tackle was insecurity. Studies have revealed that the public believed that solutions to such problem should be through a joint action between the government and the community, because the traditional response based on the system of "police, justice and prison" was insufficient to contain the crime. Therefore, I need to articulate an adequate system of prevention and control of crime, which was emerging as the product of a thorough and comprehensive study of the situation in different areas prevailed (Grover, 2007). The causes of insecurity are, Lack of equal access to education and the labor market, Inadequate living conditions, Presence of high levels of violence, discrimination, intolerance and hopelessness. Existing conflicts in the family, in schools and child abuse charge singular importance, Abuse of drugs and alcohol. Shortcomings in the early years of life (lack of supervision, family breakdown, abuse, trauma). Difficulties in education (behavior problems, truancy and dropout rates, etc, Problems in the functioning of law enforcement agencies and courts. The diagnosis guided the implementation of the strategy, structured based on different policies for every need, which in turn contain various programs. These policies were applied throughout the national territory through various national, provincial and municipal agencies and jointly by the official, community and private sectors, developing various application programs. Work on the community focuses on creating informational and educational spaces about the magnitude of the criminal problem and its negative consequences for the country, as well as awareness of the conditions that encourage criminal actions and mechanisms created to fight it (Card, Blundell and Freeman, 2004). Other policies to tackle this problem are Plans targeting the family are intended to provide tools for the proper management of conflict situations and / or violent household, from the concept that the conflicting and aggressive family environment makes young people looking for spaces outside the bosom of the family linking, optionally with the criminal world. This policy of improving security guarantees me 33% of the votes in the game. With regards to taxes, my policy was to ensure that there is a sustainable government expenditure that ensures people are no overburdened by overtaxation.The importance of indirect taxes in low-income countries is largely due to aspects of tax administration and compliance. It is significantly easier to manage and administer indirect taxes raise income taxes. Customs duties, for example, are relatively easy to collect, that all goods entering the country through a port that can be controlled by tax administrators. All importers who do not fulfill the duties (or do not provide sufficient assurance) are not allowed to withdraw their assets (Hubbard, 2009). The income tax, on the other hand, is much more difficult to manage because the tax can not be collected through physical controls. The authorities rather require you to file a declaration and must invest resources to verify the declared income. The only exception is income taxable by withholding, but even in this case the authoritie s have to monitor withholding agents to ensure the transfer to the government of taxes withheld. The policy solution to these problems also consists of three parts: First, a recognition that the adaptation of the tax system to achieve a precise balance of social and economic objectives is necessary for example provision of subsidies where necessary , the second can not be achieved some gains by changing the combination of tax direct and indirect, but each instrument specific income should remain relatively well defined; third, the understanding that a sound tax structure without adequate attention to the tax administration is not a desirable tax policy (Singh, 2013). This will ensure that I get a considerable percentage of votes but not enough to get me elected because I only managed to get 40% of the total vote. Learning outcomes I utilised my resources to help work towards the objectives I set for this particular simulation. From this experience I found my weaknesses to be based around focusing on a few areas of investment and taking reactive measures to areas such as crime. Interesting was that I ended up investing a lot of money into crime reduction area , although the area of focus should have been employment creation (Anders, 2010). I find the topic of sustainability very interesting and something that is a major issue in todays society, and therefore, to achieve the outcome of GDP and economy, I was significantly focused on three areas of improving GDP, crime and health. From the investment and focus shown through the initiatives outlined in Description of Activities it is very clear to show that my personal values towards the worlds future were skewed towards these areas. Conclusion Of all these policies, the one that guaranteed me maximum votes and a win was the one that was to generate GDP growth. that we review in this report have been prolific in economic policies. If political power always tries to guide the evolution of the economy, much more it is doing now, where economic agents themselves ask relief intensely. I saw the face of crisis, companies and financial institutions around the world who have been performing poorly in the economy .in these simulations only the first p[olicy guaranteed me an outright win in election, thus, it tell you that a lot needs to be done to improve the GDP, ensure that the peoples social welfare is improve, job creation e.t.c. However, other policies in health, security and transport ensured that after implementation I get more than 30% of the total votes. Thus, the economy generally needs intervention in all spheres as the people felt that all areas needed reforms. However, full implementation of the policies may take a lon g time to realize the needed change. References Anders, G. (2010).In the shadow of good governance. Leiden: Brill. Arbuckle, G. (2012).Humanizing Healthcare Reforms. London: Jessica Kingsley Publishers. Card, D., Blundell, R. and Freeman, R. (2004).Seeking a premier economy. Chicago: University of Chicago Press. Grover, J. (2007).Healthcare. Detroit: Greenhaven Press. Hubbard, R. (2009).Macro economics. Frenchs Forest, N.S.W.: Pearson Prentice Hall. Jomo K. S., and Chowdhury, A. (2012).Is good governance good for development?. London: Bloomsbury Academic. Mukhopadhyay, S. and Sudarshan, R. (2003).Tracking gender equity under economic reforms. Ottawa: International Development Research Centre. Munshi, S. and Abraham, B. (2004).Good governance, democratic societies and globalisation. New Delhi: SAGE Publications. Okma, K. (2009).Six countries, six reform models--the healthcare reform experience of Israel, the Netherlands, New Zealand, Singapore, Switzerland, and Taiwan. New Jersey: World Scientific. Singh, S. (2013).Macro economics. New Delhi: APH Pub. Corp.