lntroducins the resident

Mrs I is an 84 year old woman suffering from Alzheime/s disease. She moved
into the home after
agreeing with her son that she was vulnerable due to increasing mobility issues
following a stroke.
Mobility issues were however just the beginning of her health probtems. Mrs l,s mobility
was limited
but used a zimmer frame to get around. She had poor short term mernory leading
to her gaining
weight and becoming very intoxicated when consuming alcohol. Her stroke
had led to her having
issues swallowing food as well as decreased fine motor control (She
sometimes struggled to use
cutlery).

ln her working life, Mrs I worked as a French teacher and could still remember
some of the language.
Mrs I lived a very financially comfortable life, she was brought up in Cyprus
and was from a wealthy
family. Her husband was also very affluent as he worked as a judge. Her
whole life Mrs I had servants
or maids so was used to being cared for in some aspects. Mrs lwas well educated
and enjoyed
reading and writing poetry. She played board games with her son and
staff; Scrabble was her
favourite game.

Mrs l's life at Clara Court

When I started working at clara Court, Mrs I had already tived there for
a number of years but
through reading her care plans and speaking with my senior staff
I could grasp how her care had
been tailored for her. Mrs I is a large woman and had very active
sleep (she rolled around in her bed
a lot when sleeping). She quickly began falling out of bed and
measures were taken to protect her
from hurting herself. lnitially tactics to reduce movement whilst asleep
were taken such as using
more pillows to keep Mrs I in a more upright position. staff had to
be careful in ensuring she could
still move to the bathroom during the night otherwise this woutd be neglectful practice.
unfortunately this did not work so after discussion between Mrs l, her
son and staff; lt was agreed
that purchasing a double bed would be necessary. This worked and
Mrs I slept a lot better. lt was my
iob as a carer to continue to monitor her safety in bed through observation and discussion
with Mrs
t.

Whilst working with Mrs l, I had noticed she had a tendenry to use
other residenfs frame when
leaving after meal times. I reported this to my senior and it was
decided that we would label Mrs t,s
frame with her name. This seemed to work for the most part and changes
were made to her care
plan to make all staff on the unit aware of the changes.
The nature of dementia is that an individual
will decline and over time it became clear that Mrs I required inreased guidance
with getting out of
her seat. Her care plan was further altered to ensure that staff brought
her frame to her and provide
verbal guidance with how to get out of her seat. This allowed
her to maintain her independence as
much as possible and prevented her from requiring use of a lifting
belt. My responsibilities for this
issue were much the same- monitor any changes and continue
in accordance with her care plan
unless othenrise noticed.

I previously mentioned to you Mrs I had difficulties swatlowing

and her short term memory. Mrs I
ate very fast due to her impaired memory and when coupled with her
difficulties swallowing often
led to her choking. obviousty this was very distressing for her as
an individual but also placed staff in
very stressful situations. staff undertook several risk prevention
steps such as suggesting softer food
options to Mrs I and reminding her politely to eat slowly if she was eating particularly
fast.
Sometimes staff would cut food deemed hazardous into smaller portions
with Mrs l,s permission. I
made sure to be vigilant when taking her food order and to monitor
her eating in general so as to
avoid her choking. Any changes I observed I reported to senior members of staff so Mrs l's care plan
could be reviewed if necessary.

Conclusion- Mv reflections

Mrs l's care is obviously a very complex subject with many subtleties however when broken down is
also quite simple as all measures taken are very logical {e.g. double bed for her sleeping dilemma}.
All of the measures that have been taken have required discussion with Mrs I and her ideas into
finding a solution appropriate for everyone. When necessary her son has been involved in the
discussion to provide clues into what she used to like.

Dementia is itself a complex subject but from a carer's perspective should not be. Dementia may
impede some of an individual's abilities but it is our role as carers' to minimise the disruption and
maintain as much independence as possible. The disease is very different from person to person and
it is important to understand how variation between individuals will lead to a person-centred
approach. lndividuals in care may sometimes lack the capacity to make informed decisions and it is
essential that carers make constant assessments of capacity before making decisions in their best
interests. Mrs I has sometimes lacked capacity in regards to certain decisions (eating very fast) but
by discussion with her son and other members of staff she has remained the focal point of her own
care plan.

My role as a care assistant is seemingly easy: monitor and record any changes as well as reporting
the changes to my senior. Nonetheless, caring is about being proactive in what can be a very
dynamic environment. To achieve the highest standards of care I have made constant risk
assessments, been very observant and used my intuition when suggesting ways to reduce any risk to
Mrs l.

Caring requires team work between all parties: the individual, the care team and her family. The care
plan is the holy grail of caring and tells you nearly everything you need to know. Care plans are
carefully tailored to provide person-centred care by working with the individual, the family and the
staff. A culture of inclusion must be created for care to be efficient and effective. All parties must
have an input and achieving a balance is what is key for an effective care plan. Ultimately, the care
plan must be constantly reviewed but if you implement the procedures and be hands-on you should
be successful.