Introduction to Individualized Care
Dementia, a neurological condition affecting around 50 million individuals globally, continues to rise as the population grows (Abraham et al.,1994, 160). Understanding the needs of dementia patients and elderly individuals necessitates a thorough understanding of caregivers’ lives to tailor care to their interests, requirements, and beliefs. Emphasizing each individual’s unique experiences, happiness, and dignity, Thoms Kitwood’s innovative approach ensures the holistic consideration of the social and psychological aspects of elderly patients (Mitchell and Agnelli.,2015, 46). Mrs Davies will be integral in developing an individualized care plan (ICP) incorporating self-management techniques, shared decision-making (SDM), behavioural adjustment strategies, and multidisciplinary team (MDT) collaboration. Consequently, conventional interventions like motivational interviewing (MI) may not yield optimal results due to her specific cognitive condition. Given the many factors contributing to her current health status, a comprehensive approach is imperative to stabilize Mrs Davies’ frailty.
UTI – Hospital Admission
Following hospitalization for a urinary tract infection (UTI), Mrs Davies experienced significant declines in mobility and mental acuity. The combination of her Alzheimer’s disease and the acute illness left her disoriented and vulnerable to delirium. While transferring her to a community hospital for rehabilitation might seem logical considering her limited mobility (Zeng.,2018, 2015), the potential risks of exacerbating confusion and delirium due to another change in the environment must be carefully weighed.
Mrs Davies’ cognitive impairment poses challenges in engaging in shared decision-making (SDM) for her discharge plan. Assessing her mental capacity is necessary to determine her ability to participate in decision-making processes. If she is deemed incapable, deprivation of liberty safeguards (DoLS) may be considered, and involving an Independent Mental Capacity Advocate (IMCA) in decision-making becomes crucial to acting in her best interests.
A multidisciplinary team (MDT) approach is indispensable for collaboratively planning person-centred care post-discharge. Within a healthcare facility or nursing home setting, a physical therapist could design a tailored exercise regimen for Mrs Davies, considering her preferences and daily activities, such as mobility while having tea. Occupational therapists (OTs) could aid in orientation strategies, ensuring safe living environments, and providing assistive devices (Kim and Park.,2017, 390). General practitioners should review the “This is Me” document completed with assistance from dementia nurses to mitigate fall risks while nurses advocate for patients like Mrs Davies. Nutritionists can assist in maintaining her weight, and speech-language pathologists can address any swallowing difficulties she may experience.
No matter their geographical distance, involving the care home staff and Mrs Davies’ family in decision-making and care-planning processes is crucial. Staff members possess valuable insights into her preferences and baseline functioning, while family members can help honour her wishes.
Alzheimer’s Disease
Mrs. Davies’ quality of life is significantly compromised by Alzheimer’s disease and its associated side effects. Factors contributing to her increased social isolation include limited opportunities for social engagement, bladder control issues leading to dehydration risks, anxiety stemming from disorientation, and challenges with mobility and recovery (Downs and Collins.,2015, 37). Restoring her functional level and quality of life hinges on addressing these factors.
Assessing how communication and therapy strategies can be adapted to Mrs Davies’ cognitive capacity is urgent. Proven effective methods for memory rehabilitation in Alzheimer’s patients include priming, errorless practice, and repetitive reinforcement, as indicated by studies (Li and Liu.,2012, 294). Additionally, consistent practice has shown positive effects on individuals with Alzheimer’s disease.
Incorporating Mrs Davies’ interests, such as musical theatre and amateur dramatics, into her rehabilitation program can enhance its effectiveness and enjoyment (Vun et al.,2017, 11). For instance, integrating music into mobility exercises can encourage movement and strength-building, akin to motivating a deaf individual to engage more through music.
Effective communication techniques are paramount in dementia care. Research, like the systemic review by Eggenberger et al. (2013), highlights significant improvements in quality of life, emotional state, and social interaction among dementia patients through communication skills training across healthcare settings. Essential components for effective communication in dementia care include using simple language, maintaining eye contact, speaking slowly, creating a non-distracting environment, and incorporating nonverbal cues such as touch and gestures.
Developing these communication strategies provides effective medical care for Mrs. Davies. Educating caregivers and families about these methods through lectures, simulations, group discussions, and role-playing is essential to enhance their skills and confidence while communicating with dementia patients (Eggenberger et al., 2012, 351). Considering how Mrs Davies communicates by tuning in to activities she likes and making her part of a conversation, using those activities could provide meaningful communication to her well-being.
Osteoporosis and Lumbar Wedge Fractures.
Mrs Davies, due to her previous lumbar wedge fractures and osteoporosis, should engage in personalized workout training. Training against gravity and resistance may be helpful for people without osteoporosis and athletes with compression injuries.
SMART objectives setting helps Mrs Davies progress in small increments to determine if the progress is significant. Considering the nature of her cognitive impairment and frailty in general, her progress could be limited (Benedetti et al., The Impairment of Cognitive Functioning in an Aged Person, 338). However, the same achievements, scaled to be small and insignificant, could dramatically increase the very quality of her life. Instead of using household chores as a substitute for exercise, she could incorporate the chores simultaneously in her exercise routine to make more motivation and effectiveness, as results show (Zhang et al.,2022, 364). Inserting standing activities at every moment she has to stand in place, like when your tea is the one she is waiting for or sit-to-stand exercise, is an excellent way to regain her health. Teaching care house staff to apply such a telecentric attitude requires the institution to set up programs in that direction, for example, seminars or presentations.
The last alternative covered is social prescription, centred on community-generated exercise activities intended to allow her to do what she wants and interests her. Several activities, including physical activity, socialization, fellowship, and involvement in community events, are essential for holistic well-being (Sueyoshi et al., 2022, 1224). Groups make it possible for individuals to participate in these activities. To tailor a treatment plan for Mrs Davies, it is essential for the physiotherapists, occupational therapists, and staff members at the care home to communicate and engage with one another. Because her recuperation is anticipated to be prolonged, the strategy should be submitted to suitable periodic assessments and alterations.
Immobilization, COPD, and Long-Term Condition Management
For senior people made to stay home, deconditioning, muscle loss, and bone mass reduction can significantly be a concern risk, ing fatal results like bed sores at some point. Mrs Davies’ extended recovery can result from the listed factors and, perhaps, other factors she and her family did not know about. One of the most critical areas is creating individually focused therapies to support patients in carrying out their daily activities easily (Dimitrova et al., 2017, 720). Nonetheless, the unknown factors of the event give this specific scenario a high level of uncertainty.
Staff also need training to supervise Mrs. Davies when participating in the exercise sessions, assist her as required, and tailor the intensities. Eliciting case management of COPD symptoms, e.g., using inhalers per instructions and notification of symptoms, will help Mrs. Davies better handle COPD symptoms. Also, integrating respiratory therapists to guide families in meetings demonstrates responsible self-care techniques.
Making healthcare managers deal with COPD in Mrs Davies’ situation calls for further measures that need more time for planning. Her exercise program is optimal for aligning with her constraints, such as timing, by including breathing techniques and, if possible, participating in sports activities without fatigue. Instead of serving as an obstacle, Mrs Davies’s teaching could be managed through caregivers concerned about Alzheimer’s to promote compassionate self-management.
Consistent interval exercise session updates, post-discharge program schedules, and continuance monitoring on improvement are essential for the program to continue. Inscription of nurses actively in the creation process is fundamental (Zhu et al., 2018, 680). Social Prescribing may be found to check its impacts on improving Mrs Davies’ well-being. The young woman can seek the organization’s Alzheimer’s Society aid to meet people in her community who can offer social resources for her.
Neglecting the integration of multiple disciplines when caring for Mrs Davies, including optometrists, dieticians, social workers, nurses, and diabetologists, will be detrimental to comprehending her glaucoma (Jayaram et al., 2023, p. 1790). The matters of mobility, in turn, present her with the increased risk of falls coupled with the obligation to revise her treatment plan as well as living arrangements. Providing educational and support programs for Mr Davies and healthcare employees who wear proper eyewear and regular check-ups of Mrs Davies’s eye condition is critical.
Another reason for additional assessment of Mrs Davies is the likelihood of diseases of the respiratory organs similar to pneumonia, including the progressive deterioration of chronic respiratory problems. Teaching the correct form of hand washing for coughing or sneezing and developing a ritual that calls for not passing on the disease is the most efficient prevention of the spread of respiratory diseases.
Conclusion
In conclusion, the need to put into use a multidisciplinary team, especially when prioritizing Mrs Davies, the recipient of care based on her psychosocial, psychological, and biopsychosocial wellness, is crucial. Having a fragile medical condition and suffering from a disease that changes dynamically, her symptom control is highly complicated. Therefore, careful monitoring and modification are required. We have to decide on issues for Mrs Davies. In that case, it should be how to cope with her long-term challenges, which are responsible for her independence, autonomy, and a better quality of life. The family of Mrs Davies, in tandem with the professionals, the multidisciplinary team (MDT), and the health workers, labour collectively to achieve this within Mrs Davies’ consolidated cognitive capability. Core values include a personalized approach, excellent skills as a therapist, the evaluation process, and the establishment of a trusting connection in the person-centred approach customized for Mrs Davie, her individuality and the ability to revive and live life the way every individual wants, although the challenges are focused.
References
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