In the report, an analysis of the case study of a person in person-centered care is discussed. The experiences behavior and capacity assessment of the individual is discussed. Further, the roles of healthcare professionals in person-centered healthcare are also discussed followed by the discussion of different person-centered assessments that is useful in defining the care pathway of the patient. Lastly, the capacity assessments are evaluated to identify the key areas of development.
Some individuals go through daily life problems such as problem-solving, learning, communication, etc. due to mental disabilities also called the intellectual disability where the functioning of the affected person is impacted in two major reasons; adaptive functioning activities such as living independently or communication and the intellectual functioning which involves judgment, problem-solving, and learning. About 1% of the population is diagnosed with disability disorders and out of these people, the majority (up to 85%) have a very mild intellectual disability which can be treated with care and medicines (Person-Centred Care, 2012).
The case study is based on the person-centered care of a patient in his sixties and diagnosed with dementia. When the patient approached the person-centered care, the individual was in the initial stages of dementia and later the situation was complicated and the person was given more care. The intellectual disability impacted the social interacting capacities of the person to large extent. The care pathway is designed for the patient with the intervention of the patient, family, and different teams of the healthcare in person-centered care to help the individual with the intellectual disability. In the initial stages of Path creation, the patient contributed very much in defining the goals and activities that were supposed to be included in the care pathway. Later, almost after three years, the capacity of patients to intervene in the path creation reduced and the involvement of family members increased (Santana et.al, 2018). The care pathway is person-centered and hence, the choices of best practices, goals, etc. can be decided by the patient if the patient is willing to and capable of doing it. However, in the case study, the involvement reduced gradually as the impact of intellectual disability increased on the patient.
In the initial stages, the individual was comfortable in communication with new members of the team in the healthcare as well as family members but, when the dementia level increased, the individual was reluctant to communicate or be taken care of by the new staff, or family members. The patient selected family members and limited staff to interact with during the care. Hence, the selection of teams in the care pathway is largely impacted by the choice of the patient. When the changes appeared in the behavior of the patient such as reluctant to meet new people unlike before when the patient used to enjoy social gatherings, the changes in goals and practices were decided and implemented (Edvardsson, 2015). The patient was comfortable with the least number of people around him. Instead of discussing every day with the patient, all the tasks were written down on a big 4*3 size picture and individually started to point to the activity which the person wants to execute. In the initial stages, the patient can identify the care, goals, and needs. However, with time the capacity to identify the care needs reduces and the support level from the healthcare professionals and family is increased.
In supporting the patient, professional healthcare plays a very important role in developing the skills, knowledge, and confidence of the person to outweigh the impact of intellectual disability and lead a normal life. My role as an intern at the healthcare was to coordinate with different teams and contribute to the path care process of the person. I communicated with different multidisciplinary teams, patients, and family members and updated them on the conditions and progress of the patient. Different healthcare professionals were involved to take care of the patient such as psychologists who played important role in diagnosing and prescribing medicines and developing the path care for the patient in coordination with the person-centered care team and the family members (Ramseyer, 2020). The teams of person-centered care play role in communicating with the different people, families, and creation of care paths as well as its implementation.
The person-centered assessment is used to plan the care pathway for the person with intellectual disabilities. The assessment is being designed based on both nomothetic and idiographic perspectives, the nomothetic assessment is designed based on the analysis of behavior and experiences of people who face these intellectual disabilities and idiographic perspective is based on the deep analysis of the experiences of a particular person who is diagnosed with the condition. The assessment collects information about the person’s experiences, history, dreams, preferences, etc. which helps the healthcare professional to develop and implement the care pathway for the patient.
To assess the capacity of the patient in person-centered care, several assessments are developed such as activities that describe the individuals’ strengths and interests. However, this assessment is not appropriate to assess the interest of people who are not interested to work as the activities are related to different mainstream professions but it is essential in understanding the career goals of such people in the majority of the cases (Santana et.al, 2018). The next assessment is considered to understand the level of supervision and support required by the individual by assessing the social activities of the person. However, this assessment is not helpful for many individuals as they have minor disabilities which is generally not reflected among many people. Therefore, idiographic assessments should be used for customized plans and approaches used in person-centered care.
It has been analyzed in the report through the case study that individuals; capacity may vary from person to person to decide personal care needs. The capacity may vary in different stages of the pathway as people tend to intervene less as the effect of disability increases. The healthcare professionals play important role in contributing to the care pathway of the person by communicating and coordinating with different teams involved in the process.
A person-centered planning approach is the most recent approach being employed to treat people with disabilities. This approach requires multidisciplinary teams to function well separately, as well as together to devise personal betterment plans for patients. In this report, I discuss observation reports of two such patients and explain my understanding of how processes are run in such teams, and my role as a healthcare professional.
Observation Report I
The patient observed in this report is a student of age 12 with moderate to severe learning disability. As mentioned in the guidelines, at least three teams of varying disciplines are necessary for an optimal rehabilitation process. Multidisciplinary teams involved in the case were composed of nurses, social workers, and psychologists. The following indicators judge the effectiveness of the patient's person-centered treatment process.
Interaction with the patient
The three teams involved had effective communication with the patient, fueled by the patient's desire to get involved in the process. The variety of disciplines involved in the process provided the patient with different approaches to interaction. Due to this open and expansive communication process, psychologists were able to better diagnose the patient's conditions, and provide proper instructions of care to the nurses (Morgan and Yoder, 2012).
As the communication process with the patient was comprehensive, the different teams were able to formulate clearly defined instructions for person-centered planning. There were some barriers to the process of sharing information within the teams, as teams did not have much interaction with each other before. These barriers included a difference in opinion of what treatment the patient should be administered with, but these were easily sorted out during discussions between the teams (Kogan et.al, 2016).
The parents of the child were very supportive and involved in the process. They continuously remained in contact with different teams to understand the situation of their child. They showed eagerness to learn the next steps in the treatment of the patient, and are doing their part perfectly in the process.
Leadership, laws, and regulations
The quality of communication with the patient and within different teams were a result of good leadership. The leaders involved in this case were familiar with proper rules and regulations of person-centered planning and played a part in enforcing them.
Observation Report II
The patient observed in this report is an old man in his sixties with a severe learning disability and a growing condition of dementia. mentioned in the guidelines, at least three teams of varying disciplines are necessary for an optimal rehabilitation process. Multidisciplinary teams involved in the case were composed of nurses, psychologists, and psychiatrists. The following indicators judge the effectiveness of the patient's person-centered treatment process.
Interaction with the patient
The patient had problems in communication with the different teams. His learning disability has made him a socially averse person. The growing condition of dementia only exaggerated his problems as he could not recall most of the situations that troubled him. Due to these barriers in communication, the teams had a hard time diagnosing issues and devising strategies for further treatment.
Due to the issues in communication with the patient, different teams had trouble formulating laid-out instructions for continuing the treatment. The lack of familiarity and interaction between the teams led to a difference in opinion of what the next steps should be. The sharing of information between the teams was not up to the mark.
The patient had no support from his family. None of his children are close to him, and his wife had passed away a few years ago. This lack of any sort of interaction with the patient’s family made his diagnosis and treatment even tougher (Kogan et.al, 2016). Different teams had to look for ways to incorporate the responsibilities of family in the treatment through other media.
Leadership, laws, and regulations
The leadership throughout this case was not up to the mark. The leaders in the institution paid little attention to enforcing the new guidelines, laws, and regulations of the person-centered planning process. This resulted in poor cooperation between different teams.
Reflection of practice and development
Through my journey as a healthcare professional involved in the person-centered planning process, I gained knowledge of what multidisciplinary teams are, what the relationships involved within multidisciplinary teams are. Multidisciplinary teams include people of disciplines like nurses, social workers, psychologists, and psychiatrists. Each of these teams is responsible for communicating with the patient, gathering data, and devising care strategies. During my work, each case had at least three of the abovementioned disciplines working on it, and they needed to maintain effective and regular communication between them (McCausland et.al, 2019).
The most important part of devising an effective treatment plan is having a proper channel of communication between teams. Many teams rely on the data collected by other teams to align with their findings to formulate a plan (Riley, 2020). The main advantage of sharing information is the increase in the accuracy of the diagnosis, and betterment of the action plan, whereas, the con of sharing information excessively can be over-reliance on other teams' data, and a slow diagnosis and strategy formation process.
I worked in the institution as an intern with one of the psychologists. My role as a member of the team of psychologists was to interact with the patient, collect useful data, analyze the underlying psychological conditions, and interact with senior psychologists. The senior members were then responsible to share this information with other teams, gather their findings, share them within the team, and discuss what the next steps should be.
Throughout the process, it was made sure that the patient's data remained confidential, and the patient was not forced to get involved in anything he wished not to. A balanced approach to positive risk-taking had to be used because patients are not usually good at communication, and they could not be forced into doing anything. It was my role to make sure that each of the laws and regulations is properly enforced during my communication, while still being able to provide a healthy medium of communication to the patients (Oppert et.al, 2018).
A person-centered approach is a right way for people with mental learning issues and disabilities as every individual has his own set of issues that must be taken care of separately. Through this report, my experience as a psychology intern is discussed using two observation reports on person-centered planning processes. It can be observed that there are various nuances of working in multidisciplinary teams, and if every part of it is done correctly can lead to a great treatment strategy.
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