Guidelines:

You are required to write three reports on the following skills/tasks. In the reports you are required to illustrate good client care practice that you will implement in future practices.

In each of the reports you need to illustrate understanding and knowledge of your role in promoting safe practices, client independence and dignity during care interventions.

Task 1: Assisting a client with a meal or feeding a client a meal.

Task 2: Assisting a client with Personal Hygiene (tub-bath, bed bathing or showering).

Task 3: Assisting a client to a commode or assisting with toileting a client or emptying a catheter bag.

Instructions:

For Your Skill Reports you can:

1. Choose one of the case studies profiles below to complete the reports and follow the guidelines provided to complete same. The below case studies are a brief overview of a client and you are free to interpret and expand upon the client history, background if you wish. You can use the same client for all 3 reports if you wish or alternate.

OR

2. Complete the assignment on a service user you have cared for during work placement or family member relative you have cared for in the home, whereby you have been involved in assisting them with personal care and their healthcare needs.

Case Study One

Mary Jones is a 75-year-old female, currently residing in Lakeview Nursing Home. Mary was admitted to the nursing home four years ago, following a left sided Cerebral Vascular Accident (stroke). Mary has a supportive family, two daughters and several grandchildren, who frequently visit her on a weekly basis.

Mary requires assistances with her activities of daily living, personal hygiene, and dressing, maintaining safe environment, mobility, and elimination needs. The Barthel index shows Mary is of medium dependency.

Case Study Two

Michael Byrne is a 72-year-old male, with Parkinson disease, who has reduced mobility, type 2 diabetes, and history of falls. Michael is currently being cared for in his own home, with the support of community health care assistants. Michael lives with his wife (Mary) and receives 3 calls a day under the homecare package.

Michael uses a wheelchair, and a downstairs room has been modified to a bedroom. Michael requires assistances with personal care and is occasional incontinent of urine and requires incontinent wear. Michael also requires hip protectors due to his history of falls.

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Care Plan Structure / Headings for each report:

Please structure your three reports under the following Headings and fully address the key areas.

•    Activity /Task: State the named task to be completed.

•    Introduce the client you will assist, providing relevant background information (Medical problem, age, name, how long in care setting).

•    Preparation for task (In this section outline how you would prepare client, environment, materials, equipment and how you would obtain consent).

•    Determining Clients Level of Assistances (In this section outline how you would determine client’s level of assistance with this task, for example: asking client, liaising with nurse, reading care plan).

•    List the equipment / material you would need to complete this activity efficiently.

•    How would you ensure good Infection Control practice when completing this task (Such as: Hand Hygiene, PPE, Waste disposal, Linen Disposal, Surface clean, Equipment clean)?

•    What communication skills would you use when communicating with the client during the planning and execution of task? (key areas to be focusing on include verbal and non- verbal skills).

•    Outline the health and safety issues that would be involved in this task and show understanding for the rationale for interventions. (Areas to consider include, environment, manual handling, waste disposal, food hygiene, hazards, etc.)

•    Outline in detail how this task would be carried/executed from beginning to completion, to include rationale for interventions, demonstrating good client care. (In this section emphasise how you would promote good client care and safety. Addressing how you would maintain dignity, privacy and independence of client).

•    Outline how you would communicate with other team members. (reporting and recording on the task).

•    Reflection (In this section reflect on your learning and how this will assist you in practice).

Answers 

Report 1: Assisting Stroke patient Mary Jones with a Meal or Feeding Her a Meal

Activity / Task

The task under scrutiny involves assisting Mary Jones with her meal or, if necessary, feeding her.

Introduce the Client

Mary Jones, a 75-year-old woman, has been a resident of Lakeview Nursing Home for the past four years subsequent to experiencing a left-sided Cerebral Vascular Accident, commonly referred to as a stroke. This medical condition necessitates that she receives assistance in various daily living activities, inclusive of meals.

Preparation for Task

In anticipation of the mealtime, a meticulous consultation with Mary's comprehensive care plan would be imperative. Concurrently, a dialogue would be initiated with Mary to ascertain her meal preferences, whilst taking into account any dietary limitations she may have. Subsequently, sanitation measures would be enacted in the dining area, and it would be ascertained that all utensils are scrupulously clean (Lee, 2017). Explicit consent for assistance would be sought from Mary.

Determining Client's Level of Assistance

To gauge the requisite level of assistance, a multi-pronged approach would be employed. Firstly, direct communication with Mary would be conducted. Additionally, consultation with her nursing team and examination of her care plan would offer valuable insights. The Barthel index categorises her as requiring medium-level dependency (Mudge et al., 2017).

List of Equipment/Material

•    Adaptive utensils
•    Non-slip placemat
•    Clean plate and cup
•    Napkins

Infection Control Practice

Exemplary hand hygiene practices would be stringently adhered to both prior to and subsequent to the task. Utensils and dishes would undergo thorough cleaning and disinfection. Protective gloves would be donned in instances where direct contact with food is necessitated.

Communication Skills

A synergistic approach incorporating open-ended questioning and active listening would be utilised to discern Mary’s individual needs. Non-verbal cues, such as maintaining eye contact and nodding, would be judiciously employed to convey attentiveness and understanding.

Health and Safety Issues

Utmost care would be exercised to ensure that food is prepared and served in accordance with stringent hygienic standards, thereby mitigating the risk of foodborne illnesses. Furthermore, a clutter-free dining environment would be maintained to preclude any potential hazards, such as falls (Keller and Slaughter, 2016).

Task Execution

Upon the culmination of preparatory steps, Mary would be actively engaged in the process of meal selection. Upon preparation, the meal would be served, and I would position myself at eye level with Mary, thereby facilitating a more dignified and personal experience. While Mary would be encouraged to eat independently, assistance would be offered as necessitated, thereby striking a delicate balance between promoting independence and meeting nutritional requirements (Young et al., 2018).

Communication with Team Members

Pertinent details pertaining to Mary's meal intake and any associated challenges would be meticulously documented in her care plan. This invaluable information would be relayed to the nursing team during the handover session.

Reflection

The undertaking of this task has imparted upon me the pivotal importance of achieving an equilibrium between fostering client independence and ensuring nutritional adequacy. This invaluable insight will indubitably serve to inform and enhance my future practices in the provision of client care. This report endeavours to illustrate a comprehensive approach to assisting Mary Jones with mealtime, emphasising the promotion of her dignity, safety, and independence.

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Report 2: Assisting Stroke Patients Mary Jones with Personal Hygiene (Tub-Bath, Bed Bathing, or Showering)

Activity / Task

The task at hand entails the provision of assistance to Mary Jones in the domain of personal hygiene, specifically focusing on tub-bathing, bed bathing, or showering.

Introduce the Client

Mary Jones, a septuagenarian, has been a resident at Lakeview Nursing Home for a duration of four years subsequent to suffering a stroke. The aftermath of this medical event necessitates that she receive aid in personal hygiene.

Preparation for Task

Prior to the initiation of the bathing process, a meticulous examination of Mary's care plan will be conducted. This will be followed by a consultative discussion with Mary regarding her bathing preferences. The bathroom will be prepared in accordance with requisite safety and hygiene protocols. Unambiguous consent for the task will be obtained from Mary (Dong, 2017).

Determining Client's Level of Assistance

To ascertain Mary's level of required assistance, a multi-faceted approach will be adopted. Direct consultation with Mary will be supplemented by liaison with the nursing team and a thorough analysis of her care plan. According to the Barthel index, Mary falls under the category of medium dependency (Simorangkir and Sinaga, 2019).

List of Equipment/Material

•    Non-slip mat
•    Soap
•    Towels
•    Adaptive shower seat (if required)

Infection Control Practice

Stringent hand hygiene protocols will be adhered to throughout the task. Protective gloves and a disposable apron will be donned. Used towels will be meticulously segregated and disposed of in a designated linen bag (Lyddiatt et al., 2021).

Communication Skills

Verbal communication, characterised by clarity and precision, will be employed to ascertain Mary's comfort level and preferences (Warkentin et al., 2022). Furthermore, non-verbal cues such as maintaining eye contact will be utilised to reinforce a sense of attentiveness and reassurance.

Health and Safety Issues

To mitigate the risk of potential slips and falls, I shall ensure that the bathroom floor remains devoid of moisture and that non-slip mats are judiciously placed. The application of proper manual handling techniques will also be rigorously enforced.

Task Execution

The bathroom will be expeditiously prepared in line with established protocols. Mary will be safely escorted to the bath area, where she will receive assistance in bathing, whilst ensuring that her privacy and dignity remain uncompromised (Mlinac and Feng, 2016). She will be encouraged to engage in the process to the best of her ability, thus fostering a sense of independence.

Communication with Team Members

Upon the completion of the task, all pertinent observations and actions will be comprehensively documented in Mary's care plan. This information will subsequently be communicated to the nursing team during the course of regular handover sessions.

Reflection

The execution of this task underscores the criticality of maintaining an individual's dignity, particularly in intimate settings such as personal hygiene assistance. These experiences provide invaluable insights that will indubitably inform my approach in analogous future care scenarios. This report aims to provide a holistic approach to the task of assisting Mary Jones in personal hygiene matters, prioritising her safety, dignity, and autonomy.

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Report 3: Assisting Mary Jones to a Commode, with Toileting, or Emptying a Catheter Bag

Activity / Task

The focal activity of this report pertains to the provision of assistance to Mary Jones in utilising a commode, engaging in toileting activities, or the emptying of a catheter bag.

Introduce the Client

Mary Jones, a septuagenarian at 75 years of age, has been residing in the Lakeview Nursing Home for a span of four years, subsequent to a debilitating stroke. As a result, she necessitates assistance for toileting and other elimination needs.

Preparation for Task

Prior to undertaking the task, it is paramount to scrutinise Mary’s care plan to discern any specific requirements or preferences she may harbour. The toileting area shall be meticulously prepared, ensuring all requisite equipment is both readily accessible and sanitised. Informed consent shall be duly obtained from Mary (Hägglund et al., 2017).

Determining Client's Level of Assistance

To ascertain the level of assistance warranted, a consultative approach shall be adopted, encompassing discussions with Mary, review of her care plan, and liaison with the nursing team.

List of Equipment/Material

•    Commode or toilet seat adaptors
•    Disposable gloves
•    Sanitary wipes

Infection Control Practice

Hand hygiene protocols shall be rigorously adhered to both before and after the execution of the task. Disposable gloves shall be worn, and waste materials shall be consigned to a clinical waste bin. All surfaces and equipment shall be subjected to thorough cleaning and disinfection (Brown and Hatch, 2017).

Communication Skills

Clear and unambiguous language shall be employed, in conjunction with active listening skills, to comprehend Mary’s needs accurately. Non-verbal cues such as nodding shall serve to affirm understanding and attentiveness.

Health and Safety Issues

Proficient manual handling techniques shall be utilised to safely assist Mary to the commode. Moreover, waste disposal shall be executed with scrupulous care to mitigate the risk of contamination (Kamiya et al., 2023).

Task Execution

Initial preparation shall entail readying the toileting area and ensuring all equipment is sanitary and in working order. Subsequently, Mary shall be assisted to the commode or toilet. During this process, the utmost care shall be taken to safeguard her privacy and dignity.

Assistance shall be provided for toileting or the emptying of the catheter bag, followed by an exhaustive clean-up procedure (Gibson et al., 2021).

Communication with Team Members

Upon completion of the task, meticulous documentation shall be undertaken, encapsulating all salient details. This shall be duly incorporated into Mary’s care plan and communicated to the relevant team members.

Reflection

The undertaking of this task has been instrumental in elucidating the nuanced complexities involved in assisting with sensitive activities such as toileting. It serves to reinforce the imperative nature of maintaining the client's dignity and privacy, lessons which shall indubitably inform future professional practices.

The report aims to provide a comprehensive framework for the task, thereby ensuring that the needs of Mary Jones are met in a manner that venerates her dignity, safety, and independence.

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References

Brown, K.R. and Hatch, J., 2017. Strategies to Maintain Continence in Elders. Occupational Therapy with Elders-eBook: Strategies for the Occupational Therapy Assistant, 245.
Dong, X., 2017. Elder self-neglect: Research and practice. Clinical interventions in aging, pp.949-954.
Hägglund, D., Mooney, T. and Momats, E., 2017. Nursing staff´ s experiences of providing toilet assistance to elderly nursing home residents with urinary incontinence. Open Journal of Nursing, 7(2), pp.145-157.
Kamiya, M., Osawa, A., Shinoda, Y., Nishii, H. and Kondo, I., 2023. The current state of family caregiver burden and support of toilet problems for elderly with mild cognitive impairment and Alzheimer's disease. International Journal of Urology.
Keller, H. and Slaughter, S., 2016. Training programmes and mealtime assistance may improve eating performance for elderly long-term care residents with dementia. Evidence-Based Nursing, 19(1), pp.32-32.
Lee, K.H., 2017. An intervention study of self-feeding for the elderly in nursing homes. Journal of Korean Academy of Community Health Nursing, 28(4), pp.450-462.
Mlinac, M.E. and Feng, M.C., 2016. Assessment of activities of daily living, self-care, and independence. Archives of Clinical Neuropsychology, 31(6), pp.506-516.
Mudge, A.M., Banks, M.D., Barnett, A.G., Blackberry, I., Graves, N., Green, T., Harvey, G., Hubbard, R.E., Inouye, S.K., Kurrle, S. and Lim, K., 2017. CHERISH (collaboration for hospitalised elders reducing the impact of stays in hospital): protocol for a multi-site improvement program to reduce geriatric syndromes in older inpatients. BMC geriatrics, 17, pp.1-9.
Simorangkir, L. and Sinaga, E., 2019. Self-Care Agency Improves Personal Hygiene Of Elderly In A Nursing Home In Binjai [Self-Care Agency Meningkatkan Personal Hygiene Pada Lansia Di Panti Werda BinjaI]. Nursing Current: Jurnal Keperawatan, 7(1), pp.60-67.
Warkentin, N., Wilfling, D., Laag, S. and Goetz, K., 2022. Experiences of family caregivers regarding a community‐based care‐and case‐management intervention. A qualitative study. Health & Social Care in the Community, 30(1), pp.e204-e212.
Welch, V., Mathew, C.M., Babelmorad, P., Li, Y., Ghogomu, E.T., Borg, J., Conde, M., Kristjansson, E., Lyddiatt, A., Marcus, S. and Nickerson, J.W., 2021. Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map. Campbell systematic reviews, 17(3), p.e1175.
Young, A.M., Banks, M.D. and Mudge, A.M., 2018. Improving nutrition care and intake for older hospital patients through system-level dietary and mealtime interventions. Clinical nutrition ESPEN, 24, pp.140-147.