Reflection on Experience with an Individual with Dementia

Reflection on Experience with an Individual with Dementia

1. Introduction

Graham Gibbs’s (1988) reflective framework is a cycle that helps one reflect from past events or situations with five significant steps. The first step entails describing a situation in detail, including place and time and the surrounding persons. A reflection of feelings then follows it at the time of the case. Thirdly, it is about an evaluation of approaches that worked to solve the situation followed by the conclusion stage on what alternative should have been adopted. The final step is the action where one thinks about the future and how to make better decisions should it arise again. In this discussion, I will be adopting Gibbs’s framework to reflect on an experience with a dementia patient.

1. Description of the Event

My most vivid dementia experience was at a hospital’s reception. I had finished my shift and decided to pass by to say my goodbyes to a colleague working at the reception. I found her serving a mid-20s aged man taking demographic information of the older man he had brought to the hospital. The older man started shouting, demanding that he wanted his cat fed right away. The young man walked to the older adult who was his father and tried calming him down. With the hospital receptionist, we, first of all, stared at the two as the son tried to explain that they were in the hospital. Only one more patient was waiting in the reception, and she was confused. I walked to the father and son. I asked him for the name of the cat. He shared the information and assured him the cat was being fed. He remained relaxed even as the fellow nurses pushed his wheelchair to the observation room.

1. Feelings

The moment I realized he had dementia, and he was shouting, I felt empathy. His son was confused, and he appeared fatigued. I felt sorry for him for the responsibility he had to carry. It was, however, satisfying that despite dementia, at least he had the memory of his son. He was warm towards him. At that time, I remembered that my parents were aging, and I imagined my father developing dementia. From that, I could somehow relate to the mental struggle that the son was experiencing. As he was pushed to the observation, I developed a curiosity. I wanted to know how long he would be relaxed before the condition arose again. On my way home, I felt some satisfaction that I had contributed to helping him unwind. After reflection of all, I still empathize with both the father and his son. I believe that empathyassists in being passionate when rendering health care services..

1. Evaluation

The most detrimental thing about the situation is that I directly went to the ailing father before seeking consent or introducing myself to the son who was in charge. Though he was not offended and was grateful for it, his approval should have been requested. It was satisfying that informing the father the cat was being fed calmed him down. From the look of the receptionist and the son, it was apparent that talking to him about things that were bothering him was the right thing to do. It was about listening and observing his behavior and responding to them positively. Through the experience, while it may become monotonous to keep reminding the dementia patients about the dates and locations, we should have mentioned it this one time. It is possible that the son and the nurses who took over reminded him, but I felt it was our responsibility.

1. Analysis & Critical Appraisal

When the older man was shouting, de was under a delusion that he was at home. Additionally, restlessness and verbal aggression demonstrated his agitation. According to Galik (2016), preventing agitation amongst dementia patients includes using gentle reminders, changing the patients, expectations, removing the danger, triggers or stressors, and offering privacy or security. One could be appreciative that I only used gentle reminder as a way of minimizing his agitation. If the gentleness had not worked, then I would have interacted with the son to understand non-medications approaches that they had used in the past to control his agitation. I needed to remember that non-medication approaches to handling patients with dementia patients are highly recommended, as discussed by Osterholm&Hyden (2016). In episodes of agitation, one is expected to back off and ask permission, use affirmative and calm statements, focus on pleasant events, and limit stimulation or simple exercise options (Galik, 2016).

1. Conclusion

From the experience, the biggest lesson I took him is the power of empathy and learning how to communicate. For a nurse, interpersonal skills are fundamental. One has to know how to approach patients and other people who are all dynamic. There is a possibility that shouting at the patient would have made him stop talking. Such behavior would, however, be aggressive, and though the patient may be silent, his next incident of agitation would have been more severe. Asking thoughtful questions such as “May I help you?” and using words such as “I apologize” or “You are safe here” is very important. Through the process of controlling, agitation arising from dementia patients, a health care provider should not take offense, raise their voice criticize the patient. If I was to go back to the situation, these are some of the things I would communicate with the son.

1. Action Plan

At the hospital and in other settings such as our homes, schools, and churches, dementia symptoms are likely to be observed. As a nurse, I am already educated on the ways one can handle the situation and ensure that the patient’s condition is manageable. But for the young man who brought his father to the hospital, he lacked training, and his approach to calming his father was not working. Dementia overwhelms families of the affected, including their caregivers, who might not necessarily be as trained (Sun et al., 2017). Financial, emotional, and physical pressures can cause stress for them. As a qualified caregiver, it was my responsibility to take a few minutes to educate the son on possible ways to interact with his father, especially when he expressed agitation during dementia episodes. I should also have informed the receptionist on how to deal with the situation should it ever arise again. In the future, my goal will be to educate or inform the people around how to deal with such situations.

References

Galik, E. (2016). Treatment of Dementia: Non-pharmacological Approaches. Dementia Care, 97-112. https://doi.org/10.1007/978-3-319-18377-0_7

Gibbs, G. (1088). Learning by Doing: A Guide to Teaching and Learning Methods (1st ed.). Further Education Unit, Oxford University.

Older People with Dementia: The Development of Community Care. (2016). Supporting People with Dementia at Home, 1-11. https://doi.org/10.4324/9781315611358-1

Osterholm, J. H., &Hyden, M. J. (2016). Citizenship as practice: Handling communication problems in encounters between persons with dementia and social workers. Dementia, 15(6), 1457-1473. https://doi.org/10.1177/1471301214563959

Sun, F., Gao, X., Brown, H., &Winfree, L. T. (2017). Police officer competence in handling Alzheimer’s cases: The roles of AD knowledge, beliefs, and exposure. Dementia, 18(2), 674-684. https://doi.org/10.1177/1471301216688605

Williams, K., Woolliams, M., & Spiro, J. (2012). Using a framework for reflection: Gibbs’ reflective cycle. Reflective Writing, 90-102. https://doi.org/10.1007/978-0-230-37724-0_16