University of Arkansas System
Type of paper: Thesis/Dissertation Chapter
Promote person centred values
Person-centred is about providing care and support that is centred or focused on the individual and their needs. We are all individual and just because two people might have the same medical condition, for example, Dementia, it doesn’t mean that they require the same care and support. You will need to develop a clear understanding about the individuals you are working with. This includes their needs, their culture, their means of communication, their likes and dislikes, their family and other professionals’ involvement so you can promote and provide person centred care and support.
Individuality: Assumptions should never be made about an individual. They should never have to fit in with you or your employer. Individuals should be allowed and supported to make their own choices. Care and support needs should be tailored to suit each individual. This shows respect by preserving the individual’s dignity and individuality. Their personal beliefs should be respected. Independence: Allow the individuals you support to do things for themselves, however small. Being independent does not necessarily mean being completely alone, but being supported to do things for themselves. Take time to enable the individuals you support to be independent. Independence makes people feel in control of their lives and gives them a sense of self-worth. Privacy: You will need to understand each individual’s need for privacy and support this in the way you work.
The availability of private space will be different in residential care home and home care environments. Irrespective of which environment, you should always ask permission before entering an individual’s room. Always knock on their door. Close doors when performing personal hygiene but first check the individual is happy with you doing so. Every individual should have time and spaces to do things in private if they should wish to, for example, meeting friends and family or making phone calls. Partnership: Working in partnership with other professionals, with colleagues, families and carers is an essential part of providing care and support. Person-centred care and support is about a whole range of people working together to improve the lives of individuals.
Partnership is all about the individual you are supporting and all of the partners involved will need good communication, sharing appropriate information, putting the individual’s best interests at the centre of everything that everyone does. Choice: Each individual you are supporting should be allowed and supported to make choices. They should be given thorough information in order to make informed choices themselves. Never take over because you can do things faster or because you think something should be done a particular way. Always involve the individual in decisions about their care and support. Sometimes individuals can be overwhelmed with choice, for example, individuals suffering from Dementia, may respond better if you give them two simple choices but this is much better than giving no choice at all. Must be able to communicate and listen well.
Dignity: Dignity is what we feel when we are respected and it is what makes us feel important in society and in our lives. Whether individuals are eating, sleeping, washing, shopping or dying, care and support workers must help them to feel dignified. Be aware of the importance of preserving an individual’s dignity, ask them how they wish to be addressed; try not to rush them and take time to listen; use towels or clothing to cover them up when performing intimate care tasks. It is important not to stereotype or make guesses about individuals and their needs. Respect: Is showing an individual respect, you will support them in what they believe is important, whatever their age, culture, disability, gender, belief or sexual orientation. When working with other people or professionals, never ignore the individuals you are supporting.
Always include them in the conversation, irrespective of the subject? Rights: Individuals you care for and support should continue to have the same rights as when they were living independently. Each individual you support has the right to say no, the right to have a relationship, the right to have a say about how they are supported. They have a right to choose what they eat and when, how they dress and when. They have the right to choose their friends and what they want to do with their time. You may have to make changes to take an individual’s rights into account. You may have to balance an individual’s rights against your responsibilities and consider if either they or you are at risk? If you are concerned or unsure, check with your supervisor or manager. Choice and Control – Enabling people to make choices about the way they live and the care they receive. Communication – Speaking to people respectfully and listening to what they have to say; ensuring clear dialogue between workers and services.
Eating and Nutritional Care – Providing a choice of nutritious, appetising meals, that meet the needs and choices of individuals, and support with eating where needed. Pain Management – Ensuring that people living with pain have the right help and medication to reduce suffering and improve their quality of life. Personal Hygiene – Enabling people to maintain their usual standards of personal hygiene. Practical Assistance – Enabling people to maintain their independence by providing ‘that little bit of help’. Privacy – Respecting people’s personal space, privacy in personal care and confidentiality of personal information. Social Inclusion – Supporting people to keep in contact with family and friends, and to participate in social activities.
Working in a person centred way
Person-centred approaches are about the individual being the centre of their care and support plan enabling them to have control over their lives. Person-centred approaches are about enabling individuals to live their own lives and not just providing a service. It is about focusing on the individual person’s needs and not the tasks that need completing. Person-centred planning is a way for individuals to plan for what they want now and in the future, together with the people in their lives who they like and trust. It is based on the following values: Everyone has a right to plan their own lives and be at the centre of any planning that is done for them. Be part of their community, live their lives as they want, and if they need support to do this for this support to be provided in a way in which they want it. The person is at the centre. Family members and friends are partners.
Reflects what is important to the person and their capacities. Specifies the support the person needs to make a valued contribution to their community. Builds a shared commitment. Leads to continual listening and learning about what the person wants to get from their life. You should always reflect on and celebrate the diversity of the people you are supporting. There are many reasons why individuals think and act the way they do and only by building up comprehensive knowledge about these important things can you help them to fulfil their wishes and needs. You can find out about an individual’s history, preferences, wishes and needs by looking at their Individual Needs Assessment. This will look at a variety of different things depending on the individual being assessed, for example, physical, emotional, social, spiritual, communication, support or care needs. The individual will need to be able to trust the person conducting the Individual Needs. Assessment and encouraged to use their strengths to feel confident that the process will lead to positive outcomes for them.
Establish Consent when providing care or support
A care or support plan sets out what care or support an individual needs. The Individual Needs Assessment will enable the required care and support to be determined. The care plan will contain lots of information, for example, medical history, family contacts, risk assessments. It is usually written by someone who has specifically been trained to do this. Your role is to make sure you read and work to the requirements of the care or support plan, to record any changes and to report significant changes. You will need to understand the boundaries of your responsibilities regarding the individuals you support. Just like your needs and desires change, so will those of the individuals you support. Changes could be from a whole range of aspects of the individual’s life. It is important to recognise that as needs change, how support is provided will also need to be reviewed regularly to see if any changes or adjustments are required.
You have a responsibility to listen to individuals, to hear what they are saying, to write down any information about change in the care or support plan and contact your supervisor or manager if this is likely to have an impact on the level or type of care and support that is provided. Supporting an individual to plan for their future well-being may include the following, their: Sense of hope , Confidence , Self- esteem , Ability to communicate their needs , Ability to make contact with other people , Ability to show warmth and affection , Experience and showing of pleasure and enjoyment. Fulfilment is about feeling satisfied, pleased, content, a sense of achievement and success. Supporting active participation
Providing individuals with empowerment is important. Empowerment is about enabling the individuals you support to contribute and have an influence over the issues which affect the way they live. When individuals make choices, they have more control and feel valued. Providing individuals with empowerment to make informed choices enables individuals to maintain their rights of choice, equality and opportunity. Active Participation is a way of working that recognises an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than just a recipient. Being part of a community is particularly important to individuals who live on their own and do not work. It means they have relationships and make friendships with other people giving them a more fulfilling life.
It doesn’t matter what kind of contribution they make or the type of activities they are involved in, just being part of something will give them a sense of belonging, a feeling of self-worth and independence. Your role as a care or support worker is to help individuals to make informed choices about things that happen every day and also in planning for the longer term. Each time you work with an individual you should be able to give them choices. Individuals’ choices will be different depending on the types of tasks you are doing together and their abilities. Good communication is essential so that you can give choices and individuals can make them. It doesn’t matter what environment you support an individual in, there should always be plenty of opportunity to provide choices.
Here are some examples: When would they like to get up? What would they like to wear? What would they like to eat and drink? What brands would they like to use, for example, shampoo, toothpaste, moisturiser? What activities would they like to take part in? You can support individuals to make choices by giving them encouragement and giving praise when they have made a choice. This will give them the confidence to continue to make choices about other aspects of their lives. If an individual identifies a particular hobby or activity they wish to participate in, it might be worth checking if there are local groups or facilities that would be prepared to support the individual to participate. Supporting an individual’s rights to make choices
In order to enable an individual to make an informed choice, both you and the individual first need to think about what all of the available options are. You then need to look at what are good and bad about each option. Health and safety are important factors and must be put first for you, the individual and anyone else involved. The Mental Capacity Act provides the legal framework for capacity and decision making about health and social care and financial decisions. It applies to everyone aged over 16. You will need to consider whether the person you are supporting has capacity to make informed decisions or whether you need a formal mental capacity review. It is important to note that a person is assumed to have capacity unless it is proved otherwise. There is a four-step way to test for capacity: A person must be able to:
1. Understand the information relevant to a decision
2. Retain the information
3. Use the information as part of the decision making process
4. Communicate their decision
In supporting a person to make a decision, you have a duty to assist the person in all four of these steps. For example, using appropriate communication methods to help the person to understand and communicate. Capacity is assessed specific to each decision and each occasion. For example, a person may have capacity to make a decision in the morning about what to wear, but not later that day in deciding if they want to move home. If someone is assessed as lacking capacity, any decision taken on their behalf must be in their best interests and you must consider if there are less restrictive options. For example, if a decision can be delayed until a person is less distressed, this is the best course of action.
However, if a person does have capacity this over-rides what you may consider as an unwise decision. Each individual should have a formal risk assessment as part of their care and support plan. The risk assessment should contain information about the individual and the type of care and support they need. It will provide the most appropriate options for keeping the individual and anyone else involved as safe as possible. It will also tell you how to do some tasks where these tasks have been risk assessed and the best option has been established.
A particular way of moving and handling is recommended for Mr X because he has health issues that mean he or she can only be moved in a particular way. Mr X doesn’t like being moved this way and asks to be moved another way. You should always follow the risk assessment. You should report Mr X’s request to your supervisor / manager. You should always record any changes in Mr X’s wishes and in the way you perform tasks. Every effort should be made to support Mr X to be moved in the way he wants to be moved. He has the right to make this choice but an appropriately trained person will need to review the risk assessment first and work out if it is safe for all involved for Mr X to be moved in the way he wishes. You might not approve of or like the choice he has made. You might need more moving and handling training, perhaps for a specialist piece of equipment.
However, the choice is not yours and you are not allowed to influence Mr X. In supporting Mr X to make his decision, you need to listen to him and put his wishes and best interests first. He is the customer and you are providing a service. This means the service must be provided in the way Mr X would like, as long as it is safe and approved through care and support plans and risk assessments. This is because the choices belong to Mr X, not to you. He needs to make his own decisions in order to feel he is in control of what happens to him. This leads to positive feelings around dignity, pride and satisfaction. When an individual has made a decision which you feel is risky, you need to make the individual aware of any consequences involved in the decision; however you should not try to influence the individual with your views and opinions.
It is the individual’s freedom of choice to make decisions about their own future and support. Providing they have the right information (including the advantages and disadvantages) to make an informed choice and have the capacity to understand their choice; it is part of your duty of care to enable them to do so. If a relative or friend has made a decision about an individual’s care, support or life that the individual is not happy or comfortable with, you may need to support the individual to question or challenge the decision. It is important that you obtain and understand the facts and reasons surrounding the decision so you can make sure the individual has a clear understanding.
If the individual remains sure that he / she is not happy with the decision, once he / she has this information, you can work with the individual to support them to challenge the decision. Any changes that are made as a result of this challenge must be safe for you, the individual and anyone else involved. You should never make changes unless you are trained to do so or your supervisor or manager confirms you can make the change. You should always record any changes in individual’s wishes and in the way you perform tasks.
Promoting spiritual and emotional well-being
Spiritual well-being is an integral part of mental, emotional and physical health. It can be associated with a specific religion but does not have to be. It is about an individual’s own journey to discover things of importance in their lives and enabling them to find purpose and meaning in life. The effects and impact of spiritual well-being is determined by each individual and can make a huge impact in their lives. Through spiritual well-being, individuals can become empowered and realize that even though they have issues, stressors, and challenges, they are not defined by their circumstances. A few of the numerous benefits of spiritual well-being include:
•Feeling content with your life’s situation
•Making time to spend alone and find inner peace
•Taking time to reflect and resolve life’s issues
•Finding satisfaction in a job well done
•Taking part in an active lifestyle rather than merely standing by and watching life as it passes
•Maintaining balance and control of life
•Feeling purpose and meaning in life
•Accepting and growing from the challenges of life
Emotional well-being is based on how individuals feel about themselves.
Someone who is emotionally healthy:
•Understands and adapts to change
•Copes with stress
•Has a positive outlook on life and themselves
•Has the ability to love and care for others
•Can act independently to meet his or her own needs
Everyone, including people who are emotionally healthy, have problems. If something or someone threatens our happiness or wellbeing, we would feel uncomfortable emotions such as anger, sadness or fear. When we experience something that enhances our situation, we feel emotions such as joy, satisfaction or a sense of achievement. The way we’re brought up and our culture have a great influence on how we feel. They help us to form ideas and decide what we care about. Everyone deals with situations in life differently. Sometimes an individual’s self-esteem can become so low that everything seems a lot harder to cope with compared with when they are feeling confident. Being emotionally healthy doesn’t mean that you feel happy all the time.
That is impossible. Good emotional health is about having lots of different emotions, and being able to accept them and talk about them. Signs that individuals are not coping well emotionally might include having a lack of self-confidence, having trouble with relationships or feeling unhappy a lot of the time. Because we are all so different and diverse, we have different and diverse views about every subject. You may not approve of or agree with the views of the individuals you support but your role is about working with them in ways that support their views. The best way to find out about an individual is to ask questions that are not threatening but show you have a genuine interest in the individual. By encouraging them to talk about themselves and listening to their views, you will learn a great deal about the individuals you work with. Through this learning, you will be able to meet their needs in ways that are sensitive and supportive of their views making individuals feel valued. •Appreciated, cared about and loved
•Safe and secure
•Extra supported when they feel sad, depressed or lonely
•That they are not a burden but an important priority
•Listened to and respected
•Satisfied with relationships
•Independent and in control of their lives
•That they have a purpose and meaning to their lives
You will need good communication skills and be able to listen but also to encourage individuals and show understanding and support for what is important to them in life. Each individual’s spirituality is greatly impacted by the community they are a part of and the relationships they take part in. Individuals may be able to find spiritual well-being programs in their local area. By promoting an individual’s spiritual and emotional wellbeing, you can help improve their self -esteem and make them feel valued and remain their own person. Focussing on what they can do rather than on what they can’t do, will encourage their independence and feeling of self -worth. It is also important to help individuals to deal with stress. Changes in situations and in their ability to do things can cause stress. However, by providing encouragement and positive support you can improve their inner self and quality of life.