Capstone Experience in Healthcare

This article discusses the capstone experience in healthcare, focusing on the management and treatment of dementia in aged care homes. It explores the goals of a capstone project, the prevalence of dementia in Australia, and the challenges in managing the condition. The article also highlights the importance of nursing self-assessment and its role in improving patient care. Overall, it provides valuable insights into the field of healthcare and the role of nurses in addressing critical health issues.

Running head: CAPSTONE EXPERIENCE IN HEALTHCARE 1
Capstone Experience in Healthcare
Student’s Name
Institution

CAPSTONE EXPERIENCE IN HEALTHCARE 2
Capstone Experience in Healthcare
Introduction
Like in most graduate school programs that require the fulfillment of a thesis, a capstone
project is a similar program used in the competition of undergraduate and graduate course
degrees. This projects are however quite different from theses when the goals and aims of the
program are considered. Hence, a capstone project allows a student the opportunity to use
learned materials and apply them in a specific area of practice. The capstone experience will in
such a case entail identification of a particular issue or problem in the real world and then
utilizing or applying the learned skills to develop the solution that will directly resolve the
problem at hand. Thus main goals of a capstone experience will entail define a problem or
opportunity, decide on the techniques to be used, make a positive influence on the community
and base the findings on specific area of interest.
Alternatively, capstone projects aim to enable a student take advantage of the learned
knowledge and theory and utilize such information in a real world setting. Nursing students are
for instance given the opportunity to be involved in public health practice projects and further
synthesize, integrate and apply the skills and competencies acquired during their course work.
By focusing on a specific issue, students are expected to describe the problem using an evidence
or fact-based approach taking into account various contributions by other scholars. Hence, the
completion of a capstone project experience requires the student to base their findings on their
field experiences.
In my case, the capstone experience project revolved around the prevalence of dementia
and ways through which medical practitioners can manage or treat the condition. Notably,

CAPSTONE EXPERIENCE IN HEALTHCARE 3
dementia is not a specific disease but rather, it is a degenerative and irreversible condition that
mostly affects the elderly populations (Cations, Radisic, Crotty & Laver, 2018). The current and
widely used management practices involve provision of support to patients with dementia and
their caregivers. In Australia, care is mostly provided in residential aged cares with hygienic
routines, timely sleep and waking time, and engagement in physical activities being the primary
management practices in these care facilities (Dementia Australia, 2019). Caregivers in this case
follow a strict formula of impact, progress and treatment for every patient.
The aims of the capstone experience project is to determine the prevalence of dementia in
Australia and unfold the methods and techniques through which care and treatment are provided
for patients diagnosed with dementia and are living in age care homes (WHO, 2019). Ideally, it
can be noted that based on the capstone experience project operational and managed care plan
for dementia patients in aged care units lies on seven key areas including; communication,
spiritual and emotional wellbeing, social interaction and lifestyle management, personal care,
cultural and behavioral needs, and the environment.
Another aim of the capstone experience project is to identify the prevalence, causes and
challenges in managing dementia. Notably, this information will aid in the justification of
dementia as a concerning health issue in Australia. The data will similarly aid in identifying the
patient populations that are most affected and pinpointing the pitfalls associated with currently
used treatment and management practices (Gaskin, Georgiou, Barton & Westbrook,
2012)Finally, this capstone experience project aims to reflect and analyze the applicability of the
identified treatment and management plan.
Outline and the content of the body of the essay

CAPSTONE EXPERIENCE IN HEALTHCARE 4
The capstone experience project contains a specific outline which can be described as
follows. The project experience will first justify the choice of the capstone experience project by
highlighting the prevalence of dementia in Australia. Justification will also be based on the
health, psychological and cost impacts that dementia has on the patients and other key
stakeholders such as the national government and patients’ relatives and friends. Ideally, this
justification process will help in bringing to light why dementia is one of the main healthcare
concerns and further illustrate how nurses have a critical role to play in management of this
condition (ABS, 2016).
The essay will then focus on self-assessment and evaluation. In this section, details
concerning the student’s assessment will be discussed in the process detailing journalizing and
itemization of guidelines as the main tools used in the assessment process. Such information will
further be aided by a rationale why self-assessment is important in nursing profession (Lima,
Newall, Kinney, Jordan & Hamilton, 2014). Also, the section will entail the main goals that
were set by the student in an attempt to fulfill the requirements of the capstone experience
project. Ideally, the main goals will encompass the identification of an evidence-based nursing
care for treatment and management of dementia cases among the elderly in residential care
homes (Arendts, Dickson, Howard & Quine, 2010).
The following section will comprise a critical reflection and analysis of the capstone
experience project. In this part, the essay will cover the experiences of the student in applying the
evidence-based nursing approach in the management of dementia in residential aged care. A
critical reflection framework will specifically be used to provide a vivid narration of the

CAPSTONE EXPERIENCE IN HEALTHCARE 5
experiences that the student had in their area of practice. As such, this critical reflection section
will be focused on the total experience of the nursing issue. The discussed stages will include;
description, feelings, evaluation, analysis, conclusion and an action plan.
The fourth section of this essay will be based on the professional portfolio of the student.
The content of the professional portfolio will include; personal details, educational
qualifications, professional membership, personal goal, work experience, key personal strengths,
and a description of the students current position.
Finally, this project will conclude by detailing a summary of all the findings in this
capstone experience project. Ideally, this information will include; aims of the project,
identification and justification of the issue, the devised action plan and a description of the same,
and a reflection and outcomes of the capstone experience project.
Justification for choice of capstone experience project
More than 50 million people are currently diagnosed with dementia. In Australia, the
prevalence of this condition has been alarming and since the condition lacks any desirable
treatments or cure, dementia has resulted in thousands of deaths over the past few years. The
latest evidence reveals that dementia related cases have been on the rise with data revealing that
more than 400,000 Australians are diagnosed with dementia as of 2018 (Dementia Australia,
2019). Most of the affected individuals are the elderly who are aged 65 years and above. 40% of
these cases are attributed to people who are aged above 85 years. This population group is also
the most vulnerable to other health conditions such as increased risk of falls and other disabilities
(ABS, 2016). It is further expected that without timely and effective management of this
condition, it is highly likely that dementia prevalence will continue to increase in the near future.

CAPSTONE EXPERIENCE IN HEALTHCARE 6
Dementia poises advance health, social and cost implications to affected individuals and
their families. At the onset of this condition, dementia is associated with other health conditions
such as diabetes, cardiovascular diseases, stroke and ultimately death. The best that medical
practitioners can do to manage the condition comprises delay in its progression. Dementia
patients and their caregivers have also been dealt with hefty costs of medications coupled with
adverse psychological effects as dementia progresses towards its latter stages (Hunter & Doyle,
2014). The costs have also been borne by the federal government with latest evidence indicating
that the government of Australia spent more than $15 billion in managing this condition by the
end of 2018. Such costs have been disseminated through programs such as Dementia Initiative
but changes in government policy and priorities have either terminated such initiatives or
provided lesser funds to finance the entire management process inclusive of education and
training of caregivers and treatment options (AIHW, 2016).
Families and carers also suffer a great deal of emotional burden when providing care to
patients of dementia. It can be emotionally overwhelming to experience the health of a loved one
deteriorates especially when this condition reaches its latter stages. Financial pressure further
contributes to stress thereby warranting the need for support (Fazio, Pace, Maslow, Zimmerman
& Kallmyer, 2018). Thus, in light of the aforementioned challenges not only to the families and
carers, but also towards the state of a nation, dementia becomes a great public health concern that
must be tackled. Even so, evidence indicates that delaying dementia by at least two years can
have significant psychological and financial effects (Wells & Smith, 2017). In this light,
residential care for the aged populations has been touted as the most and one of the primary
settings to offer care and service to the aged people diagnosed with dementia (Parker & Clifton,
2014).

CAPSTONE EXPERIENCE IN HEALTHCARE 7
It is worthy to note that such services provided under home care facilities should be
tailored in accordance with the available evidence-based practices. This comes after research
indicated that many of the dementia patients who are under this provision of care have been
denied their human rights in the latter stages of their lives (Westbury, Beld, Jackson &Peterson,
2010). Precisely, physical and chemical restraints were used extensively in care homes for the
elderly. Hence, the environment in which dementia patients are located needs to be suitable to
manage the behavioral and social expectations of these patient populations.
Another notable issue arises from stigmatization. Ideally, many individuals diagnosed
with dementia tend to be socially isolated given that overtime and with the progression of the
condition, such patients find it difficult to integrate into the society. Many of the society
members find it difficult to relate with these patients since they lack sufficient knowledge to
understand how dementia patients can be handled or managed (Parker & Clifton, 2014). In the
end, such situations and environments further exacerbates the condition thereby increasing the
likelihood of dementia progression and the inevitable deaths of these population groups. In
consideration of such findings and in accordance with the capstone experience project,
communication, spiritual and emotional well-being, and environment are the most notable
aspects that would help in addressing such challenges (Leydecker, 2017).
Many patient groups diagnosed with dementia and the society alike has been led to
believe that dementia is a normal part of aging. As evidenced with the behavioral tendencies of
many patients, dementia patients may become delusional and spend long periods in denial (Wells
& Smith, 2017). In such situations, these patients refuse to accept that have developed dementia
and subsequently disassociate themselves with treatment plans. Thus it becomes difficult to

CAPSTONE EXPERIENCE IN HEALTHCARE 8
provide care for such patient groups and personal care in conjunction with behavioral
environment would aid caregivers in managing this group of patients.
In light of the above detailed evidence, this capstone experience project proposes an
evidence-based approach to nursing care for patients with dementia. It will therefore, focus on
the importance of importance of communication in residential aged care, spiritual and emotional
wellbeing of patients, social interaction and lifestyle changes, personal care and healthcare, and
physiological health.
Self-Assessment Statement
Nurses’ clinical competence is critical in their field or profession primarily because they
are the first line of service to their patients. This implies that they should at all times ensure that
patients are provided with quality care and that patient safety is maintained (Haugen & Musser,
2012). Moreover, the healthcare industry is undergoing rapid changes with changes in patient
needs and increased demand for cost effective healthcare (Finnbakk, Wangensteen, Skovadhl
& Fagerstrom, 2015). With such events on the rise, nurses must strive to assess themselves in
order to ensure that they provide the best services in accordance with available evidence-based
practices. Also, in all care settings, nurses have been given an important role to improve patient
safety and realize high quality care (Lima et al, 2014).
Given the continuous shortages in nursing workforce, self-assessments for nurses
becomes pivotal in alleviating job satisfaction and increasing the willingness to stay within this
profession. When nurses are subjected to self-assessments, they are provided with the platform to
identify key areas of improvements and they are also able to understand the areas of practice in
which they are good at (Jane Brooke, 2013). Such opportunities enhances the nurses’ ability to

CAPSTONE EXPERIENCE IN HEALTHCARE 9
provide the most suitable mix of nursing competence tailored towards the satisfaction of both the
nurse and the patient as well.
Another relevance that can be drawn from nursing self-assessments is that such a tool can
facilitate clinical competence of nurses. In their area of practice, constant monitoring and
supervision have become the norm for nursing environments. Historically, such authority has
been used as a tool to enhance nursing competence. However, nurses need to take another step
by being cognizant of whether their competence levels coincides or meets with required set of
standards (O’Connell, Ostaszkiewicz & Hawkins, 2011). In this light, self-assessments will
enable nurses to track their individual competence levels and be able to gauge whether such
levels meets the stipulated standards of healthcare services.
The elderly or rather older populations have acute and complex needs which will require
advanced competence from nurses in regards to provision of nursing care and administration
medical treatments (Hunter & Doyle, 2014). Therefore, this tool of self-assessment will prove to
be crucial in enabling me to keep track of my competence levels and be able to meet the diverse
demands of the elderly who are primarily the patient populations that I am in service to.
My self-assessment tool comprised of a well-developed checklist that I went through on a
daily basis. Since I was the one who solely developed the checklist I had to rely on complete
honesty and integrity in developing and answering the questions. I developed five key self-
assessments items in the checklist and which would guide me in tracking my competence levels.
For one, I had to ensure that I accurately completely nursing assessments on a timely basis. I also
had to report any changes in the condition of the patient to physician whenever they came about.
Checking on patients on an hourly basis was also made a priority. I had to assess cases of pain or

CAPSTONE EXPERIENCE IN HEALTHCARE 10
progression of pain especially after medications and report the same accordingly (Finnbakk et al,
2015). Finally, I strove to incorporate the best practice in service provision in accordance with
the available literature. This item would also entail making any relevant contribution to my field
of practice which in this case was provision of care to the dementia patients.
This self-evaluation proved to be a critical process in my area or practice. It required
demonstration of self-awareness and demonstration of high level of efficiency as a nurse. To
eliminate any chances of bias, I had to engage my supervisor every once in a while to go through
my checklist and further provide insights in areas where he felt some aspects were not
sufficiently addressed. I also perceived this step to be pivotal in giving my supervisor new
insights regarding my job satisfaction, areas of successes and the future goals that I had set for
myself (Vertino, 2014).
The final step that I took in completing this assessment was journalizing the findings
from the items on the checklist. I devised a weekly journal to denote whether the items
mentioned above were thoroughly addressed and met in accordance with provision of care for
patients diagnosed with dementia. It is worthy to note that the journal also comprised the initial
identified five objectives that govern provision of care for dementia patients under residential
care.
Additionally, it was worthwhile to incorporate some technical aspects of evaluation when
journalizing the findings from the five items. For one, it was of utmost importance to manage the
journal as a professional file. This meant that every detail that was denoted in this journal had to
be well-written. Grammar and spelling checks in addition to comprehensive proofreading were
done on a continual basis. The aim here was to catch missed mistakes and pay attention to detail.

CAPSTONE EXPERIENCE IN HEALTHCARE 11
These techniques would also ensure that the information in this journal were honest and could be
used by another professional evaluator (Lima et al., 2014).
Even though a journal is not a mandatory requirement in self-evaluation or assessment, I
have come to appreciate the calming effect that a journal has on me as a medical professional.
Nursing in particular can at times be stressful characterized by emotional highs and lows (ACU,
2017). For instance, when dealing with dementia patients who are irritable and aggressive, I
became subjected to high emotional levels and likewise, I was hit with an emotional low
especially when realizing the health deterioration of some of the patients. It was extremely
emotional to provide care to patients with the degenerative condition especially in cases where
most of them experienced complete loss of memory. In such cases, I often resorted to
journalizing my experiences in a bid to get these emotions out of my head. The medical journal,
therefore, became my coping strategy during emotional times. In one occasion, the journal
enabled me to deal with the heaviness of losing one of the patients who I had grown so fond of.
On the bright side, the journal also acted as a guide on my performance since I could be
able to document my progress and evaluate whether I met the standards that was required of me.
After journalizing weekly events, I could then reflect on my abilities and in this process identify
areas of weakness and areas of success (Reymond, Israel & Charles, 2011). For instance, I
realized that from my itemized practices, my supervisor had denoted that I failed to check up on
a patient at the required interval. This note was reminiscent of the time that the physician had
berated my ignorance to the situation. Sincerely, this was not one of my proudest moments but I
sure did manage to react on this situation and changed for the better.
A Critical Reflection and Analysis of the Capstone Experience

CAPSTONE EXPERIENCE IN HEALTHCARE 12
For purposes of conducting a critical reflection and analysis of the capstone experience,
background information regarding dementia is in order. Since dementia is not a specific disease,
it can be classified as collective set of symptoms for cognitive decline. Dementia affects the
brain functioning by impacting on an individual’s ability to reason, think, remember,
communicate and undertake regular physical activities (Cunningham, McGuiness, Herron &
Passmore, 2015). The common symptoms of dementia therefore, include; memory loss,
personality and mood changes, difficulty in performing familiar tasks, problems with language,
poor judgment and, disorientation of place and time.
Dementia progresses in several different stages. The first stage of dementia is mild
cognitive impairment. This stage is characterized by forgetfulness. This stage may occur in many
of the old aged people and in such cases, it tends to fade away as some people regain their ability
to remember. However, if general forgetfulness continues or prevails for a considerable amount
of time, then it can be taken to be the first stage of dementia. The stage is mild dementia. At this
stage, the affected individuals will experience cognitive impairments that affect their daily life.
Some of the symptoms that can be realized in this stage are memory loss, changes in personality,
confusion, and difficulty in carrying out tasks.
Moderate dementia is the third stage and the affected individual finds it very challenging
to carry on with their daily lives. In such a case, the dementia patient cannot carry out simple
activities like combing their hair and getting dressed. Their personality also changes significantly
and the dementia patient becomes suspicious or agitated with no definite reason. The final and
fourth stage is severe dementia. All the symptoms of dementia worsen considerably and the
diagnosed patient cannot be able to sustain themselves in the absence full-time care. The
situation is worsened since the patient of dementia is unable to control their body functions. In

CAPSTONE EXPERIENCE IN HEALTHCARE 13
such cases, they find it difficult to sit, hold their heads up and they cannot control their bladder.
The late stage of dementia results in coma and eventually, death.
Alzheimer’s disease is the most common type of dementia accounting to more than 60%
of all dementia cases across the globe. This type of dementia is caused by deterioration of brain
cells and as such, the brain tissues for such persons tend to have fewer nerve cells and
connections. This condition subsequently causes the brain to shrink in size. Mixed dementia,
dementia with Lewy bodies and, Parkinson’s and Huntington’s disease are the other well-known
types of dementia (Lapore, Ferrel & Wiener, 2017).
As aforementioned, not all signs of dementia can result in progression of dementia
implying that dementia-like symptoms can be reversible. Infection and immune disorders have
been known present dementia signs. As the body attempts to fight off the infections, multiple
sclerosis may occur thereby depleting the nerve cells and presenting dementia-like symptoms
(Lang et al, 2014). Metabolic and endocrine abnormalities that are common in people with low
blood sugar can result in personality changes. Likewise, poisoning, medication side effects and
nutritional deficiencies such as dehydration and lack of vitamin B-1 might also incline an
individual to think that they have developed dementia while it may not necessarily be the case
(Wells & Smith, 2017). Medical practitioners therefore, need to be wary of such cases in order
not to misdiagnose a patient.
Nonetheless, the common risk factors for dementia are age, family history and down-
syndrome. These are uncontrollable causal factors. There also exist controllable risk factors that
dictate most of the treatment plans. Namely; diet and exercise, alcoholism, depression, smoking
and cardiovascular risk factors are manageable in a way that they can be used to control

CAPSTONE EXPERIENCE IN HEALTHCARE 14
dementia progression. Aside from avoiding such risks, dementia treatment is confounded on
early diagnosis so that early and optimal management can be initiated to mitigate dementia
progress. Optimizing physical health, treating accompanying illnesses and managing
psychological symptoms are also vital in the treatment plans for dementia (Buffington, Lipski &
Westfall, 2014).
Critical reflection and analysis of the capstone experience project
This critical reflection is based on the total experience of the nursing issue. My personal
view regarding reflection is that there is dire need to assess the situation or the problem itself. In
regard to the capstone project experience, the situation would entail elderly people diagnosed
with dementia seeking care in residential care facilities. The problem involves finding a
treatment or effective management plan for dementia cases. Thus, reflection and analysis of the
capstone experience will involve mitigating the progression of dementia among the elderly in
residential aged care.
Critical reflection linked to appropriate model or framework
The model used in the critical reflection will entail the REFLECT model developed by
Barksby, Butcher & Whysall (2015). The model consists of seven stages with each of the letter
model representing each stage. As such, the stages include; Recall Examine, Feelings, Learn,
Explore, Create and Timescale. In accordance with these stages of REFLECT, I developed a
framework comprising of description, feelings, evaluation, analysis, conclusion and action plan
which coincide with each stage of the model as will be discussed below.
The first stage, Recall, refers to a detailed account of a previous event or situation within
the area of practice. This stage entails a vivid and detailed explanation regarding a past

CAPSTONE EXPERIENCE IN HEALTHCARE 15
experience where the nursing student encountered the problem. In one of my experiences in a
voluntary service to care for the aged in residential care facilities, I encountered a patient with
dementia. These facilities often receive new patients diagnosed with dementia. Patients are taken
in basically on a daily basis. The newly admitted patients are left at the care of nurses and other
caregivers in these medical institutions. It was not surprising to observe that the facility received
at least one patient in a span of five days. This perhaps attributes to the fact that more than 240
people are being diagnosed with dementia in Australia on a daily basis (AIHW, 2018).
Most of the dementia-related cases were for people who had reached the second stage of
dementia. Almost the entire patient groups comprised of individuals who were 65 years of age
and above. For those who were already under the care provided at the residential facilities, most
of them had reached the third and fourth stages of dementia (Cunningham et al, 2015). Many of
the patients experiencing mild cognitive impairment presumed that their signs were a normal part
of aging and that their memory losses would soon go away only to realize that the condition was
spreading. Rarely did a patient check in by themselves. Dementia patients were brought to the
facilities by either their closest friends or close relatives. Recent memory loss was reported as the
most common sign of dementia. Relatives would often lament that the dementia patient was
losing track of time and they could not locate their homes. Performing simple tasks such as
cooking or picking up grand children from school became challenging since the patients were
forgetful (Hunter & Doyle, 2014). When engaged in conversations, the dementia patient was also
finding it difficult to follow the storyline and was repetitive without their knowledge. Friends
and relatives also reported that when these patients were confronted regarding these signs, they
became irritable and defensive citing the symptoms as normal part of aging.

CAPSTONE EXPERIENCE IN HEALTHCARE 16
The second stage of the REFLECT model, Examine, entails analyzing the events or
activities from the situation. One particular case comes to mind. On this occasion, Mary a 78
year old woman was brought in to one of the residential aged care facilities in which I was
serving. She was accompanied by her two sons one of whom was devoted towards taking care of
the patient. The son reported that although he had tried his best to provide care to his mother, the
changes in both her emotional and physical wellbeing was making it difficult for him to continue
with care (Leydecker, 2017). From the son’s account, Mary could not manage to trace her way
home when left a few blocks from home. Behavioral changes were also prevalent including
wandering off and repeating her questions even when they are answered. The son experienced
the most difficulty in providing personal care since he could not assist her mother in other
personal issues such as bathing (Lang et al, 2014). From this account, I immediately knew that
Mary was in the second stage of dementia and was thus experiencing mild dementia.
To further substantiate my speculation, I consulted the doctor on duty. The doctor
performed a complete medical and psychological assessment on the patient. With the assistance
from the son, the doctors noted down a detailed medical history of the patient. A physical and
neurological examination was also done. This included tests of the senses and movements. The
doctor instructed that a dementia screen comprising of blood and urine tests be done. At this
juncture, my suspicion was confirmed and Mary was diagnosed with second stage dementia
(Wells & Smith, 2017).
The diagnosis marked the third stage of the model which was feelings. As a practicing
nurse and having encountered quite a number of patients suffering from the condition, the
diagnosis touched me and I could identify with the patient. In particular, I empathized with Mary
and her sons knowing the road that this family will take as a result of the condition. I knew that a

CAPSTONE EXPERIENCE IN HEALTHCARE 17
few months down the line, dementia would reach its latter stages and result in an untimely and
inevitable death. Most worryingly was the fact that as the condition progressed, Mary’s brain
function would degenerate to the point that she wouldn’t recognize her loving sons (Fazio et al,
2018). It was difficult for me to explain these outcomes to the patient and her loved ones.
Nonetheless, I did my best to reassure the family that we would create the best possible
environment for Mary so that she can enjoy her final stages of life. I also made it my personal
objective to ensure that the patient was socially engaged. Her spiritual wellbeing would likewise
be of equal importance in the management plan.
The fourth stage which is learning from experience covers the nurse’s obligation to learn
from the situation. To me, I used evaluation of the entire situation in accomplishing this stage.
This evaluation process expounds from the above mentioned feelings of empathy. The provision
of personal care and healthcare in general requires proper evaluation of the patient’s
psychological and physiological state (Hunnicutt, 2010). I identified a mental status test to check
for the intellectual functions of the patient’s brain. This included the patient’s ability to read,
write and communicate in the preferred language. Cognitive testing was alternatively considered
in this case to evaluate the thinking capacity of the patient. As stipulated by the doctor, a
neuropsychological testing was done in addition to brain imaging techniques (CT scan and MRI)
to determine the areas of the brain that were affected. The findings illustrated that the patient was
unaware of the progress of dementia and assumed that it was normal part of aging.
In the fifth stage of exploring, the medical practitioners are expected to review the event
and determine the chances of reoccurrence. In my case, I knew that second stage dementia was
serious and would only get worse with time. Analysis at this stage would confirm the diagnosis

CAPSTONE EXPERIENCE IN HEALTHCARE 18
that the patient is suffering from dementia. The patient had to be informed of these results and
management plan or rather the conclusion laid out in bare terms.
The sixth stage which is to create entails the plan of action in management of the
healthcare problem. In my case and in accordance with the capstone experience problem, I
identified communication, spiritual and emotional wellbeing, social life interaction, personal care
and environment as the primary aspects to be included in the action plan. Ideally, these aspects of
the treatment were specifically tailored to suit the patient needs (Calma, Dudgeon & Bray, 2017).
Under communication, proper verbal communication counseling was done in an empathetic
manner implying that the patient’s perceptions and worldview were taken into consideration
when administering care (Sherrat & Bell, 2014). As the primary caregiver, communication also
entailed paying close attention to the patient’s body language in order not to miss any
unanticipated messages that the dementia patient was putting across (Bennett, Ward & Scarinci,
2015).
A spiritual and emotional well-being also entailed a nursing care plan comprising of a
holistic approach to promote the self-worth of the patient. Musical therapy was performed
occasionally to the patient for purposes of decreasing stress levels thereby eliminating instances
of aggression and irritability (Shin, Lee & Miller, 2013). Meditation similarly proved to be
effecting in minimizing anger and aggression from the patient (Westbury et al, 2010).
Personal care was also accorded to the best of my efforts. This included routine checks to
ensure that the patient was provided with all the necessities demanded. Maintenance and
monitoring of proper hygiene were also observed as the condition continued to deteriorate the
patient’s physical health. This included providing aid to activities such as bathing and dressing.

CAPSTONE EXPERIENCE IN HEALTHCARE 19
The environment was also modified in the best way possible to cater for the diverse needs
of the patient. For instance, I ensured that the patient was put under a healthy diet. Regular
breathing exercises were also conducted in a bid to reduce the stress levels of her body. To
promote a joyful sensation, I collaborated with other caregivers to provide a calm and cheerful
environment to the patient. It is worthy to note that these activities were performed through a
regular schedule that was followed strictly on a daily basis. Ideally, such discipline in carrying
out the management plan coincides with the seventh stage of the REFLECT model which is
maintaining a timescale.
Professional Portfolio
Personal Details
Name:
Address:
Mobile No.:
Email:
Education Qualification
Professional Membership
Personal Goal
Work Experience
Key Strengths

CAPSTONE EXPERIENCE IN HEALTHCARE 20
Current Position
Conclusion
Summary of the Capstone Experience
The aim of this capstone experience project was to identify the prevalence of dementia
among the elderly and further to expound on the best practices in managing and treating
dementia among elderly patients in residential aged care.
The findings indicate that dementia is mostly common among old people who are above
the age of 65. The condition has no imminent cure or treatment since it is degenerative and
irreversible. It also poises various psychological, physical and cost impacts on both the patients
and their caregivers. The causes of this condition can be avoidable even though in most of the
presented cases, its risk factors are unavoidable depending on the stage of dementia. Medical
providers have thus been faced with a critical challenge to address this health concern especially
since it leads to an inevitable death. In Australia, the condition has become the second leading
cause of death.
In my capstone experience project, I realized that the onset of dementia among the
elderly can be marked by several noticeable signs and symptoms. Loss of memory, difficulty in
performing daily tasks, problems with communication, disorientation of time and place, poor
judgment, behavioral changes, and changes in moods and personality are all some of the most
common signs that can be used to identify dementia in old aged individuals. Diagnosis of this
condition is based on several physical and psychological tests which primarily aim at eliminating
other causal factors and establishing the functioning of the brain.

CAPSTONE EXPERIENCE IN HEALTHCARE 21
Once the condition is diagnosed, it is advisable for nurse practitioners to utilize evidence-
based approaches in managing this condition (Green, 2012). This should be done on a timely
basis so as to prevent progression of dementia. In this light, communication in residential aged
care, maintaining spiritual and emotional wellbeing of the patient, enhancing social interaction
and lifestyle change provision of personal care and creating a suitable environment can go a long
way in ensuring that the patient is accorded sufficient care to cater for their needs (Shin, Lee &
Miller, 2013).

CAPSTONE EXPERIENCE IN HEALTHCARE 22
References
Arendts, G., Dickson, C., Howard, K., & Quine, S. (2010). Transfer from residential aged care to
emergency departments: an analysis of patient outcomes. Internal Medicine
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