Dementia Care: Case Study of a Dementia Patient

Dementia Care
Healthcare Management: Principles and
Practices

Dementia Care
Case study of a Dementia patient/ experience
Mrs Grey is a 87-year-old widow who was admitted to the nursing home for dementia treatment.
This step was taken because she does not maintain hygiene and was regularly lost in the
neighbourhood. She is generally frustrated with other people and from her own children and
family. According to her, they always kept interfering in her life and regularly troubled her about
things that are not important to her. She spends most of the time in her room, which affects day
to day functioning.
In the starting, nursing staff provided with certain support so that she could effectively perform
her regular activities. However, after a few days, maintaining her hygiene and preventing her
from wandering around was becoming a challenge, as she preferred to move around freely.
With the treatment, Mrs Grey was very upset. The complexity of the situation and the ethical
dilemma made it challenging for the nurses to deal with the situation.
The critical incident related to the management process
To determine what initiatives taken in a situation was right or wrong and identify learning from
the incident, Gibbs Reflective Principle(1998) may be considered.
As in the case of Mrs grey, there are some good and bad steps that are taken by the management
group. It's time to consider the learning from the case.
Reflect on Management process in the case of Mrs Grey with the help of Gibbs Reflective
Principle(1998).
We would try to understand the case of Mrs grey.
Gibbs reflective principle contains six steps
1) Description - This section deals with explaining the situation in details. This deals
with some question like
 What has happened?
 When and where this happened (Davies, 2012)1?
1 Davies, S., 2012. Embracing reflective practice. Education for Primary Care, 23(1), pp.9-
12.

Dementia Care
In the case of Mrs Grey firstly management team decided to promote hygiene and restore Mrs
Grey’s ability of performing regular activities. However, this was becoming challenging as the
patient was not allowing maintaining her hygiene and preferred wandering around. Later the
other members are included in the team but this plan did not work as expected by the
management team. This is eventually the wrong decision as in such cases where care user are not
supporting the care service, they are needed to made realize the importance of the care service
for their wellbeing. In this case, doctors suggest regular maintenance of her hygiene and use of
retrain for preventing her from wandering around. This made her angry and resulted in agitating
her. In the hospital, restrains were used on her so that she would not roam in the hospital. This
was mainly done to reduce the risk of her wondering around and being injured. At times, family
issues raised after seeing the patient in such condition as it was traumatizing for them. At this
stage hospital, faced a bit problem due to the ethical dilemma, as the preference of care user was
different from that of her actual good. It was the preference of Mrs. Grey to wander around
freely and eliminate the use of restraints on her. However, it contradicting to her actual good
because wandering around increases risk for such patients to not being able to return to the
hospital or being harmed or injured while wandering around.
There is no method to understand the mood of the patient, made the situation even more complex
(Thomas, and Grossberg, 2009)2. It became serious issue, when the patient became aggressive
towards doctors and nurses. Hence, the multidisciplinary team required incorporating the care
user in the care process, which they failed to do.
2) Felling: This relates the feeling that trigger to your mind during the treatment. It also includes
the thoughts of other people in the same situation. Some of the question raised in this context are:
 What is your feeling during the event?
 What is your feeling after the event?
 What do other people think about that event?
2 Thomas, S.J. and Grossberg, G.T., 2009. Memantine: a review of studies into its safety
and efficacy in treating Alzheimer’s disease and other dementias. Clinical interventions in
ageing, 4, p.367.