Person-Centred Care for Dementia Patients: A Case Study

Running head: ESSAY
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ESSAY1
Part 1Introduction- The idea of person-centred care is
obviously different from a traditional treatment
approach that holds the opinion that patients adorn the
role of passive receivers of a particular clinical
intervention. Numerous health professionals are
conventionally dedicated to meet the demands and
preferences of the patients, rather than the resources
(Surr, Smith, Crossland & Robins, 2016). Relatively
differing from the conventional method of stating
clinical recommendations to a patient, the
aforementioned concept of person-centred care model
creates the provision for presence of the patient, in
addition to family members, at the time of clinical
decision making. In other words, implementation of
person-centred care encompasses the procedure of
doing and thinking things that consider patients as
equal partners in the development, planning, and
implementation of care, such that it meet the needs of
the patients (Brooker & Latham, 2015). This case study
will focus on the delivery of person-centred care to
patient X, a septuagenarian, who had been diagnosed
with dementia two years ago. The essay will elaborate
on her social, individual and health history and will
comprise of an overview of the national and global
policies and legislation that are relevant to the case
study. It will also contain an overview of different
theories of aging, and correlate the case study to the
SENSES framework.Case study- Dementia is an umbrella term that
refers to conditions and diseases, primarily
characterised by a deterioration in memory (Livingston
et al., 2017). The patient X, aged 71 years, had been
diagnosed with dementia two years ago. She started
reporting problems in concentration and demonstrated
a failure in remembering recent circumstances. These

ESSAY2
symptoms were observed during the last few months of
2016. Her hobbies included gardening, cooking, and
playing and she was the primary caregiver to her
husband, aged 75 years, who suffered from COPD and
anxiety. Her husband mistakenly assumed that such
characteristics were a normal component of the ageing
process. However, on February 2017, her condition
further worsened and she found it extremely difficult to
complete everyday tasks. This was concomitant with
depression and apathy, and several behavioural
changes were also observed. Upon her relative’s visit,
she immediately noticed the behavioural changes in X
and took her for an appointment with the general
physician. Reports from MRI scan, laboratory tests that
included folic acid, vitamin B12, complete blood count,
thyroid stimulating hormone, and Global Deterioration
Scale for Assessment of Primary Degenerative
Dementia (GDS or Reisberg Scale) confirmed the
presence of dementia in the patient.
After developing the condition, her health condition
began to worsen to an extent that she was no longer
able to live independently in her home. She required
assistance for completing activities of daily living and
suffered from frequent falls. She reported joint pain
that increased with time and was not able to participate
in different social activities. Gradually, she became
increasingly isolated and withdrawn. She was no longer
able to care for her husband as well. Activities that had
given her pleasure, all throughout her life, now became
inaccessible and she eventually started to fall and hurt
herself. This resulted in injuries and a hip fracture. She
reported a pain score of 7/10, when assessed by the
Verbal Numerical Rating Scale (VNRS). A score of 7
indicated that the pain was severe and resulted in
disability, in relation to performing activities of daily
living. She eventually lost the capability to feed herself,

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which was marked by a significant loss in body weight.
She also appeared anxious on being admitted to the
care centre and showed little or no signs of interest to
interact with others.International and national policies- Aged care,
simply referred to as elderly care refers to the
fulfilment of particular requirements and needs that are
experienced by older adults. This term generally
comprises of several services namely, assisted living,
long term care, adult day care, hospice care, nursing
homes (residential care), and home care (Nagaratnam
& Nagaratnam, 2019). According to the International
Federation of Social Workers (2012) the proportion of
older adults is increasing at a steady rate and this
population increase has far-reaching political and socio-
economic implications. Identifying that the ageing
creates an impact on different regions of the society,
the IFSW focuses on considering older adults in
different policies that are related to their health and
wellbeing. It states that respect must be demonstrated
for the quality of life of the elderly, and also focuses on
creating provisions for equal and universal access to
comprehensive, coordinated and affordable care
services, notwithstanding their ethnicity, gender, race,
language, values, cognitive ability, and other factors.
This policy also places an emphasis on accessible and
safe housing for the elderly in community settings, and
highlights the need of their societal integration in
health promotion. This policy is applicable to the case
scenario discussed above owing to the fact that the
disorder that the patient X is suffering from, is
characterised by several symptoms that decrease the
capability of performing similar tasks, and also results
in an impairment in reasoning, memory, and judgment,
besides altering mood and behaviour (Cross, 2018).

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The relevance of the policy statement to dementia
can be accredited to the fact that interactions that
improve personhood are typically established and
assumed through deferential relationships, and call for
the presence of an active and synchronised
intervention. Moreover, actively engaging dementia
patients in care process helps in maintaining strong
therapeutic relationship, which has been recognised as
an essential component of person-centred care (Bray et
al., 2015). It has often been found that therapeutic
relationship assists the patient to modify his or her own
life for good, and also helps in sharing intimate beliefs,
thoughts, and emotions about the disorder that is being
treated (Devine, 2017). Taking into consideration the
fact that dementia is likely to create huge impacts on
the life of X, and might also lead to loss, anger,
disbelief, shock, and even grief, showing adherence to
this policy is vital.
The WHO global plan on dementia is also related to
the case study. The World Health Organization adopted
the Global action plan on the public health response to
dementia 2017-2025 in May, 2017. This policy focuses
on improving the lives of dementia affected individuals,
their families and caregivers, and also intends to
reduce dementia impact on different countries and
communities (World Health Organization, 2017). The
plan recognized the fact that there are roughly 50
million individuals who suffer from dementia and can
be overwhelming, not only for the patient suffering
from dementia, but also for their family members and
carers (World Health Organization, 2019). This global
action plan offers a set of actions that will help in
realizing the vision of the world, in relation to
prevention of dementia. The plan also focuses on the
need or increasing dementia awareness and
prioritization, reducing its risk, supporting dementia

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carers, promoting research and innovation, and
strengthening information systems. Importance of this
plan to the case scenario can be accredited to the
seven cross-cutting principles.
The patient X and her husband have the right of
being treated with dignity, while receiving support and
care that are based on their individual preferences, in
place of assumptions. Moreover, since the patient has
lost the capability of performing several tasks,
empowerment will form a core component of the care
plan, which will focus on advocacy, active listening,
development and maintenance of relationship, and
patient education (Scales et al. 2017). Hence, the plan
stated above is significant since it will meet the human
rights and expectations of the patient, while showing
consistency with the Convention on the Rights of
Persons with Disabilities. Moreover, adherence to this
policy will also ensure that the patient is empowered
and provided access to several preventive and
diagnostic care procedures (United Nations, 2016).
Hence, the policy will create an impact on the care
provision by ensuring equity, health service access and
protection of rights.
The Ministry of Health (2013) of Singapore has also
formulated the MOH Clinical Practice Guidelines in
2013, for guiding clinical practice related to dementia,
based on best available evidences. Dementia has been
recognized as a public health issue in Singapore and an
estimated 55,000 people will be affected with the
disorder in Singapore by 2020. The practice guidelines
place an emphasis on routinely inquiring dementia
patients about anxiety, depression, paranoia, agitation,
sleep problems, and hallucinations. This is significant
for the case study since patients suffering from
dementia report symptoms discouraged, hopeless,
tearful and sad. Similar symptoms were reported by the