Essay on Specific Service Provisions for Families

Specific service provisions for families and carers of individuals living with dementia
Introduction
The aim of this study is to account for the needs for people with dementia, their carers and the need
to care and support for them. It is imperative to hold up under as a main priority that, while
numerous individuals with dementia will need and need indistinguishable results from services from
their carers, now and again their needs and wishes will be at change with each other and may even
clash. The proof base concentrating on service provision is thin. The primary accentuation of services
for individuals with dementia is on advancing their autonomy and personal satisfaction and, any
place reasonable and conceivable, supporting them and their carers in the network. Social services,
accordingly, have a noteworthy job in offering help and services to individuals with dementia and
their carers living in the network, alongside upheld lodging choices, including protected lodging and
private consideration, for those requiring progressively concentrated consideration and backing.
Explore the current service provision in relation to your contemporary issue
Care management
Care management, which is also referred to as case management, or care programme approach
enables different community services to interact and cooperate with one another to provide
enhanced healthcare services to the patient and their carer. This service provision consists of four
different elements: full assessment of the patients from cooperating healthcare facilities, devising a
care plan, planning the delivery of services and reassessing the plan for a changing need of the
patient (Ballard et al. 2001). There are great evidences that support that the care management for
people diagnosed with dementia and for their carers has brought in improved outcomes. The
greatest impact was on the quality of life of the patients. After receiving care under this service
provisions for 6 months, the dementia patients were more satisfied and at peace within their home
environment. In case of the carer, this provision was able to relieve the carer burden as their patient
had lower number of needs and were provided with greater support. However, the impact on the
carer outcomes were only seen after a period of 12 months (Beck et al. 2017). There is more
research being carried out for enhancing the outcomes at a smaller period of time.
Counselling therapy and support for people with dementia and their carers
There is much evidence-based service provisions that support the use of counselling therapy on
patients with dementia. This provision enables them to access individual or group based counselling
therapies and psychoeducation (Bunn et al. 2016). The disease causes the cognitive and speech skills
of the person affected with it to deteriorate as a result they are unable to communicate and express
their needs sufficiently. The therapy is also impactful on their emotional well being and mental
health. The use of therapy on dementia patients also relives their carers somewhat by providing
them with initiatives to express themselves better. However, the service provision now allows even
the carers to access therapy as well. This enables to manage feelings like guilt, stress, emotional pain
and enables to cope up with the demands on their roles (Cleary and Doody, 2017). The services
provision also accounts for the care seekers to be arranged under the care of an in-house attendant,
making it possible for the carer to take part in therapy.
How does this link to drivers?

According the priority areas marked in the Carer Strategy of, the above-mentioned care service
provisions are associated with priority area 2 “Realising and releasing the potential”. Under this
priority area, the aim is to releasing the potentials of the care regime for the dementia patient by
combining the health services from various facilities and empowering the carer with increased level
of support (Digby et al. 2016). This releases the pressure on the carer in two ways: by enhancing the
quality of care which satisfies the needs of the care seekers making them satisfied and less erratic
which on the other hand lessens the burden on the carer and provides them with their free time.
There are also provisions for spending leisure time for both the carer and the care seeker together
where both of them are able to spend quality time without the stress of providing care. the other
priority area is supporting carers to stay physically and mentally fit. The high amount of pressure and
demand put on the role of carers causes them to have carer stress which causes them to burnout
before their age. as a result, the provisions allow the carer with extra support to relive some amount
of their duties.
Explore the political and societal drivers that influence service delivery in relation to your
contemporary issue
Political drivers
The concept of service delivery in the field of nursing comprises of several important factors. These
may include various political drivers that influence the particular idea. The NMC Code of Conduct
states the nurses to uphold a professional degree in order to be a registered practitioner in the UK
(Nmc, 2017). This helps the nursing professionals to be able to prioritize the patients and practise
effectively in the concerned environment by preserving both safety and trust.
The code of conduct helps in binding both the practitioner and the patient into a certain group of
customary rules and expectations. The concept of nursing in the United Kingdom is determined by a
set of particular standard and precepts. It reflects the advanced set of behavioural and ethical norms
of the society as practised by the nurses. They apply to every professional in the register, both on
and off duty. An example of the off-duty code of conduct is being respectful of your patient’s
confidentiality.
The Carer Act (2014) came into effect in April 2015. This was later revised in April 2016. The Act
helped in the establishment of new rights for carers in the UK in order to empower them in their
practice (Legislation, 2014). They help in focusing on the promotion of wellbeing and good health,
the right for the carer’s needs to be taken into consideration, the duty of the NHS to cooperate with
the local institutions and authorities and to delay, prevent and reduce the requirement of support,
that is, the needs and demands of the carers (Legislation, 2014). These local institutions and councils
are also supposed to provide enough information to the carers and nurses for their designated role
in the medical sphere (Beck et al.2017). The Act also has the right to assess the carer’s appearance of
needs.
The Carer Act mostly relates to adult carers. This Act allows the institutions to give their maximum
care to the patients in need without compromising the carer’s time and effectiveness (Digby et al.
2016) The aspect of culture and faith also plays a huge role in the management of care services. The
diversity in the community, coupled with a variety of different mindset and beliefs, can often create
a hindrance in delivering proper care and service. Thus, the nurses should keep in mind the diversity
of various cultures while providing care to the concerned patients. However, the mental and physical
health of the patient plays a huge role in this case (Machiels et al. 2017). The expectancy of the care
might change with health criteria of the patient. As the nurses are obligated to follow the NMC Code

of conduct, they are expected to interact and collaborate with the family and the patient due to the
rising inclination towards the informal cares (NMC, 2017). In this case, the registered nurses are
supposed to deliver and modify their services according to the suggestions implemented by the
informal carer as well.
Societal drivers
Currently, there are 3 million people in UK who have taken on the role of an unpaid care providers
along with having to juggles paid work of their own. This accounts for about 1 in every 7 people in
the workforce of the country is likely to increase by half within the time span of next 25 years. The
given trends of demographics show that the population is ageing and is likely to live longer with
disability through the help of advancement in medical and care facilities. As a result, the carer
population also age with their care providing roles (Saini et al. 2016).
The religious and spiritual needs of a care seekers with dementia is also essential to be met
whenever possible. This provides them to be more suited and calmer in their environment. As a
patient of dementia is contained within their known schedules and environment, it is essential to
provide a suitable environment which mimics their earlier lifestyle. If their earlier lifestyle involved
religious and cultural activities then there is a need to account for it in their dementia care provision.
It is better to not assume the preferences of the care seeker and rather let them or their family
members guide the care pattern. The importance of religious and spiritual settings also provides a
sense of togetherness and ray of hope through faith.
Also, the expectations and demands on the role of the carer changes with the prognosis of the
disease. The condition of the disease may deteriorate suddenly or slowly. It is difficult to provide
prognosis for the disease and the carer needs to be ready for the oncoming set of symptoms. Also,
the symptoms differ from patient to patient. It starts with forgetfulness and loss cognitive skills
which prevents them from fulfilling daily tasks (Smythe et al. 2017). It is then followed with sudden
drops and changes in the mood or personality of the person. The last stage of dementia is often
understood when the care seeker begins to lose their ability to form coherent sentences and express
themselves. Depending on the stage and intensity of symptoms, the role of the carer changes.
Consider how the above may be influenced by individual need
The aim of dementia care is to take care the psychosocial needs of the person with dementia. It is
essential to note at this point that the needs of every dementia care patient are not the same. As a
result, they need tailor made assistance and care regimes. Often the psychosocial needs of the care
seeker are ignored to pay more attention to their physical needs. The manner in which an individual
with dementia feels and encounters life is down to something beyond having the condition. There
are numerous different factors beside the side effects of dementia that assume an enormous job in
forming somebody's involvement. These incorporate the connections the individual has, their
condition and the help they get. When supporting an individual with dementia, it very well may be
useful for carers to have a comprehension of the effect the condition has on that individual. This
incorporates seeing how the individual may think and feel, as these things will influence how they
carry on (Stensletten et al. 2016). The individual might encounter a world that is altogether different
to that of the individuals around them. It will help if the carer offers support while attempting to see
things from the point of view of the individual with dementia, quite far. The care person’s role will
be dependent on the level of disability of the care seeker as their role is to support them to live an
independent and complete life. An individual with dementia may continuously lose their autonomy

and become progressively dependent on the consideration and backing of others around them. This
can be a hard change to make and can be troubling for everybody included.
It is significant that, where potential, families, companions and carers bolster the individual to get
things done for themselves instead of 'dominating'. This builds the individual's prosperity and keeps
up their respect, certainty and confidence, as opposed to making them feel powerless or useless.
The individual's endeavours to keep their autonomy may cause strife among them and others giving
consideration and backing. The individual may oppose help since they would prefer not to
acknowledge that things have turned out to be increasingly hard for them or would prefer not to
request help. The differences in the care provided to a person with dementia is often related to how
their disabilities are assessed and perceived by their attendants.

References
1. Ballard, C., O'brien, J., James, I., Mynt, P., Lana, M., Potkins, D., Reichelt, K., Lee, L., Swann, A.
and Fossey, J., 2001. Quality of life for people with dementia living in residential and nursing
home care: the impact of performance on activities of daily living, behavioral and
psychological symptoms, language skills, and psychotropic drugs. International
psychogeriatrics, 13(1), pp.93-106.
2. Beck, E.R., McIlfatrick, S., Hasson, F. and Leavey, G., 2017. Nursing home manager's
knowledge, attitudes and beliefs about advance care planning for people with dementia in
long term care settings: a cross sectional survey. Journal of clinical nursing, 26(17-18),‐ ‐
pp.2633-2645.
3. Bunn, F., Goodman, C., Pinkney, E. and Drennan, V.M., 2016. Specialist nursing and
community support for the carers of people with dementia living at home: an evidence
synthesis. Health & social care in the community, 24(1), pp.48-67.
4. Cleary, J. and Doody, O., 2017. Nurses' experience of caring for people with intellectual
disability and dementia. Journal of Clinical Nursing, 26(5-6), pp.620-631.
5. Digby, R., Williams, A. and Lee, S., 2016. Nurse empathy and the care of people with
dementia. Australian Journal of Advanced Nursing, The, 34(1), p.52.
6. Legislation, (2014), Care Act 2014, Accessed from
http://www.legislation.gov.uk/ukpga/2014/23/contents/enacted
7. Machiels, M., Metzelthin, S.F., Hamers, J.P. and Zwakhalen, S.M., 2017. Interventions to
improve communication between people with dementia and nursing staff during daily
nursing care: a systematic review. International journal of nursing studies, 66, pp.37-46.
8. Nmc, (2017), The Code, Accessed from https://www.nmc.org.uk/standards/code/
9. Saini, G., Sampson, E.L., Davis, S., Kupeli, N., Harrington, J., Leavey, G., Nazareth, I., Jones, L.
and Moore, K.J., 2016. An ethnographic study of strategies to support discussions with
family members on end-of-life care for people with advanced dementia in nursing homes.
BMC palliative care, 15(1), p.55.
10. Smythe, A., Jenkins, C., Galant-Miecznikowska, M., Bentham, P. and Oyebode, J., 2017. A
qualitative study investigating training requirements of nurses working with people with
dementia in nursing homes. Nurse education today, 50, pp.119-123.
11. Stensletten, K., Bruvik, F., Espehaug, B. and Drageset, J., 2016. Burden of care, social
support, and sense of coherence in elderly caregivers living with individuals with symptoms
of dementia. Dementia, 15(6), pp.1422-1435.