Nursing Reflection: Dementia Care and Ways of Knowing

This assignment is a reflective piece from a nursing student detailing an experience in a mental care center, specifically focusing on elderly patients suffering from Dementia. The student describes the challenges of caring for these patients, including memory loss, communication problems, and potential for violence. The core of the reflection centers on Carper's four ways of knowing: empirical (therapies and treatments), aesthetic (practitioner's responses), personal (unique style of care), and ethical (sense of right and wrong). The student analyzes how each way of knowing was applied in the context of the event, detailing the treatments, communication strategies, and ethical dilemmas encountered. The conclusion suggests improvements in communication and care, emphasizing the significance of the ways of knowing in medical practice.

Running head: REFLECTION
Reflection
Name of the student:
Name of the University:
Author Note:

1REFLECTION
1. Event description
This assignment highlights one event of my nursing career that has a special significance.
I have used Carper’s ways of knowing, located within the event and identified the impact of each
of the ways of knowing. I had been associated with a mental care centre, where elderly people
suffering from Dementia were being treated. I have been associated with the treatment of these
elderly patients. People suffering from Dementia tend to forget things very easily (Alzheimer’s
2015). The symptoms include memory loss, communication and language problem, unable to
focus or pay attention, loss of reasoning and power of judgement. Moreover, patients suffering
from Dementia also experience immobility and visual perceptions (Mill et al. 2016). The
patients, who have been suffering for a long time, tend to become arrogant and violent. They
tend to harm the other patients as well as the doctors and nurses treating them. Being one of the
care workers, I have often faced violence from the patients suffering from Dementia. Moreover,
since they tend to forget things and suffer from short-term memory loss, hence they often forget
whether they have eaten their food or taken their medicine. Patience and empathy are the only
ways to keep the patients from being violent (Garrett and Cutting 2015). During the period of
treating the patients, I have learned a lot and experienced various way of knowing. Treating the
patients suffering from Dementia is critical, since I have to be patient and empathetic towards
them. Since Dementia has, no definite medicine to completely cure it, hence care and therapy are
the only treatment for the well-being of the patients suffering from Dementia.
2. Ways of knowing
In nursing and healthcare, Carper’s fundamental ways of knowing is a classification that
categorises the various sources of knowledge and beliefs in the professional nursing practices

2REFLECTION
(Terry et al. 2017). The ways of knowing could be categorised into four fundamental patterns.
These are as follows.
1. Empirical knowing
This refers to the knowledge that is organized systematically into theories and laws and
helps in explaining the suffering of a person along with predicting the cure of the suffering. The
empirical knowing is based on science and highlights the theoretical knowledge that a medicine
practitioner needs to know. The empirical knowledge is believed to be factual and reliable.
However, it is a generalised knowledge that is applicable for the initial treatment. This kind of
knowledge acquired is useful for a reflective practitioner and has to be interpreted according to
the situation encountered.
In the chosen event, the empirical knowledge includes the therapies and treatment for
Dementia (Steen et al. 2014). As a medical practitioner, the knowledge that I have gained, for
treating the Dementia patients are included in the empirical knowing. Dementia cannot be
completely cured. However, the various symptoms of Dementia could be lessened and prevented
from getting worst. Acetyl cholinesterase inhibitors could be used for the patients suffering from
mild Dementia. These patients suffering from Dementia with Lewy bodies, such that the
hallucination could be reduced (Zolnierek, 2014). The Acetyl cholinesterase inhibitors also slows
down the rate of the heart beat, hence ECG before and after the treatment has to be done.
Another treatment to curb down the effect of Dementia is Memantine hydrochloride. This is a
medicine that works by blocking the effects of a chemical on the brain. This is usually used to
treat people suffering from severe Dementia. Patients who are not responding positively to the
Acetyl cholinesterase inhibitors also undergo this treatment.

3REFLECTION
I can also use cognitive simulation and reality orientation therapy for the Dementia
patients. The cognitive simulation therapy involves problem-solving skills, enhancement of
memory as well as exercise to reduce the immobility (Garrett and Cutting 2015). I can use the
reality-orientation theory to reduce stress and mental-disorientation of the patients, thus reducing
memory loss as well as confusion. This helps in improving the self-esteem of the patients
(Klapwijk et al. 2014). Thus, using the empirical knowledge, I have gained knowledge about the
treatment that is most appropriate for the patients suffering from Dementia, based on the severity
of the suffering.
2. Aesthetic knowing
The aesthetic knowing includes the practitioner’s responses to the clinical situation. The
aesthetic knowing involves the ability of the practitioner to grasp the nature of a particular
situation, interpreting the situation and the practitioner knows taking the best actions that
(Carnago and Mast 2015). Even if the practitioner faces the same situation, the treatment and the
responses vary. The aesthetic knowing includes grasping and interpretation, envisioning and
responding. As a medical practitioner, it is important for me that I respond to the same situation
differently, depending on the situation, which I am facing. With my own style of care and
empathy, I am able to establish a positive relation with the patients, thus assisting them to be
cured faster. Moreover, since the patients suffer from Dementia, hence a positive relation with
the medicine practitioner is effective and useful for the faster cure (Richardson et al. 2013). My
personality and my way of communication have to be empathetic and directed towards ensuring
the well being of the patients.
3. Personal knowing

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The personal knowing, in contrast to the empirical knowledge, highlights the unique style
of each practitioner to respond to a situation in his or her own way (Kelley et al. 2015). Based on
the empirical knowledge, the response of a medical practitioner is referred to as the personal
knowing (Garrett and Cutting 2015). The modifications of the empirical knowledge, according to
the demand of the situation are essential for the practitioners. I, as a medical practitioner have a
unique way of treating the patients suffering from Dementia. I am empathetic towards the
patients and treat them with care. Since the patients are old, hence they suffer from immobility,
visual impairment, auditory impairment and other age related diseases. Along with these,
suffering from Dementia makes the patients confused and violent (Robert et al. 2014). Thus, I
need to be empathetic towards them, in order to reduce their suffering. The patients tend to ask
the same question over and again, since they suffer from short-term memory loss (Garrett and
Cutting 2015). Hence, I use hand-written text in order to communicate with them. The writings
remain with the patients and they are reminded of the conversation by the written text. This is my
way of treating these patients, thus helping them to reduce the state of confusion. The personal
knowing involves three inter-related factors. These are:
1. The perception of the feelings of a person, along with the prejudice within the situation
2. The effective management of the personal feelings and responding to the prejudices
effectively
3. The effective management of anxiety of the practitioner (Garrett and Cutting 2015)
Thus, I have to ensure that I am able to respond to the prejudice effectively, along with having
control over my emotions and feelings. Thus, I will be able to ensure that the care and cure given
to the patients will be effective.

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4. Ethical knowing
Ethics has a major role to play in the lives of a medicine practitioner. The ethical learning
highlights the sense of right and wrong in the medical practice. Based on the ethical dimensions,
the practitioner makes the choice between the right and wrong. Ethics have to be maintained,
while ensuring that the requirements of the patients have been met. As a medical practitioner, I
have often faced ethical dilemma. The path of truth and the benefits of the patients might often
take different paths (DiCenso et al.2014). Thus, ethical dilemmas are caused. In such a situation,
I have to take critical decisions and ensure that the people suffering from Dementia do not get
worst. There is often a tension between the ethically right situation and the best suitable decision
for the patients. However, I have to ensure that I take up the best possible decision, thus helping
in the faster recovery of the patients.
3. Conclusion
This assignment highlights the ways of knowing and its reflection in a real life event. The
ways of knowing includes the empirical knowing, personal knowing, aesthetic knowing and
ethical knowing. The empirical knowing has been done successfully and based on it, the personal
knowing is applied. Using the aesthetic knowing, the patients could be helped to recover faster,
while the ethical knowing helps to take the right decision in case of ethical dilemma. The
empirical knowing could have been used more effectively, such that the personal knowing would
have been enhanced. The interactions with the patients suffering from Dementia could have been
made better, thus relieving them from the suffering. Better communication could have relieved
the patients from confusion and helplessness. Thus, with the enhancement of the communication
with the patients, the care given to them could have been improved. Various innovative ways of

6REFLECTION
communication could be used as a form of activity, to improve the mental health of the patients.
The ways of knowing are significant in the lives of a medical practitioner.

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References
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