Some of these link to maslow’s hierarchy of needs which explains that if our basic needs are not addressed then we cannot progress further, when a person feels in good health they feel well.
Other needs could be environmental (noise, lighting, warmth etc,) non-medical interventions (massages etc), equipment and aids (to ensure independence to fulfil life) and alternative therapies (to support and enhance well being)| Emotional/psychological needs | These relate to an individual’s need to feel loved, to be accepted and to belong.They will need to be monitored for any form of depression which could lead to refusal of treatment. | Social needs | The social needs involve relationships, companionship and interaction with others. There are different types of social need – physical, spiritual, intellectual, emotional and recreational.
There is the need to feel important to other people; that people approve and the feeling of acceptance as part of a group. Contact with remote family members and the healing of broken relationships or putting bad situations right can sometimes become important. Intellectual needs | These needs should not be forgotten, these link closely to emotional, social, cultural and communication needs and often form the basis of how a service user may react to their life-limiting illness. These needs being met may result in the service user dealing with the subject of death and dying in a more positive way| Religious needs | Religion often involves a set of organised rituals and practices, which an individual will follow and practice.They follow this system of faith and it is important to them, it could aid their acceptance of their forthcoming death and aid their emotional and psychological well being| Cultural needs | These refer more to beliefs and values. They are passed on from one generation to another and the service user will need to feel that their particular customs, language and beliefs will be respected thus aiding their emotional and psychological needs| Spiritual needs | Spiritual needs refer to the part of the person that is concerned with ultimate ends and looking for the meaning of existence.
It involves searching for answers to questions and comes into focus at times of emotional stress, illness, loss, bereavement and death. Spiritual needs are highly individualised and can change, these will aid their emotional and psychological needs| Communication needs | Everyone has different communication needs depending on various factors, this need to be considered when planning a service user’s end of life care. Every service user is different and communication needs to be user-specific.Things like translation services may be necessary for users who do not speak fluent English| Q2: When planning holistic care for an individual, describe how you would take into account the needs of others Undertaking a holistic needs assessment is not an end in itself.
It is a means of ensuring that the person’s concerns or problems are in the first place identified so that attempts can be made to address them. It supports the broader aim of ensuring personalised care that reflects an individual’s health and care needs. An assessment should always result in a care, or action plan.Holistic health incorporates the physical, mental, emotional and spiritual needs of the individual, family and community. Things become holistic when all of the dimensions of the whole being are considered. We may address each dimension individually but must realize they are all connected.
Each part enhances supports and affects the others. Individual wellness is reflective of how each of these factors is addressed. When planning realistic care, the needs of others should be taken into consideration. (Others could refer to family members, friends, work colleagues or carers. When an individual is diagnosed with a life-limiting illness and they are supported by a family member, an assumption is made that care will be provided by that relative. A carer assessment is used as part of holistic care to assess the carers own needs, preferences and wishes in order to assess whether they can provide adequate care for their relative.
It would be good practice for carers to complete a questionnaire as a form of self-assessment, it helps give care providers a better picture of carers needs and abilities to care.All assessments must be reviewed at regular intervals as needs and abilities can change. When planning the care you also need to take into account the spiritual and religious needs along with emotional needs of not just the individual but also the family/carer, when providing support the family etc may find it distressing and you may need to ask them to leave if they become too upset, you could warn people in advance about what you are going to be discussing thus preparing them ready. Practical needs are often required by family and carers, things such as washing/bathing, day to day living tasks etc.
You will also need to check as to whether care is easily accessible and transport is accessible to attend clinics and hospitals and also look at the persons physical ability. All information around the care needs to be communicated in a way that can be understood to not only the individual but also the family/carers. You will need to be aware of language and cultural barriers that need to be addressed and may need to ensure there are translators available to assist, especially if around issues such as for funeral arrangements.As the term holistic means, you need to look at the whole situation and not just from the individual’s perspective to ensure a package of care incorporates all who are going to be involved in the end of life care. Q3: Explain why it is important to ensure that the individual is at the centre of all aspects of end of life care planning It is important to ensure that the service user is at the centre of all end of life care planning as this is what person-centred approaches is all about; it is at the forefront of person-centred work.
Being person centred or using person centred approaches means ensuring that everything we do is based upon what is important to a person from their own perspective. Person Centred planning discovers and acts on what is important to a person. Person Centred planning helps do this by discovering and acting on what matters to a person. It gives us a structure to help us continually listen and learn about what is important to a person now and in the future and to act on this in alliance with friends and family.
It requires a fundamental shift of thinking from a “power over” relationship to a “power with” relationship.Ensuring the service user feels respected and fully valued throughout the end of life period is an ethical duty of every care worker. End of life care seeks to support the service user not only with their physical needs, pain and other distressing symptoms but also their emotional, social, religious and cultural needs and beliefs. This is a more holistic approach which ensures that the individual feels valued and is respected.
Q4a: You are asked to support an individual who is new to your care setting. Outline how you could assess their needs and prioritiesTo assess the needs and priorities of a new service user would involve using a specific assessment tool, along with information you have gathered from areas such as health, support available to the individual from immediate family and housing information. Some providers conduct interviews with the service user and their family which helps to support an initial assessment of the individuals needs and priorities, others may ask that a needs-based assessment questionnaire be completed Q4b: Identify three tools which you could use to inform your assessment of a service users needs and priorities . The Personal Healthcare Plan – which was developed for service users with long-term conditions so they could adapt to live with the condition and take control of their care. The service user is at the centre of this plan and makes the decisions on what should be included.
The plan can also specify the types of treatment and care a service user would prefer. 2. Social Care Assessment of Need and Support Plan – this tool is a single assessment process which was introduced through the National Framework for Older People.The aim is to ensure that older peoples care needs are assessed thoroughly. 3.
The Liverpool Care Pathway – following a holistic realistic assessment, a service user will be assessed throughout the end stages of their life. As an assessment tool, the LCP is used to guide the healthcare team in the care of an individual during the last hours or days of their life. Q4c: Consider one assessment tool from your list in question 4b which you would use to assess the needs and priorities of the individual and evaluate ow this could be used to plan their end of life care. (You may also refer to your own work practice, paying attention to confidentiality issues) Assessment tool: the assessment tool I am going to evaluate is the Liverpool Care Pathway (LCP) How this would be used: The Liverpool Care Pathway for the Dying Patient (LCP) has been developed to transfer the hospice model of care into other care settings. The Marie Curie Palliative Care Institute Liverpool (MCPCIL) is supported by Marie Curie Cancer Care and has pioneered the implementation of the LCP.
This programme is recognised nationally and internationally as leading practice in care of the dying to enable patients to die a dignified death and provide support to their relatives / carers. The LCP provides a useful template to guide the delivery of care for the dying to complement the skill and expertise of the practitioner using it. Once commenced the goals of care prompt staff to consider the continued need for invasive procedures and whether current medications really are conferring benefit.The healthcare professional is free to use his or her own clinical judgment in this process. The use of the LCP does not preclude use of antibiotics or artificial nutrition or hydration but it does ask the professional to consider an appropriate decision for that moment in time and document the reason for decisions made. Using the LCP in any environment requires regular assessment and involves continuous reflection, challenge, critical decision-making and clinical skill underpinned by learning and teaching programme.
Advantages: * It helps to create a potential lasting memory for relatives and carers * The LCP supports the health care professional and the relatives and carers to achieve the best quality of care at what can be a very difficult time * It can support communication between the multidisciplinary team * It supports communication with the family of the service user * It prevents unnecessary hospital admissions by ensuring the care planning has been completed in advance Disadvantages: It means that in a similar way to other plans, the actual documentation needs to be updated regularly in order to be effective * Kelly (2003) comments that care of the dying may be ‘standardised to such a degree that reality is reduced to a flow diagram and palliative care is simply a series of boxes to be ticked by professional care givers’. (taken from nursing times. net) * Without a robust implementation and education strategy the LCP could be at risk of becoming a ‘series of boxes to be ticked’.It is crucial that the health care worker understands the background and principles of palliative care and the LCP in order to use the document to its full potential. It should be used for guidance when offering high-quality, individualised care. (taken from nursing times.
net) Q5a: Describe how you would assess and manage risks of an individual not achieving their goals, aspirations and priorities before they die Assess:
