Maintaining Personal Rights and Dignity in Care

Introduction

Care is that aspect of life which is needed by everybody whether old aged or a child or any middle aged person. It is that feeling which makes people feel secure and safe. In order to give care also come the power of owner to take decisions and responsibility of that person in hands of the care givers. This power is sometimes breached or becomes intrigues the personal rights of the people which need to be maintained properly. This assignment will fill focus on the case of an older woman, Mrs. McDonahue who is having advanced dementia for the last two years. The case is about an argument between the care giving staffs about her personal choice of how she wants to be taken care of and how she needs to be given care without interfering in her personal space.

In this writing, the morals concepts which says what to do and how to maintain the freedom and personal rights of a person keeping a full-fledged responsibility towards them. It highlights the communication skills with the patients like dignity compassions and respect of him/her. This assignment here gives a brief knowledge about the strategies which may help in enhancing the respect and dignity accorded towards the people in a care giving setting.

Q1. Demonstrate an understanding of the ethical and moral concepts of freedom, rights, responsibilities and the use of power in care.

The ethics of care that pertains right, responsibilities, and freedoms are also just termed as just simple normative ethical theory that holds the thought that moral action centers related to interpersonal care and relationship or a sense of benevolence as a feeling of virtue. Grant and Goodman (2018) suggested that a new approach is possible to adopt for theorising the power in care giving endangers radically a difficult set of concepts & models and normative concepts. Like in this case, where the care givers gave Mrs. McDonahue (84) the care can adopt such concepts where there will be freedom and rights of her reserved and the responsibility will be properly fulfilled by them. Giving care to every patient despite the gender, age and whatever disease the patients are having, a little hold of freedom of their own must be given to them by not breaching the service and care giving responsibilities. The same must be provided to Mrs. McDonahue who is 84 years old with advanced stage dementia and wants to masturbate every day as presented in the case study.

Some of the moral and ethical concepts which are essential and describe the matter of responsibility of care givers and rights and freedom of the patients while using power to care are as follows-

Relational Ontology

This relational management model says that the responsibility and ethics of power in care depict the caregiver's morale, which is not primarily in terms of equality of power, independence, enjoying almost unrestricted freedom to do whatever the person wants to. The relational ontology is the state of a philosophical position that distinguishes the subject from object or the subject from subject and also objects from object in a mutual relationship rather than distinguishing the substance which can be referred as the basic nature or essence of a human being. The relational ontology model allows the power in care in a better and wider understanding of who is individual but exists within a group everyone equally takes care (Hammar et al. 2017). In this case, Mrs. McDonahue’s freedom is necessary as some care givers were saying but since the responsibility to give care is more important than getting freedom of what to do, the power here becomes more to take decisions for that patient by the responsible person. According to the Health and Social Care Act 2012, it is must that when serving any patient or giving care to them their personal space must not be interfered at any cost. The patient's rights restricts the care giver to interrupt in the personal life choices of a person but the patient in this case having advanced stage of dementia is not in that state to assume and think what they should do or what they should not. In case of Mrs. McDonahue the care givers somehow are trying to interrupt the personal choice of her to masturbate because according to them that must not be done by her. They are fully responsible for the well-being of that patient. Under the Human Rights Act, it is the moral duty of that care giver to look after what the person wants to do or what they are choosing and make them understand carefully what’s good for them and what’s bad without breaching or intervening the person’s privacy rights. A little privacy can be given in some cases where the patient is able to decide and think properly.

Normative Care

Different moral and ethical theories persists different core normative values in different cases. As per Siau and Wang (2020), care giving as a normative core value in indeed sometimes related with the idea and concept of not inflicting any kind of harm to anybody but also at the same time it also must include a reasonably limited commitment of actively working in the process of giving care to a person preventing any such harm to them. In case of Mrs. McDonahue, to prevent her from masturbating everyday some staff members ensures that her pads should be firmly fixed in place so that she could not be able to reach her body which could be painful for her and can make her frustrated as Mrs. McDonahue has the habit of masturbating every day. Further the concept of normative value of giving care is connected to the idea of generating and contributing the promotion to do good but at the same time it is also crucial that it must be narrowed down for not entailing the self-sacrifice or in other words sacrificing the part of well-being. The Social Value Act 2012 by the healthcare legislations declares that the respect of someone’s own choices and permission before taking care of that person is must. Care giving, the common normative core value of ethics in power of care under the Patient Protection and Affordable Care Act can be portrayed as a merging scenario of all the principles regarding non-maleficence whenever it has been expanded for allowing in certain types of principles and interventions of beneficence (biomedcentral.com 2020). There exist restrictions in the prevention of a systematic self-sacrifice and also the surrendering of all the other concrete interests.

Q2. Discuss effective communication and interpersonal skills which includes compassion, dignity and respect.

The acquirement of strong and effective interpersonal and communication skills is necessary to establish real and specialised therapeutic alliances that require a profound medical knowledge and expertise to diagnose the disease and treat them, capability to gather all the information from that patient. As Valderama‐Wallace (2017) stated, the interpersonal skills of care giving respond towards the feelings and concerns of all the patients and their ability to create a therapeutic relation and maintain it like a concrete and strong offering of information and also the medical education. As Grant and Goodman (2018) opined, the establishing of the treatment and diagnosis is the main purpose of a patient-doctor relation is a must which needs to be realised as per the patient’s need to be taken care of and be informed about all the complementary items and knowledge of those clinical importance from the view of a medical perspective.

Compassion in accordance with care

The elements of compassion in care giving and nursing skills include being a person who is empathetic enough to understand what the patient is going through n a better way than a normal person (sagepub.com 2016). In heath condition such as Mrs. McDonahue is having there requires a person who will be able to understand her inner feelings which she cannot explain to anyone easily. Someone from the care centre must talk to her to understand that why she masturbates every day, what is her thought on this and how she wants to be taken care of there. Compassion skills gives the knowledge of being someone like with whom the patient can talk to freely which is very much crucial for the patients with dementia because in that disease the patient becomes numb and talk less with people (Dignum et al. 2018). So it is essential to talk to them and get to know that what they feel, how they think, what goes in their mind, did they like the treatment or not and many other things which a dementia patient would not be able to share with anybody on their own.

Dignity in accordance with care

There is an unclear meaning of dignity in case of caregiving to patients due to its complex and multi-dimensional perspectives in various cases such as in case of Mrs. McDonahue where dignity can be referred as the freedom which must be granted to her to choose what she wants to do whether that is liked by the care givers or not. It is her choice to masturbate every day and intervening in that means failing to protect her privacy and dignity. The self-respect attribute stands for self-respect of oneself and others, respecting the peoples’ privacy, self-belief, and confidentiality about something and belief in others (Sleeman et al. 2018). Empowerment attribute involves the feeling of being valuable and essential, increasing the self-esteem, modesty, believing in self-worth and having pride in oneself. Next attribute which is anatomy, whose elements are like giving any choice or having any own choice, making decisions, competence, being able to make decisions which are correct, needs and independence. The last attribute communication says that it could be written or verbal or non-verbal in any other form which includes all the understanding and explaining of feelings, information, comfort and sending time with the audience (springer.com 2020).

Respect in accordance with care

Except in some rare cases and exceptional circumstances, it is kind of a violation of a patient’s primitive right to get respect and getting treatment or any other assistance to the without their consent (World Health Organization, 2018). A violation of a person’s privacy and respect is a punishable offence if registered within law. As per the Equality Act 2010, it is must to establish equal behaviour in healthcare and care giving centres. Any disruptions in this process can be registered as against government rules and regulations. In this specific case where Mrs. McDonahue is at advanced stage of dementia and is somehow unable to make her own decisions, the care takers can breach her privacy but not respect only when there is a need for it. Not giving respect to any person is purely wrong and offensive and against human rights laws also. Respect is a basic human right and there should be equality and believe that respect will be mutual within both care takers and patients under The Universal Declaration of Human Rights (UDHR) where the peoples of the country reaffirmed their faith on the fundamentals of dignity, respect, human rights and worth of the people along with equal rights of both the men and women (World Health Organization, 2018). It has been assumed that every adult have the capacity to decide and make their own healthcare medications and decisions that what to do and what not. But in old ages also with having disease like dementia it can be assumed that the decisions will be taken by the responsible person though with the consent of the patient (biomedcentral.com 2020).

Q4. Identification of strategies for enhancing dignity and respect accorded to people in a care setting.

The strategies of healthcare setups are mainly focused on how to make patients comfortable, and there need to be proper treatment arrangements, more efficient and reliable medications must be provided to the patients, safety and security of the care givers as well as to the patients, confidentiality about patients, providing dignity, respect and privacy to the patients and many other things (sagepub.com 2016). These strategies always need time to time enhancements in their working so that the latest and updated services can be provided to everyone involved in the setting. Grant and Goodman (2018) advised that the needs and demands of the older patients along with their supporters or attenders are increasingly coming into the forefront of both the service and policy developments. The National Healthcare Service (NHS) Plan which is under the protection of Department of Health laid few of the series of enhancements or reforms in the policies and plans to take place in the future for the betterment of the care setups. According to Siau and Wang (2020), recently the National Service Framework who works of the older people regarding their proper care taking services have initiated few of the reformed programs that will be taken forward. Some of them are like: NSF has made it clear with their new reforms that in past times the older people and their carers were not treated with proper respect and dignity. So there will be new training skills introduced so that the healthcare centre staff members and other people can have the knowledge about how to treat people and their supporter in an appropriate manner. The Essence of Care (EoC) is a kind of document that contains issues regarding the individual’s rights to privacy, respect and dignity and ensures that all of these must be strictly followed in care setups (springer.com 2020). However in case of Mrs. McDonahue’s documentation privacy is strictly followed by the care givers. It contains some toolkits used for benchmarking the standards of the eight major clinical areas. Some times in the past years the treatments of patients specially the older patients who are unable to communicate to the healthcare workers about their treatment were either given wrong treatments or have not received accurate and full treatments for their illnesses (Dignum et al. 2018). So the new enhancements need to be done especially highlighting the evidence-based specialist care to the older people and other people. This will remove the mistakes of the past treatments and will do the accurate work. Valderama‐Wallace (2017) stated that it will also save time since if the carers will exactly how what they have to do they can act quickly rather than spending time about reading the whole case study of each of the patients. The healthcare regime of specially he older people needs all types of activities like mental refreshments through various games or roaming in natural places, communicating with each other which will promote a sense of closeness between all of them and they will feel relatable to each other (biomedcentral.com 2020). In this case Mrs. McDonahue also needs to improve her daily routine. Being a patient of advanced stage of Alzheimer, she needs to meet more people and talk to the person around her which is good for her health also. The reforms in policies and plans must focus on how to awaken the old patients by making them act whatever they like to do (Hammar et al. 2018). This will provide them an active and healthier life which is must for their better health.

Dignity is that thing which everybody wants to get in their personal life. So the enhancements require promoting a better dignity to the older people. The policies need to ensure that the government must improve older patients' care in the hospitals and nursing homes with proper attention and a good behaviour (World Health Organization, 2018). It has been seen from various studies and researches that care giver often gets irritated and behave very badly to the old people which hurt them to that extent that they lose hope to be better in their conditions which somehow fails their treatment responding also (Sleeman et al. 2018). As seen in case of Mrs. McDonahue, the staff members don’t like her habit if masturbating every day and don’t like disruption in the care process given to them. There are some laws and acts are amended by the Department of Health and Clinical Commissioning Groups to protect mostly elders from such bad behaviour. Good practice and expert trainings will raise the standards of the hospitals also.

Dig deeper into Local Police Representative Position Paper with our selection of articles.

Conclusion

The report concludes that it is the ethics and moral concepts of care that which provides a novel reading human relations as a fresh approach towards several empirical challenges facing is possible. The healthcare regime of especially he older people needs all types of activities like mental refreshments through various games or roaming in natural places, communicating with each other which will promote a sense of closeness between them and feel relatable to each other. The strategies of healthcare setups are mainly focused on how to make patients comfortable, there needs to be proper treatment arrangements, more efficient and reliable medications must be provided to the patients, safety and security of the care givers as well as to the patients, confidentiality about patients, providing dignity, respect and privacy to the patients and many other things. Lastly it can be concluded that more development ad improvement is needed in healthcare setups.

Q3. Reflective Report

Following the Gibbs’ (1988) Reflective Cycle model which was developed by Graham Gibbs, I will present my views, thoughts, feelings and perspectives while preparing this report. The Gibbs’ model basically covers all the aspects of the care giving process to the special old aged patients in the hospitals and nursing homes and their care givers and other staff members of the healthcare unit. The aspects which were covered in this report are mainly three such namely: demonstration of the moral and ethical concepts regarding rights, freedom and responsibilities while having the power to care in hand, the second aspect covers the effective and efficient interpersonal and communications skills which includes respect, dignity and compassion in it and lastly the topic discussed is the strategies needed for enhancement in the policies and plan related with respect and dignity who are accorded to those people who are in the healthcare setups. Here we will use this model to create a learning structure regarding this above written report about how I felt doing this assignment regarding hospital or nursing home or any kind of care giving settings. The various stages of the reflective model are like-

Description- The description of this report says the importance of respect, privacy, dignity, compassion, communication and many other aspects are necessary for a person and especially for a patient who is old aged like as we have seen in the case study where Mrs. McDonahue who is aged 84 years old and is facing the mental disease of advanced stage of dementia. In such type of cases a patients needs full acre and attention which is the main focus of tis report also.

Feeling- While doing this report I came across many new learning previously unknown to me. When starting the report I thought it will be quite easy since these kinds of case studies are simple to understand and analyse the situation. But when I started to get involved in the project it looked like it has a lot of deep things. I felt shy while asking people about their thoughts on older people masturbating every day. After the conversations are over I was a little shocked by the reactions of each of the people.

Evaluation- While ding this report work there were both good and bad experiences faced. The good thing which happened and worked well was that the people were quite cooperative when the time is about to give reviews about the topic and heard and understood about the case study of Mrs. McDonahue and gave their reviews according to their experiences in healthcare centres and such places. I was happy that I made people agree to talk on this and made them understand the mental and physical state of Mrs. McDonahue. It was disappointing to see that Mrs. McDonahue was judged, care staff wanting to take her freedom away by limiting her body's access.

Analysis- The analysis of this case study revealed many new policies and information which was previously not known to me. I learned a lot of deep core matters which involves in the care giving system. There are lot of regulations and acts such as National Healthcare Service (NHS) Plan, Social Value Act and Patient Protection and Affordable Care which are made to protect the patient’s safety and securing their privacy rights.

Conclusion- The conclusion can be said that this case study gave me a deep knowledge about the needs of old patients which many of us ignore while caring and treating them. All these small things together make a big thing which affects both physically and mentally on the patients and their health.

Action Plan- The action plan will be to promote more about the awareness of what should be done and how to do those changes and enhancements briefed in this report and make a better environment for the old aged patients in their healthcare settings. Further if I get a chance to study a case like this now I exactly know how to do that. This case gave me new ideas of doing research in a better way. Further next if any such case comes to me I will do that differently from this one because now I have quite an idea about these types of cases.

References

biomedcentral.com 2020. Why do family dementia caregivers reject caregiver support services? Analyzing types of rejection and associated health-impairments in a cluster-randomized controlled intervention trial, available at: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-4970-8 [Accessed on: 17th December, 2020]

Dignum, V., Baldoni, M., Baroglio, C., Caon, M., Chatila, R., Dennis, L., Génova, G., Haim, G., Kließ, M.S., Lopez-Sanchez, M. and Micalizio, R., 2018, December. Ethics by design: Necessity or curse?. In Proceedings of the 2018 AAAI/ACM conference on AI, ethics, and society (pp. 60-66).

Grant, A. and Goodman, B., 2018. Communication and Interpersonal Skills in Nursing. Learning Matters.

Hammar, L.M., Holmström, I.K., Skoglund, K., Meranius, M.S. and Sundler, A.J., 2017. The care of and communication with older people from the perspective of student nurses. A mixed method study. Nurse education today, 52, pp.1-6.

sagepub.com 2016. Family caregivers’ conceptualisation of quality end-of-life care for people with dementia: A qualitative study, available at: https://journals.sagepub.com/doi/full/10.1177/0269216316673552 [Accessed on: 5th November, 2020]

Siau, K. and Wang, W., 2020. Artificial intelligence (AI) ethics: ethics of AI and ethical AI. Journal of Database Management (JDM), 31(2), pp.74-87.

Sleeman, K.E., Leniz, J., Higginson, I.J. and Bristowe, K., 2018. Is end-of-life care a priority for policymakers? Qualitative documentary analysis of health care strategies. Palliative medicine, 32(9), pp.1474-1486.

springer.com 2020. Sexuality, Aging, and Dementia, available at: https://link.springer.com/article/10.1007/s12603-020-1345-0 [Accessed on: 12th January, 2021]

Valderama‐Wallace, C.P., 2017. Critical discourse analysis of social justice in nursing's foundational documents. Public Health Nursing, 34(4), pp.363-369.

World Health Organization, 2018. Quality, equity, dignity: the network to improve quality of care for maternal, newborn and child health: strategic objectives. Unicef, pp.11-17.