Aggression in dementia

Aggression in dementia Introduction Aggression in people with dementia is a behaviour that can be evident is care environments where dementia care is given. This is a issue that is becoming a growing health concern (Jackson and Mallory, 2009: Alzheimer’s Society, 2014: Cipriani et al. 2011). This is an issue that is likely to keep growing and developing as the population continues to age. (Nguyen, Love and Kunik. 2008). This is an issue that needs to be managed well with good leadership and guidance from management and nursing staff and the input from all relevant members of the multidisciplinary team charged with caring for individuals who show signs of aggressive behaviour and this is critical in making this achievable and protecting patients and residents in long term care environments from potential harm. This piece of work will look at a practice situation from a clinical placement area that highlights how resident safety can be an issue within a care environment. This will explore the nursing leadership sk ills and management that where utilised to address this particular situation and how all care professionals within the multi-disciplinary team (MDT) were involved and the impact this had on all team members. Situation The situation developed whilst the student was on a first year placement in a nursing care home which specialised in the care of people with varying types and levels of dementia. The situation involved a male resident who was showing signs of aggression towards other residents, both male and female. The staff where as vigilant they could be, but due to limited staff. Aggressive incidents did occur where staff had to attend and separate the residents and try to diffuse the situation. This particular person was developing unusual behaviours that manifested in the individual was found over a period of time to have been getting into various female residents beds when the residents where in them sleeping. This was initially highlighted by the care staff to the nurse in charge when it was found that this person was found in resident’s rooms and subsequently in female resident’s beds. This was however not acted upon as the nurse thought that this may be a temporary issue and a dvised care staff to observe this person as much as reasonably possible. This situation however escalated when it was discovered that a female resident was found to be extremely upset and agitated and it was discovered that this was due to this individual in question being in the same bed as her and had woke her up. This resulted in an emergency meeting having to be arranged between the nurse in charge and members of the MDT team who were involved in the care of this individual and then trying to formulate a suitable strategy that would benefit the care environment, i.e. minimise the issues that had happened and to prevent further issues developing. The nurse in charge and the management also were aware this person still had to have a good quality of life within the environment and promote the safety of the other residents within this care environment. Main body The Nursing and midwifery council (NMC) code of conduct (2008) emphasises that nurses in all care environments have a duty of care to protect individuals in their care from any form of harm, be it from staff, family members or other people within the particular care environment they are being cared in. This can be extremely challenging as nursing care homes may take residents who possibly are not suitable for the care environment, which then adds to the pressure and may increase the violent incidences that potentially may happen (Social Care Institute for Excellence (SCIE), 2011; Care Quality Commission (CQC) 2014) Aggression between residents of nursing care homes and other long term care facilities is an issue that is becoming more common as people age and their health issues become more complex (Rosen et al. 2008). Moreover; nursing home resident safety is an issue that has been report widely by media organisations such as daily mail (2014) and governing bodies for example Health and Safety Executive (HSE) (2011) and as Hughes and Lapane (2006) highlight there are some issues with how nurses and care staff perceive resident safety. This shows how important communication of issues, such as highlighted within the practice situation and how there are potential issues with trying to make sure resident safety is uppermost in the way care staff operate. Furthermore; also highlights that training within care environments can play a pivotal role in helping staff recognises when issues as shown in the practice situation are displayed. Agency for Healthcare Research and Quality (AHRQ) (2011) also emph asises an issue which has become so common within care environments, this being ‘staffing levels’ and this can be critical in making sure resident safety is at an optimum level. (Harrington et al. 2011). Leadership and leadership styles Nursing leadership as defined by Porter-O’Grady (2003) as, â€Å"a multifaceted process of identifying a goal, motivating other people to act, and providing support and motivation to achieve mutually negotiated goals† All nurses will lead and manage individuals throughout their career and for them to be effective leaders. There are specific skills that nurses require to develop, for example; able to delegate, communication, decision making, ability to inspire, conflict management and motivation as emphasized by Middleton (2011) and Contino, (2004). These are only some of the skills that need to be developed by nurses to be effective leaders. Moreover; there are a number of leadership theories which have given rise to various styles of leadership, for example; the trait, behavioural and transformational leadership theory (Yoder-Wise, 2014). All the above theories give rise to various leadership styles that are influenced by the following factors; individuals’ flaws, their qualities and the skills they have attained (Bishop, 2009). The trait theory approach relates to traits that create and effective leader and can be seen in an historical context as leaders who were born or advanced into leaders, for examples of such people are royalty, politicians and religious leaders (Valiga and Grossman, 2007; Brown, 2011). Behavioural theory approach is down to the behaviours, characteristics and personal traits and this approach can be seen as; leaders can be made rather than born and that leadership can be learned and transformational leadership can be defined as the use of charisma, inspiration, intellectual stimulation and consideration for individuals (Smith, 2011) The nurse in charge in the situation demonstrated the following leadership style, this was situational leadership style. Situational leaders can be seen to encompass supportive and directive behaviours and have specific characteristics, these are; telling, selling, participating and delegating. These can be seen with the level of guidance or direction from the leader, level of socio-emotional support from the leader and subordinates maturity (Balista, Furtado and Silva 2011). The leader applies this to whatever situation they come across adapting this as necessary and involves using the appropriate leadership skill to the said situation to motivate and utilize the capabilities of the workforce (Edmonson, 2010). Giltinane (2013) describes situational style leaders as open to change, flexible, evaluating the situation, adapting skills and tasks to the maturity of the individual being led and task orientated. Even though the nurse in the situation did not initially sort the issue, she evaluated the situation and decided on what leadership skills that best suited the situation and the best approach to use to minimise further issues from developing. All styles of leadership have benefits and drawbacks (Sullivan and Garland, 2010)

Dispensation of Study Abroad

I have been informed by the University of the need or requirement to allow myself the greatest opportunity of studying abroad and completing the said course requirements by writing a dissertation. The requirement of studying abroad was dispensed to one of the great universities in Japan. I realized that the experience would be a great opportunity for me to grow and develop my knowledge, skills, and competencies academically, as it will help me deal with the challenges and difficulties that my chosen career would present in the future.Although the prospect of studying abroad is as appealing to me as it is for other students, I would have to express my refusal and inability to complete such requirement for various reasons that I am in no control of. First, I have lived in Malaysia for more than eighteen years. Although I have struggled to learn the English language in order to cope with the challenges of multiculturalism and globalization, the application of this particular experience for the Japanese language has not been the same.My knowledge and skills of the Japanese language, as well as in writing and reading Japanese scripts, is limited consequently restraining how I would go about studying in the University and living in the country. Second, aside from my limited knowledge and skills in speaking, writing, and reading in the Japanese language, I would have to admit that I do also do not have prior knowledge of the Japanese culture.Since I intend to work in Japan while I am studying, I do not think that I would be able to handle studying and working in a foreign country of which I do not know anything about. I am expecting that my limited knowledge would offer implications to how I conduct myself considering the differences on how Japanese people regard conduct and manners. I perceive that adjusting to the culture of the country would be quite difficult to overcome.Third, I am looking into developing my communication skills first due to the opportunity of do ing so in the Open Class system at Waseda University. I am planning to take a courses or lessons with other students belonging to other departments with which I will be able to practice and develop my communication knowledge, skills, and competencies. I believe this is one of the most important steps to take prior to engaging myself in culturally difficult situations in a foreign country.Fourth, and the last reason why I am expressing my refusal and inability to complete such requirement, my financial status as of the moment hinders my aspirations to study abroad. Judging from the financial resources made available to me and my family, I believe that my parents will not be able to fund all the fees and expenses that would support my studying abroad. For the aforementioned reasons, I am unwillingly expressing my repudiation of this particular requirement proposed for my benefit. I thank your kind office for providing time to read my letter. Good day!

Terry Tempest Williams Refuge Essay examples - 1926 Words

Terry Tempest Williams Refuge In Refuge, Terry Tempest Williams weaves together her experiences and relationships with family and nature, two major themes of Refuge, as well as two apparently important aspect of Williams’ life. The book is the story of the destruction of her family and the nature surrounding her, but it is these places that are being destroyed are the same places where Terry Tempest Williams finds comfort before, during and after cancer started to consume her life. I believe on the surface it is nature and family that provides her with comfort, but in actuality, it is something beneath the surface. As a young child, Williams was taught through the Mormon teachings to appreciate nature and family, finding God in†¦show more content†¦Williams became her mother’s support, spending the last few years of her mother’s life in an understanding relationship of support and connection. The support Williams gave her mother was essential in helping her mother cope with cancer. Williams’ family support network eased her own pains caused by witnessing her mother’s and grandmother’s suffering with cancer, being a potential cancer patient herself. This support network, which the Williams’ family demonstrates, gives patients release of emotions that accompany cancer. The week after Williams’ mother was diagnosed with cancer, she stated, â€Å"I’ve experienced every possible emotion this week† (Williams 34). This build of emotion can be overwhelming for any one, making the release of emotions critical. A study done by the American Cancer Society found that releasing emotion is beneficial during treatment and can help patients and family members cope (ACS website www.cancer.org). The Mormon faith emphasizes family and community, which is a healthy place to release this emotion, which is described in Refuge. On one such occasion, Williams’ mother states, â€Å"I feel abused† when describing chemotherap y (Williams 77). The close family connection between the Williams family reestablishes the teachings of Mormonism of family and community and helps TerryShow MoreRelatedEssay on Terry Tempest Williams Refuge1182 Words   |  5 PagesTerry Tempest Williams Refuge If we bemoan the loss of light as the day changes to night we miss the sunset. In her memoirs Refuge, Terry Tempest Williams relates the circumstances surrounding the 1982 rise in the Great Salt Lake as well as her mother’s death from cancer. Throughout the book Williams gets so caught up in preventing her mother’s death that she risks missing the sunset of her mother’s life. However the Sevier-Fremont’s adaptability to changes in nature inspires Terry TempestRead More Terry Tempest Williams’ Refuge Essay1049 Words   |  5 PagesTerry Tempest Williams’ Refuge Adaptation is the source and story of a species’ survival. Human beings’ journey across and habitation of the earth’s surfaces demanded resilience to change. 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The Arab nation states all share parallel cultures thus...

The Arab nation states all share parallel cultures thus when considering Arab hospitality, we can say that the ‘communities of the Middle East share a common set of cultural idioms’ (Zubaida, 2000). Nevertheless, each Arab state is still different from one another, thus Arabs from each state have their own identity and cultural practices to follow. The Arab World has always been a huge part of the food environment, even before nationalism subsisted. In the Arab world, food can be used to tell the history of the Arabs, thus shows how significant its role is in the Middle East. In this essay I will explore the ways in which Middle Eastern culinary culture has evolved over centuries and the factors revolving around Arab food culture. The†¦show more content†¦These nomads needed to trade in order to earn money to survive. Therefore over some time, food trading meant that the nomads would eventually try foreign foods thus influence their taste. Influence may have also come from regions where the Arab armies invaded and settled. More examples of traditional trade routes into Europe, Asia and Africa will show that due international trade and colonialism, Arabs were able to get coffee from Yemen whereas spices usually came from China and India which was one of the first foreign foods to be widely used. During the 19th century, England had overthrown Egypt where rice production begun for the British, thus this is where Arabs were introduced to rice. Trade links has also affected the food culture over a long period of time, as many years ago raw ingredients were considerably cheaper and a lot more easily available. Iran is a region that has not only been both invaded and occupied, but this has led to develop new traditions in the region thus changing the existing food culture. The Turks as well as the Greeks and Romans particularly influenced Iranian culture. Iranian food is extremely similar to Turkish food that it is difficult to distinguish what foods came from which origins. Arab hospitality had begun in Lebanon, where its traders had always been extremely well known to the world. 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