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Chapter 5 Findings
“Dr. spoke to John informing him of probable cancer. Asked if he
wanted son/family informed but refused.Also refused to get pastoral
care involved.”
“Independent with ADLs” was written in many of the residents’ daily
nursing notes suggesting that the resident is self-governing, self-ruling and
self-determining. This was deemed to be evidence of the attribute but it is not
known for certain if this level of self-rule experienced by these residents was
due to their level of independence with activities of living or due to being
enabled to self-rule by the staff of the unit.
Hence the analysis revealed that this element (self-governing, self-ruling and
self-determining) was more evident in the notes for residents who were more
physically independent.
5.7.2 Element 2: Care Plans are Negotiated and Family are Involved
This was judged to be evident if there was documented evidence that staff had
assisted a resident in verbalising their needs or had advocated for them to ensure
that their needs were met. Examples included documented compromises and
negotiations and documentation of family wishes.
The analysis revealed that there was little evidence of this element. Only 13%
(n=5) of resident notes had any documented evidence (Figure 5.13). In these
notes actions identified as examples of the element related to doing something
for a resident that they had requested, e.g. sending a resident’s hearing aid for
repair. In some notes staff had noted a referral to another member of the
healthcare team:
“Complained of chest tightness – Dr. on call informed.”
In one note the nurse stated that it was important to:
“Ensure that resident x reaches their full potential by liaising with
physiotherapist.”