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Chapter 6 Phase Two
successful relationships between the older person and the healthcare professional.
The success of the relationship is determined by the level of negotiation and
mutual recognition of each others beliefs. Kellet et al. (2010) and Cook (2010)
suggest that care planning for older people should adopt a biographical approach
which aims to understand the older person, look beyond their diagnosis and
better explain their presenting behaviours whilst improving communication and
relationships with care staff and families. Tutton (2005) also stated that
understanding personal histories creates opportunities for knowing what is
important to the person. It also provides an insight into how the person is
experiencing their present situations. However, Pearson and Peels (2009)
reported that there appears to be conflict between documentation to meet the care
needs of residents and documentation to meet the needs of management and
administration, and that current approaches are inappropriate. They conclude that
further research is “urgently” required in this area. Based on this literature we
decided that it would be appropriate to design our own care plan rather than
adopt one currently in use elsewhere.
The co-researchers decided to begin by looking at various models used for care
planning in order to determine which was the most appropriate for realising the
attributes of resident autonomy. Collectively we examined four models and
summarised our findings (Table). According to Pearson (1996) at a basic level,
there are three key components to a nursing model:
A set of beliefs and values.
A statement of the goal the nurse is trying to achieve.
The knowledge and skills the nurse needs to practise.
While Fawcett (1995) suggests that the central concepts are:
Person: the recipient of nursing actions.
Environment: the recipient’s specific surroundings.
Health: the wellness or illness state of the recipient.
Nursing: actions taken by nurses on behalf of or in conjunction with a
recipient.