The Implementation of a Model of Person-Centred Practice In Older ...

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The implementation of a model of person-centred practice in older person settings the ward facilitated a process to find out if other residents would be interested in making the trip to knock which is approximately 50 miles from Carrick on Shannon. The outcome was that five residents, three of whom were accompanied by their families and staff members went on a day trip to Knock Shrine in 2008. Feedback was very positive from everyone, one of the residents has since died and the family have specifically expressed how they enjoyed the experience and how much it meant to their mother and also to them to be able to make this trip. Nutrition and Mealtimes During the programme, development work commenced in relation to nutrition and mealtimes for residents in both sites. This was identified as a result of observations of care, environment observations and patient narratives and staff/resident discussion and also in response to HIQA standards. Action plans that include the establishment of working groups are currently in progress in both sites, this is long term work involving the MDT and has many different perspectives. Providing choice around particular foods has been achieved at the request of residents, the following example demonstrates this, one resident identified that his relative brought him strawberries every year and it was a special treat, he was unaware that he could have strawberries everyday if he wanted, but he didn’t know and it was only through dialogue with residents in a meaningful way that this resident was able to voice his opinion and choice to a staff member. The learning achieved demonstrated that by utilising PD process and the Person-centred Care framework person-centred outcomes can be achieved. End of Life Care End of life care issues were introduced and linkages to the resources from the Hospice Friendly Hospitals (HfH) Programme were accessed by both sites. In Falcarragh the introduction of ‘Hospice Friendly Handover Bags’ and sympathy cards for relatives of the bereaved was successful and is now a firmly established practice and was initiated by the PD group. The PD group in St Patrick’s are involved in action planning in relation to end of life care and have established two multidisciplinary sub groups and have been expanded to include members of staff outside of the PD group including community representations for example, spiritual leaders, General Practitioners, volunteer representatives, HSE estates and funeral directors. The sub groups work 61
The implementation of a model of person-centred practice in older person settings collaboratively with the Pastoral Care Group in the hospital. The groups established represent the following: 1. Spiritual and psychological issues in relation to end of life care 2. Clinical and environmental issues in relation to end of life care The following is an overview of the PD work as a result of action planning that has been completed and in progress in relation to end of life care in St Patrick’s. • Completion of the church renovation and the installation of a video link throughout the hospital. • The introduction of specific personal property bags and sympathy cards to families is now current practice. • Clear linkages have been made with the national HFH Programme. • The development of the healthcare teams’ professional needs in relation to end of life care is ongoing through education, support and in collaboration with the HfH, Hospice and Centres of Nurse and Midwifery Education. • The creation of a ‘black bow’ in the event of a death of a resident. This is a symbol attached to each ward door on the day of a death of a deceased person that gives respect and dignity. • The introduction of the shroud for the vehicle that removes the body of the deceased to the mortuary. • New white linen was purchased for each ward to be used when laying out a resident who has died. • The introduction of aromatherapy diffusers for ward areas. • Recently, access to the mortuary has been reviewed and renovated. A new access route has been established through the construction of a new ramp system. Consultation with relevant people and organisations (HSE, HfH, residents and staff) has been part of the development work. This will ensure dignity and privacy for the transportation of the deceased person from the hospital to the mortuary. • Plans are in progress to develop a sensory garden; an area has been identified at the side of the community hospital which is accessible for residents. 62
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