Self Directed Learning Package - University of Queensland

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94 • The Palliative Approach ToolkitAssessmentAfter the reports of problems from the careworkers you conducta comprehensive oral assessment on Alfred.You notice his mouth is coated with food debris and early signsof candidiasis (thrush). His tongue is dry and coated. Alfredbecomes distressed when you attempt to look in the upper rightcorner of his mouth where you notice an ulcer on his gum wherethe denture has been rubbing.It would appear that careworkers are not routinely assessingAlfred’s mouth or providing the oral care he requires. His careplan covers only routine preventative oral care.ManagementKey PointOral care needs to be focused on the specificproblems highlighted during a comprehensiveassessment, not ‘one care plan fits all’.ActivityFor each of Alfred’s oral care problems, identify suitablemanagement strategies.Thinking PointWhy might Alfred’s mouth be in this condition?Consider the influence of Alfred, careworkers, nursesand the organisation as a whole.What steps could you take to address this shortfall incare. In particular, what could you do to ensure that thiswas an isolated incident and would not happen again?
95 • Self Directed Learning Package - Advanced Registered & Enrolled NurseDeliriumKey PointDelirium is distressing not only for the resident butfor family and health care workers.Delirium in older people is often overlooked andmisdiagnosed, especially at the end of life.Health care workers often find it difficult todifferentiate between depression, delirium, anddementia.AssessmentDelirium is a condition where the resident’s behaviour andthinking is disorganised. They struggle to focus, sustain orshift their attention. Sometimes hallucinations or delusions arepresent. It develops over a short period of time and generallyfluctuates during the course of the day. 19It is important to distinguish between delirium, dementiaand depression.
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Self Directed Learning Package - University of Queensland

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