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Care professional/service user relationships

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From Patient to Client

• The word patient was used because in the past
  people had to wait around being patient for
  busy health care professionals to find time to
  treat them.
• Today we talk about clients and care aims to be
  must more person centred than professional
  centred

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Person Centred Care

• Places the client at the centre of decision
  making in their care and is care which values and
  respects clients rights, culture, identity and
  well being.
• A key idea being this is the concept of
  personhood

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Personhood

• Personhood recognises and respects the self
  concept and self esteem of the client regardless
  of their background or medical condition.
• A belief in the importance of personhood has led
  to individualised care replacing task orientation
  care in health settings

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Task Orientated Care

• Up until the 1980's the preferred method of
  delivering health care was called "Task
  orientated care". Care workers would deliver care
  by carrying out a set of specified tasks during
  their working day - for example a carer in a care
  home might have had on their task list checking
  all patients were washed and fed, checking
  medication, checking everyone had been given the
  opportunity to go to the toilet in the morning
  etc. The medical care of patients was largely the
  responsibility of the highest qualified medical
  professionals with all decisions being made by
  them.

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Individualised Care

• In more recent times task orientated care has
  been criticised for being impersonal and
  insensitive to the needs and wishes of clients.
  Today in stead of task orientation we have a
  strong emphasis on individualised care with each
  patient having their own individualised care
  plan. Although this is certainly more time
  consuming than a task orientated approach it is
  arguably more effective as it takes into account
  the needs and wishes of the patient him or
  herself.

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Care Plans

• In order to establish a care plan for a patient
  care workers must work through what is down as
  the care planning cycle. The stages in this are
• Assessing needs - this is done through
  observations by care workers and professionals,
  discussions with client family and friends,
  reference to medical notes and earlier history,
  and through conversations with the individual
  patient
• Care Planning - where a detailed, time bound care
  plan is established for the patient. There will
  be specific objectives within the care plan and
  clear guidelines as to what interventions are
  required and by whom
• Implementation/Intervention - which involves the
  actual delivery of the care plan and the
  monitoring of what effect the care plan is having
  on the patient.
• Evaluation of the care plan - where a care
  professional responsible or the team responsible
  evaluate whether the care objectives have been
  met or not

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Barriers to person centred care

• The two main barriers are stereotyping and
  discrimination
• A stereotype is when a person may have a fixed
  prejudiced view of what a certain type of person
  is like child, disabled, elderly, black,
  Islamic etc.
• Stereotyping is very common in everyday life.
  Understanding it, avoiding it and promoting anti
  discriminatory practice are therefore big
  features of all health and social care training
  and policies within health care organisations
  (remember the CVB and remember your portfolio
  work on care settings!)
• Discrimination is when a stereotype leads to a
  client receiving worse care than they have a
  right to expect
• Discrimination damages client self concept and
  self esteem (if youve ever been bullied remember
  what that felt like and youve got the idea!)

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Empowerment

• Empowerment allows clients to make choices and
  take control of their own lives.
• Clients in care settings should be empowered
  this means they need to have accurate information
  from professionals with good communication skills
  about their care plans and their options
• The opposite of empowerment is dependency the
  old way when patients had to accept the care
  and decisions that were given to them