Caring for individuals with dementia requires a thoughtful, structured approach that respects their unique needs and challenges. Central to this approach is the care plan—a document outlining specific strategies and interventions tailored to each individual’s condition, symptoms, needs and preferences for daily care. It differs from the basic information such as food/nutrition requirements, staffing needs for doing lifts/transfers or medication regimes. However, despite its critical role, it seems that many care professionals, including professional caregivers, often fail to thoroughly review, follow, or update care plans, potentially jeopardizing the quality of care provided.
Importance of Studying and Following the Care Plan
Care plans for individuals with dementia are typically created by a nurse or manager to enhance quality of life, manage symptoms, and maintain stability. Each plan is customized based on comprehensive assessments of the individual’s medical conditions, cognitive abilities, physical health, emotional state, and personal preferences. Adhering to the care plan and the creative strategies outlined, allows professionals to provide consistent care, fostering familiarity and reducing confusion, distress and/or aggression.
Past studies have highlighted a concerning trend where a significant number of care professionals either do not read or do not follow care plans. Many would agree this continues to be an ongoing concern in many long-term care homes today. This lack of adherence can lead to suboptimal care that can negatively impact the well-being of individuals with dementia and a high possibility of unsafe situations as well as increased incidents of aggression.
Possible Reasons for Non-Adherence to Care Plan
Despite the value of having detailed care plans designed to address the complex needs of individuals with dementia, healthcare professionals often struggle to adhere to these guidelines.
This discrepancy can be due to various factors, including insufficient training, high workloads, limited time per shift, and communication gaps within care teams. We will go into more detail below.
Additionally, the dynamic and unpredictable nature of dementia can challenge the perceived rigidity of care plans, leading some caregivers to prioritize their intuition over structured approaches. This means that healthcare professionals may try a strategy once, and if it doesn’t yield immediate results, they might prematurely abandon the care plan, mistakenly believing it has no value or relevance for the resident.
Understanding and addressing these barriers is essential for the effective implementation of care plans. However, given the constant changes in cognitive abilities among people with dementia, care plans can quickly become outdated. Therefore frontline staff should be encouraged to proactively bring their concerns to management for reassessment of the situation.
Lack of Training and Understanding
Insufficient understanding of dementia and lack of training and practice in managing dementia-related behaviours may lead to skepticism or misunderstanding of care plans. Without proper training, they might not fully grasp the importance of consistently recording, sharing, and implementing tailored strategies aimed at mitigating symptoms such as agitation, confusion, and wandering. This attitude can cause them to believe the care plans are impractical, irrelevant, or ineffective for the individuals they support.
Time Constraints
Heavy workloads and time pressures can compel healthcare professionals to prioritize immediate tasks over following detailed care plans. With a high resident-to-staff ratio among most care homes, numerous immediate tasks, and the need to attend to urgent resident needs, caregivers often find themselves operating in a constant state of urgency. This environment leaves little room for the meticulous review and implementation of individualized care plans, which require time and focus to understand and execute properly.
Communication Challenges
Inadequate communication between care professionals and management can lead to inconsistencies in care and misunderstandings about the specifics of the care plan. Additionally, poor communication with individuals with dementia and their families can result in a lack of critical insights into the resident’s preferences and needs. This gap can prevent the adaptation of care plans to reflect the evolving requirements of the resident, reducing their efficacy.
Disagreeing with Care Plans
In an interesting report, by the College of Nurses of Ontario, it states that “All nurses, in all roles and practice settings are responsible for their actions and resulting consequences. As self-reflective and regulated health professionals, a nurse’s clinical judgement or critical thinking skills are always applied in assessing an order.”
However, if a nurse lacks understanding of the complexities of dementia and best practices, disregarding or disagreeing with the care plan can lead to significant harm for the individual and for all staff who are providing the care. For instance, a healthcare professional without dementia training might hastily resort to administering medication to calm a resident before a shower, when simply offering a “Spa Coupon” may result in agreement from the resident and achieve the desired outcome.
The Need for Regularly Assessing and Updating the Care Plan for People with Dementia
Regularly assessing and updating the care plan for a person with dementia is crucial to effectively meet their evolving needs. Many forms of dementia common in long-term care homes are progressive, that is, the symptoms as well as the corresponding care requirements can change over time.
Involving all individuals in the person’s care in the development of the updated plan is crucial. This includes healthcare professionals such as doctors, nurses, and PSWs/HCAs, as well as family members and the person with dementia themselves. Doctors can provide medical insights and updates on the progression of the disease, while nurses PSWs, and frontline caregivers offer practical perspectives on the person’s cognitive abilities, communication, and behaviour as well as their daily care routines and challenges. Family members bring valuable knowledge about the individual’s preferences, history, and personal triggers, which are essential for person-centred care.
This collaborative approach fosters consistency in care through informed and aligned team members implementing updated strategies and goals. It promotes shared responsibility and accountability, minimizing misunderstandings and ensuring unified efforts toward common objectives. Furthermore, involving the person with dementia in the planning process, to the extent possible given their condition, respects their autonomy and provides valuable insights into their comfort and preferences. This holistic and inclusive approach enhances overall care quality, supporting dignity, safety, and quality of life throughout the progression of their condition.
A Final Note on the Role of Care Plans to the Well-being of Someone with Dementia
As addressed above, consistent adherence to care plans is pivotal in promoting the well-being of individuals with dementia. Predictable routines and familiar interventions reduce anxiety, enhance feelings of security, and minimize the occurrence of responsive behaviours.
By taking the time to study, follow, evaluate, and update care plans, especially for residents who have had a history of triggered aggression, care professionals can significantly enhance the quality of life for those they care for. Moreover, managers who support frontline staff in understanding and implementing care plans not only help improve outcomes for individuals with dementia but also foster a more cohesive and compassionate care environment. As we strive to meet the diverse needs of individuals with dementia, honouring their care plans remains a cornerstone in promoting dignity, comfort, and a sense of security in their daily lives.
At Dementia Solutions, we’ve made it our mission to demystify dementia behaviour and continue to explore person-centred, creative, non-pharmacological solutions to manage dementia-related behaviours. We believe that awareness creation and skill-building through education is the most effective and powerful tool we have to promote and maintain the well-being of both the person with dementia and their caregiver.
At Dementia Solutions, we’ve made it our mission to demystify dementia behaviour and continue to explore person-centred, creative, non-pharmacological solutions to manage dementia-related behaviours. We believe that awareness creation and skill-building through education is the most effective and powerful tool we have to promote and maintain the well-being of both the person with dementia and their caregiver.
If you need support in your caregiving experience or would like to learn more about our educational opportunities, please reach out to us at [email protected] and we would be more than happy to support you.
DISCLAIMER:
The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.
