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The concept of quality of life
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As the Manager of Meadows Sands I am determined to improve the life choices and quality of life of all adults for whom we provide support and services. I recognise that, for the majority of people, people make decisions affecting their lives on a daily basis. It is important that individuals are supported in making their own decisions and deciding for themselves how support and services should be organised to meet their needs. It is also crucial that those people lacking the capacity to make certain decisions for themselves receive adequate support when decisions are made in their best interests.
To this end, all services and support are organised to allow individuals to direct their own support as able and it is practicable for them to do so.
In all instances where issues of risk and choice are being discussed, it is imperative that accurate records are kept of these discussions, to ensure that processes have been properly followed and decisions recorded.
Informed choice
An informed choice means that a person has the information and support to think the choice through and to understand what the reasonably expected consequences may be of making that choice. It is important to remember that too much information can be oppressive and individuals have differing needs in relation to how information is presented to them.
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For example if a person „chooses‟ to stay in bed all day, every day, the local authority or provider organisation has a responsibility to explore what is happening and respond to this appropriately, working to ensure that the individual fully understands the consequences of their decision. It is not acceptable to simply accept such a decision at face value if this would put the individual at significant risk, as acts of omission can be considered to be
an assessment of their community care needs under the NHS and Community Care Act 1990.
Jahi McMath is a 13-year-old girl living in Oakland, CA who was declared brain dead by multiple neurologists more than three months ago. Jahi was declared brain-dead December 12th after barriers during surgery a few days earlier to remove her tonsils, adenoids, and uvula at Children's Hospital & Research Center Oakland. At least three neurologists confirmed that Jahi was unable to breathe on her own, had no blood flow to her brain, and had no sign of electrical activity in her brain. Moreover, a court order kept Jahi's body on a ventilator while independent experts could be brought in to confirm the results (Wells, 2014). Even so, the McMath family was able to secure the release of Jahi's body through the county coroner, who issued a death certificate, and have been keeping her on a ventilator at an undisclosed facility ever since. This all occurred after Children’s Hospital released Jahi due to her severe brain damage along with the probability of the hospital receiving profit from discharging Jahi before her or her family were ready for her to be released (Johnson and Rhodes, 2010, p. 61).
The case study will identify a number if strategies to apply supportive approaches using the principals and practices of providing person-centred care, reflected against a real client situation within an organisational perspective. The case study is considering the situation with reflection of the two questions chosen from the Person-centred Care Assessment Tool. In relation to one’s ability to engage and be supported in the facilitation and management of person-centred care directives, within the role of a leisure and health officer.
In the case study, Betty was adamant in refusing treatment, despite the risks of the illness progressing and potentially leading to death; under the laws of the medical treatment act (1988) any adult who exhibits competency has the right to refuse treatment, even if refusal of care increases the risk to their health, this right is based on autonomy (3). The information outlined suggests that Betty was capable of making a decision as she fulfils all the elements of consent; therefore she is competent and has the right to deny treatment. Betty acknowledges the risks of not receiving treatment and admits that not receiving treatment will make it difficult, demonstrating her sound understanding of the risk and benefits of the outcomes. For a patient to fulfil the element of understanding they must receive, process and incorporate the information they are provided with into their own personal values and Betty demonstrates this level of understanding by sticking to her values, her decision to stay home and by acknowledging the difficulties and risks of not receiving treatment (3). Once Betty received a diagnosis she was informed by the paramedic of the outcomes and potential risks of not receiving treatment for her condition, Betty was sufficiently informed with information and risks relevant to her situation, enabling her to make an informed decision (3). In order for consent to be considered voluntary, a patient must consent to treatment in an environment free of threat and pressure; if a patients decision is genuine they will also accept responsibility for the outcomes and understand the risks (3). Voluntary consent is a slightly grey area in Betty’s scenario, her son is potentially placing pressure on Betty with his demands, however, Betty expresses responsibility by admitting it will be difficult to and
Everyone has the right to make his or her own decisions, health and care professionals must always assume an individual has the capacity to make their own decisions unless it’s proved otherwise through capacity assessment.
Content 1.1 how principle and support are applied to ensure individuals are cared for in health and social care practice.
The Open University (2010) K101 An introduction to health and social care, Unit 3, ‘Social Care In The Community’, Milton Keynes, The Open University.
The CPA is a care management process for people with mental health and social care needs, including managing associated risks. The CPA main elements are: Assessment, Care coordinator, Care planning, Review, Transfer and Discharge. The National Standard Framework for Mental Health introduced it to supply a framework for effective mental health care (DOH, 1999; DOH, 2008; Gamble, 2005). Under CPA, John may use an Advance statement to illustrate his personal preferences and what he would like to happen in regards to his personal and home life should they come to lack capacity. These are important mechanisms for safeguarding and promoting a patient’s interests and health. The CPA is grounded in values and principles that are central to personalisation brought about when in March 2008 ‘Refocusing the Care Programme Approach’ was issued. This updated guidance highl...
This essay will show how Goffmans theory concerning total institutions is supported and why this can cause difficulties to service users. It will also show why it important for care workers to help service users to have a voice and be heard to enable them to express their thoughts, feelings, ambitions and requests. This can by clearly illustrated by the case studies of Margret Scally a resident of Lennox Castle, an interview with Colin Sporul and Allen Williamson two nurses at Lennox Castle and final Lesley Learmonth. The essay will also show how care workers can facilitate in the process to ensure service users are confident in speaking out when they need to in the future.
Service user involvement and participation has become a standard principle in guiding social care planning in order to improve in the developing and delivery of service to meet diverse and complex needs in a more effective way. Key pieces of legislation states plainly that service users through a partnership approach should be enabled to have voice on how the services they are using should be delivered (Letchfield, 2009). The Scottish Executive (2006a:32) helpfully state ‘Increasing personalisation of services is both an unavoidable and desirable direction of travel for social work services. Unavoidable in the sense that both the population and policy expect it; desirable in the extent to which it builds upon the capacity of individuals to find their own solutions and to self-care, rather than creating dependence on services’
Health and social care professionals encounter a diverse amount of individuals who have different needs and preferences regarding their health. As professionals they must ensure that all services users, whether it is older people with dementia, an infant with physical disabilities or an adult with an eating disorder (National Minimum Data Set for Social Care, [no date]), are treated in a way that will successfully meet such needs. In fact, health and social care professionals have a ‘duty of care’ towards services users, as well as other workers, in which they must legally promote the wellbeing of individuals and protect them against harm, abuse and injury. (The Care Certificate Workbook Standard 3, [no date]) Duty of care is a legal requirement
Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed consent, the patient must be aware and should be able to give a voluntary consent for the treatment and testing without being coerced, even if coercion is very little. Being coerced into giving consent is not voluntary because others people’s opinions account for part of his decision. Prisoners and the poor population are two areas where coercion is found the most when giving consent. Terminally ill patients also give consent in hope of recovering from their illness. Although the possibilities are slim of having a successful recovery, they proceed with the research with the expectation of having a positive outcome. As stated by Raab, “informed consent process flows naturally from the ‘partnership’ between physician and patient” (Raab). Despite the fact that informed consent is supposed to educate the patients, it is now more of an avoidance of liability for physicians (Raab). Although the physician provides adequate information to his patient, how can he ensure that his patient properly ...
Within this essay, I will reflect and critically analyse an OSCE which has increased my awareness, or challenged my understanding, in assessing the holistic needs of a service user (John), referred by his GP, whilst incorporating a care plan using the Care Programme Approach (CPA). By utilising this programme and other sources of current literature, I hope to demonstrate my knowledge and understanding in relation to this skill as well as identifying areas with scope for learning.
There is a strict distinction between acts and omissions in tort of negligence. “A person is often not bound to take positive action unless they have agreed to do so, and have been paid for doing so.” (Cane.2009; 73) The rule is a settled one and allows some exceptions only in extreme circumstances. The core idea can be summarized in “why pick on me” argument. This attitude was spectacularly demonstrated in a notoriously known psychological experiment “The Bystander effect” (Latané & Darley. 1968; 377-383). Through practical scenarios, psychologists have found that bystanders are more reluctant to intervene in emergency situations as the size of the group increases. Such acts of omission are hardly justifiable in moral sense, but find some legal support. “A man is entitled to be as negligent as he pleases towards the whole world if he owes no duty to them.” (L Esher Lievre v Gould [1893] 1 Q.B. 497) Definitely, when there is no sufficient proximity between the parties, a legal duty to take care cannot be lawfully exonerated and imposed, as illustrated in Palmer v Tees Health Authority [1999] All ER (D) 722). If it could, individuals would have been in the permanent state of over- responsibility for others, neglecting their own needs. Policy considerations in omission cases are not inspired by the parable of Good Samaritan ideas. Judges do favour individualism as it “permits the avoidance of vulnerability and requires self-sufficiency. “ (Hoffmaster.2006; 36)
Making decisions is an important part of our everyday life. Decisions define actions and lead to the achievement of goals. However, these depend on the effectiveness of the decision-making process. An effective decision is free from biases, uncertainties, and is deeply dependent on information and critical thinking. Poor decisions lead to the inability to achieve set objectives and could lead to losses, if finance is a factor. Therefore, it is important to contemplate about quality and ways to achieve it in decision-making, which is the focus of this paper. The purpose is to look into the needs of decision-making, including what one should do and what one should not do.