Wilson - Caring for people with dementia: a shared approach

A Shared Approach

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Christine Brown Wilson 2017

First published 2017

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Library of Congress Control Number: 2016954243

British Library Cataloguing in Publication data

A catalogue record for this book is available fromthe British Library

ISBN 978-1-4129-6199-8

ISBN 978-1-4129-6200-1 (pbk)

Editor: Becky Taylor

Assistant editor: Charlne Burin

Production editor: Katie Forsythe

Copyeditor: Jill Birch

Proofreader: Thea Watson

Indexer: Gary Kirby

Marketing manager: Tamara Navaratnam

Cover design: Wendy Scott

Typeset by: C&M Digitals (P) Ltd, Chennai, India

Printed in the UK

This book is about enabling person-centred and relationship-centred care in practice and highlights the importance of culture in advancing this perspective. Dr Brown Wilson calls this perspective relationship-based approaches to care. An important message she shares in the introduction of the text is: To achieve the best care possible, we need to prepare nurses and other health care practitioners with the skills and attitudes to provide effective culturally responsive care. As a dementia researcher and health professional I am very supportive of this statement and I would like to promote this book as one way to help readers and students to prepare for the practice of evidence-based care of people with dementia. Dr Brown Wilsons message encouraged me to reflect on several situations in my teaching, research and family where relationship-based approaches to care were espoused but often not connected within practice. I share some of these reflections below in the hope that they demonstrate the importance of culture and relationship-based approaches to care.

Some years ago when I was teaching a postgraduate class about dementia I was confronted half way through the semester by a small group of students from a culture outside of Australia. These students argued with me that they didnt know why I was teaching subjects such as person-centred care, relationship-centred care and non-pharmacological approaches to care as these practices went against what was accepted and current practice in their country. For example, in their culture if a person with dementia was agitated or aggressive the family or health professional would manage the person and situation by giving them psychotropic medication and tying the person to a chair or locking them in a room. They argued that this resulted in the problem being contained: there was no longer a problem for staff or family of an agitated or aggressive person, and this was acceptable in their practice. I felt the floor opening up to me as I realised my teaching was representing an Australian culture of care and I had neglected to allow students the opportunity to examine their beliefs and practices in relation to evidence-based relationship approaches to care. This was a perfect opportunity for me to reflect on my teaching practice and to consider alternative ways to assist students from any culture to discuss and to understand why some practices even though they are common are not best for the individual. I hope readers of this text will also be open to practices that may be new to them and to take note of the approaches outlined by Dr Brown Wilson in this text.

A few years ago when asking staff from a residential aged care facility to tell me about their philosophy of care they all quickly expressed that the philosophy of care in their organisation was person-centred care (PCC). However, not one of these staff could tell me what they did in their practice to advance PCC. They knew the words but they didnt know how to play out such a philosophy within the care situation, as PCC was not incorporated or truly embraced within their organisation. Unfortunately even today I continue to see similar examples where PCC sits in broad statements within an organisational mission statement but is not truly practised. This text will help readers to understand the importance of culture and the impact of culture on care provision.