Unit 4 - Health and Social Care

Is my essay good so far?
Principles of Effective Care
Anti-discriminatory practice is described as an approach where patients or service users are treated with respect regardless of their health status, age, gender, religious beliefs, and other characteristics (Nzira and Williams, 2016). It is well-established in literature that patients with dementia, those with learning disabilities, individuals with progressive and debilitating disorders, and those with different religious beliefs and practices often experience discrimination when accessing health and social care services (Togioka et al., 2024). Ensuring that these persons are legally protected against discrimination is crucial in promoting their health and wellbeing. In the UK, the Equality Act 2010 (UK Legislation, 2010) underpins anti-discriminatory practice and outlines the different characteristics that are legally protected in the UK. Legislations such as the Equality Act 2010 promotes person-centred and holistic care for these individuals. In Doha, the Bill of Rights of the patients remain as the main guide in protecting patients and preventing anti-discriminatory practices.
In the first case, Sabha, a 25-year old patient, will be transferred to a facility with people who are around her age. Sabha has a progressive disorder that affects her muscles, which make it difficult for her and her family to take care of her needs. In the case, Sabha was angry that she was admitted to the care facility. Literature (Brown et al., 2023) has shown that young adults suffering from a progressive muscular disorder can experience frustration, grief and anger due to loss of function of their limbs or muscles. These feelings could be heightened especially if they feel that they are becoming a burden to their families and need to be transferred to a care facility. In the case, Sabha understands that her ageing parents and siblings could no longer support her care needs. The action of placing her in a facility with people close her age is important as this can potentially promote Sara’s wellbeing and prevent discrimination.
Transferring Sabha to a care facility with people closer to her age can promote social engagement and reduce feelings of isolation since she will participate in age-appropriate activities (Beresford and Stuttard, 2014). Living in a facility where others are also experiencing the same condition(s) or physical limitations can help her feel that she is not alone. Her peers may offer emotional support, which in turn can improve her coping mechanisms (Reynolds et al., 2022). This type of care facility can also promote her independence and identity despite her progressive condition. However, there are still challenges when living in this type of facility. For instance, Sabha’s progression of her condition might differ significantly compared to her peers in the facility, thereby creating challenges when coordinating her care (Aubrecht et al., 2021). Sabha might also witness the deterioration or decline of her peers, which might result in grief and depression (Reynolds et al., 2022).
Sabha’s case also requires that reasonable adjustments should be made to accommodate her needs. Providing her with holistic and personalised care during her stay in the care facility is crucial as this ensures that her care needs are addressed. Anti-discriminatory practice promotes the wellbeing of individuals by ensuring that reasonable adjustments are made to ensure that that care needs are satisfied (Swihart et al., 2023). For instance, Sabha should not be discriminated due to her physical condition. This will require the healthcare staff in the hospital to request special meals and adjustments to her physical environment to meet her needs. The ethics principle of beneficence states that healthcare interventions should be beneficial to the patients and promote their emotional, physical, mental and spiritual wellbeing (Beauchamp and Childress, 2019). Hence, making reasonable adjustments to meet the physical needs of Sabha will be aligned with the ethics principle of beneficence.
From this case study, the centre’s health and social care staff is following anti-discriminatory practices as effort is made to make reasonable adjustments for Sabha. The support that Sabha receives from the carers and professionals will promote her health and wellbeing and feelings of being included in the care process. However, there are still limitations even with the observation of reasonable adjustments. As outlined above, challenges on how to maintain an environment where Sabha feels included and supported can remain. Hence, providing her with the needed support as her own condition deteriorates could help alleviate perceptions and feelings of being isolated and lonely.
In the second case, Nusrat, an 86-year female patient with dementia is admitted to the residential facility for further assessment of her behaviour. She has become violent and for hers and her family’s safety, she is placed in a residential facility. This action ensures that Nusrat receives care while undergoing assessment in a safe environment. Further, placing her in the care facility allows the staff members to monitor her condition and reactions to medications. Nusrat’s case exemplifies anti-discriminatory practice since she will be given tailored and personal care in the residential facility. For instance, a structured environment can promote comprehensive assessment and identify the root cause(s) of Nusrat’s challenging behaviour (Gkioka et al., 2020). She can also access specific behavioural management strategies such as activity engagement, calming techniques and redirection (O’Donnell et al., 2022). However, to achieve this, it is crucial for the healthcare staff to be trained to manage challenging behaviours. Further, the staff also have to identify triggers and verify if her medication(s) cause her behaviour. This can be difficult as patients like Nusrat may have difficulties in communication (O’Donnell et al., 2022). Hence, being trained on how to communicate effectively with patients like Nusrat is vital in residential care facilities.
It is noteworthy that communication challenges can also be a trigger to challenging behaviour in dementia patients (Rousseaux et al., 2010). As they struggle to express their frustrations of not being understood or when they struggle to express their needs, this can lead to behaviours such as repetitive actions, aggression, and agitation (Banovic et al., 2018). People with dementia also find it difficult to understand complex language, or follow conversations, which can heighten feelings of frustrations or lead to disruptive behaviour (Banovic et al., 2018). It should be noted that challenging behaviours are a means for those with dementia to communicate emotions such as pain, fear, confusion or anxiety that they have difficulties in verbally expressing (Rousseaux et al., 2010).
As demonstrated in the case, the staff members also have to balance the need for Nusrat to receive her medication to manage her behaviour while also addressing potential side effects. Since it is suggested that her behaviour may be caused by her previous medications, the staff has to determine which of her medications is causing her behaviour. Results from these observations will allow staff members to tailor her medications according to her needs. Further, the staff members also have to navigate Nusrat’s family concerns, involve them in care planning and manage their expectations (Enmarker et al., 2011). Specifically, staff members have to reassure the family members that Nusrat is receiving the care she needs and is safe from harm in the facility. This can be concerning for family members as Nusrat’s behaviour may escalate especially when placed in a new environment (Enmarker et al., 2011). Hence, the ability of staff members to de-escalate situations could provide assurance to the family members that they can manage Nusrat’s behaviour and still treat her with respect and dignity.
Meanwhile, Nusrat may also feel disrespected due to her cognitive impairment and physical limitations. Further, she may also face difficulties interacting with other service users due to her disabilities and limitations (Irmo et al., 2017). It is necessary for care staff members in the care facility to help service users like Nusrat feel included and to promote an environment where she feels respected and cared for. Implementing legislations such as the Equality Act 2010 (UK Legislation, 2010) or similar laws in Doha can create a supportive environment since reasonable adjustments will be made. This is important as historically, people with dementia and those with disabilities are often treated with intolerance, ignorance, prejudice and ambivalence (Irmo et al., 2017). Making reasonable adjustments, such as educating other service users about the needs of people with dementia, and practicing de-escalation techniques could promote Nusrat’s wellbeing.
An evaluation of the centre through the two case studies shows that healthcare staff members also practice anti-discriminatory practices. However, safety concerns for both Nusrat and the staff members remain. While this is a valid concern, this can be addressed through training staff members on how to de-escalate challenging behaviour, and identify triggers early in the care of the patient. Further, creating an environment where Nusrat feels at ease and calm could promote her health and wellbeing. For instance, a quiet environment and implementing evidence-based interventions to reduce aggression could lead to increased patient satisfaction and higher quality of care. In Sabha’s case, there is a need to create an environment where she does not feel isolated and lonely.