EXAMPLE+from+nurse+theorist+paper

Please note the evil Dr McCook who reigned last summer made her students connect their nurse theorist to a concern identified in what is now the Healthy People 2020 guidelines so the examples I have posted address a specific aspect of health care concern .... yours this summer can simply focus on the theorist and her impact on nursing guidelines detailed elsewhere.

This summary was extracted from a pdf format so it it not in correct APA formatting and is intended as an example of a student who selected a different theorist to examine a specific area related to an interest/passion of hers

Tom Kitwood: A Theory of Dementia Care

Denise Love-Norris PMNU 4957 Special Topics in Nursing June 4, 2010

Tom Kitwood was the founder of the Bradford Dementia Care Group at the University of Bradford and innovated Dementia Care Mapping, an observational method for evaluating the quality of care in formal settings. He died unexpectedly at the age of sixty-one in November 1998. The previous year he published his well-known book Dementia reconsidered: The person comes first (1997), which brought together all his work, developments and discoveries. Kitwood was educated at Cambridge, achieving a BA in Natural Sciences in 1960. After completing his National Service he trained for the priesthood at Wycliffe Hall, and was ordained in 1962. Kitwood completed an MSc in the Psychology and Sociology of Education at Bradford in 1974 and his PhD in Social Psychology in 1977. He taught in the Department of Science and Society until 1985 and then in the Department of Interdisciplinary Human Studies. He became involved in dementia in 1985 when he was commissioned to do a service evaluation for Bradford Health Authority. His interest in dementia was established and the dementia research group was formed in 1986. The group quickly became well known for the promotion and advancement of person centered dementia care. Kitwood went on to found the Bradford Dementia Group in 1992. In September 1998 he was appointed the Alois Alzheimer Professor of Psycho-gerontology (Bradford 2005). Kitwood’s theoretical underpinning to the practice of dementia care provides an enriched model for understanding the needs of people with dementia. Kitwood proposed a definition of personhood which does not depend on cognitive capabilities. “It is a standing or status bestowed upon one human being, by others, in the context of relationship and social being” (Kitwood Kitwood: Theory of Dementia Care 1997). His definition recognizes the interdependence and interconnectedness of human beings. In this context personhood is created, or diminished, in social relationships, usually with care providers, around the person with dementia. Kitwood’s theory describes the aspects of ‘malignant social psychology’ that are not only detrimental to personhood but contribute to further neuropathological change. Kitwood also describes observable indicators of relative well- being in persons with dementia such as initiation of social contact, expression of desire or will and helpfulness. Kitwood calls for an environment of care where ‘positive person work’ enhances well-being and maintains personhood. The person centered approach encompasses all relationships, extending to care providers to bring about a change in the culture of care (Kitwood and Bredin 1992). My desire to pursue a vocation in nursing and my passion for person-centered care stems from personal experience. Beginning March of 2000 until just six months ago my husband and I cared for our great uncle who had been diagnosed with Alzheimer’s disease in 1994. During that time we experienced numerous hospitalizations. The dementia literature suggests, and it has been our personal experience, that the hospital experience for a person with Alzheimer’s disease or related dementia is often a traumatic experience. Hospitals are designed to provide acute care to individuals with full cognitive abilities. The safeguards that are in place in one’s home or in a residential facility may not be a consideration in the hospital setting. A hospital stay that neglects to meet the unique needs of the individual with dementia results in set backs that neither the patients nor their caregivers may be able to overcome. Research has shown that persons with dementia remain hospitalized four days longer than the average stay, are discharged with more functional limitations compared to before admission and are often readmitted within 31 days (Lyketsos, Sheppard, & Rabins, 2000). Kitwood: Theory of Dementia Care

This is ample evidence that the quality of hospital care for persons with Alzheimer’s disease and related dementias is an important issue and calls for a change in the focus and culture of care for these individuals. Silverstein and Maslow (2006) address this critical gap in their text, Improving Hospital Care for Persons with Dementia. Silverstein and Maslow state “there are skills that can be learned and strategies to be shared regarding the care of patients with dementia. Much of this knowledge can be gleaned from best practice care in long term care settings” (2006 p.254). Dementia Care Mapping (DCM) is an observational tool and process designed to help develop and improve person-centered care practice. By encouraging staff to consider care from the perspective of the person with dementia, the care approach shifts from solely disease management to include valuing the whole person. Personhood is not determined by ones’ abilities and capacities, but emerges in a social context of the relationships and environment surrounding the individual. Nursing staff are empowered through the recognition that their words, attitudes and actions influence the well-being and quality of life of the individual (Bradford Dementia Group 2005). An individual with dementia becomes even more vulnerable when faced with an acute illness. It is just as critical, if not even more so, that optimal care be provided during a hospitalization to ensure the best outcome possible. The quality of care, or lack there of, should not have to be a concern or a factor that exacerbates the patient’s condition and/ or compromises their ability to improve. Whereas DCM has been used primarily in day care and residential settings, promising results were realized by UK researchers conducting a preliminary study investigating the feasibility of using dementia care mapping to improve care for physically ill older adults in a hospital setting (Wooley et al., 2008). In addition, as part of my DCM certification process I conducted a preliminary DCM evaluation in two separate acute care Kitwood: Theory of Dementia Care

geropsychiatric units. I believe person-centered care training and DCM holds strong promise for improving the quality of care for individuals with dementia in acute care settings. Kitwood: Theory of Dementia Care 6

References

Bradford Dementia Group (2005). Dementia Care Mapping (DCM) 8: User’s manual. Bradford: University of Bradford.

Kitwood, T. and Bredin, K. (1992). Towards a Theory in Dementia Care: Personhood and Well-Being. Ageing and Society, 12, 269-287.

Kitwood, T. (1997). Dementia reconsidered: the person comes first. Buckingham: Open University Press.

Lyketsos, C. G., Sheppard, J. E., and Rabins, P. V. (2000). Dementia in elderly persons in a general hospital. American Journal of Psychiatry, 157(5), 704-707.

Silverstein, N. and Maslow, K. (Eds). (2006). Improving hospital care for persons with dementia. New York: Springer.

Whooley, R. J. Young, J. B., Green, J. B. and Brooker, D. J. (2008). The feasibility of care mapping to improve care for physically ill older people in hospital. Age and Aging, 37, 390-395.