Safeguarding the Older Adult with Dementia - Assignment Example

Safeguarding Safeguarding the Older Adult with dementia on an acute adult ward Introduction In this essay I am going to reflect about the scenario which I had encountered as a student nurse during my clinical placement. The scenario is based upon safeguarding an older adult with dementia on an acute adult ward. The paper will discuss how a patient with mental disease was safeguarded in an acute ward along with the policies and regulations applicable in the case. According to the Nursing and Midwifery Council (NMC, 2008) confidentiality is maintained and the name of the patient has been changed to protect the identity of patient. Safeguarding is a process of giving protection to individuals who are at risk like vulnerable adults, against neglect and abuse. Abuse does not only include physical or verbal abuse. They are of different types and can occur at home, hospital wards, at work or in nursing homes (Age UK, 2013). The term neglect means not getting appropriate services, facilities, treatment and stuff which make you feel comfortable and safe (Tidy, 2013). Older adults are people above the age of 65 referring to the retirement age ( Centre for Addiction and Mental Health, 2010). They are frail and dependent and are at great risk of getting abused. This paper will discuss how older adults in the acute mental ward are safeguarded and which issues are mostly faced depending upon the particular scenarios. In acute adult wards safeguarding patients of old age is a very challenging task. While safeguarding patients the health care providers encounter several issues. As, in the old age people become very weak a slight physical harm may result into bruises or fractures so they need to be handled with extreme care. For the older adults suffering from mental disabilities, it is very difficult to make them understand about anything. They are almost unable to protect themselves or even participate in safeguarding therefore the responsibilities on the care providers become much higher. Older adults with mental illnesses cannot take care of their financial problems in particular because of lack of understanding and their mental incapacity. The adult ward nurses and staff have to manage their financial issues which sometimes also involve lawyers and police. Handling all these problems is more specific with older adults with mental incapacity. Being older adults the vulnerability to get abused increases, but if it is associated with mental illness the threshold of abuse becomes maximum and therefore, the problems in safeguarding also get intensified. In short, the major issues are lack of understanding due to mental incapability, inability to cooperate, creating more issues themselves because of unawareness and more potential of getting abused (Pritchard, 2008). Another important concern with respect to older adult with mental illnesses is that they meet the maximum number of financial abuses from their family members (Olson, 2011). In such cases it becomes problematic for the health care professionals and safeguarding agencies to make them understand and protect them against their own family members whom they trust most. Nurses should safeguard vulnerable patients from being abused or neglected and assure their rights in getting optimal care and treatment. Scenario Tim a 70 year old patient was admitted to the acute ward and was suffering from dementia. Dementia is a condition characterized by memory impairment and difficulty in communication and thinking (MNT, 2014). Tim Candy was a rich man having several assets and property. He was very weak and bed bounded. Tim’s son took advantage of his father’s memory impairment causing financial abuse. The circumstances have made him emotionally distressed, depressed and frustrated. Apart from being financially abused Tim was also being mistreated and neglected by the medical staff and nurses. I noticed that Tim was not being fed properly, his personal hygiene was not adequately performed, he was left in the soiled bedding and clothes for the whole day and no one bothered to change his beds and clothes. Due to staff negligence, Tim used to look dirty, was always smelly, and lost severe weight. Being a student nurse, I had the responsibility to report such type of events. I informed the ward manager about the witnessed events (SCIE, 2013). The ward manager held a staff meeting and strictly inquired about the staff negligence regarding Tim’s case. He instructed the nurses and medical staff to provide high quality nursing care to Tim and treat all patients equally. He also warned the staff that any employee found violating the safeguarding principles and neglecting patients will be terminated from the job. The manager also instructed the nurses to monitor the Tim’s diet plan, food a fluid intake properly. By implementing these changes it was observed that the nurses who deviated from the rules accepted their mistakes and attempted to follow the legal obligations they have regarding patient care. The environment of the ward became more organized and disciplined. Nurses also provided a high degree of motivation and interpersonal support to Tim. Therefore, after a few days a positive change in Tim’s health outcomes and recovery was observed. During my shift, I witnessed that Tim’s son was forcing him to sign the cheque and power of attorney in his name. I noticed this financial abuse and immediately reported to the ward manager. On investigating, it was found that Tim’s son has falsely claimed his pension and benefit in his name and did dont give any money to Tim. He also wanted to claim Tim’s property in his name. Discussion The NHS and Community Care Act 1990 section 47 (5) asserts that for safeguarding against financial abuse urgent services should be provided for conducting assessment of the case. This act was supported by publication of Guidance on eligibility criteria for adult social care (9). According to this law, the ward manager referred him to state security regulator and adult services providers. These are the social work agencies which deal with abuse cases and provide additional support to the health professionals to protect their patients from financial abuse (Olson, 2011). The ward manager performed his duty and reported Tim’s financial abuse to the Department for Work and Pensions (DWP) or the Office of the Public Guardian (OPG) or local safe guarding agencies (SCIE, 2014). By following the Health and Social Care Act 2008 (regulation 11), the social work agencies ensured that Tim’s pension and benefits were transferred in his bank account instead of his son’s account. Therefore, the pin number was kept confidential and his properties were monitored under state law by the social work agency in a secure manner (Callaway & Jerry, 2011). The social work agencies made sure that Tim’s money was being used in an appropriate way, such as for his own health treatment, other facilities and was given to him whenever he needed it. The agencies also sent a letter to Tim’s son that if he would try to misleadingly claim Tim’s money then he will be punished or jailed. Tim’s son was not allowed to meet his father without the supervision of a police officer. According to NMC Code of Professional Conduct 2004, the nurses and staff in the adult ward are responsible for reporting the theft and abuse suffered by Mr. Tim for ensuring safeguarding. Following this act, I performed my duty and reported the financial abuse and mistreatment to the administration. The management was also liable to ensure safeguarding for the protection of patients with mental illness, other diseases and the victim to prevent any further act of abuse (Ash, 2014). According to the Safeguarding Vulnerable Groups Act 2006, the organizations involved in safeguarding vulnerable adults are liable for referring the data of a susceptible person which could harm the vulnerable adults to the Independent Safeguarding Authority. In this way it helps in preventing the chances of abuse in future for older adults (Social Care institute of excellence (SCIE), 2011). For safeguarding Tim against financial abuse, the ward manager should identify who else could also be involved in doing financial abuse from Tim’s family. The visitors who used to visit Tim should be monitored and every action must be governed under the laws of safeguarding. Since the case had to be handled by the social organizations everything must be conducted as per instructions to ensure safety and protection for Tim. In order to safeguard Tim from neglect the ward manager and hospital staff followed the Nursing and Midwifery Council Code of Professional Conduct (2004) which clearly defines the role of nurses in giving health support, proper care and protection of the rights of the patients. Safeguarding Vulnerable Groups Act 2006, identifies a system which help employers to check the employees if they are following safeguarding principles. The ward manager and hospital manager ensured that all the medical staff is performing their duties and delivering patient care as identified under this act (Heath & Sturdy, 2007). Implications for Practice In order to obtain improved health care outcomes for Tim it is important to make certain that the laws and policies related to safeguarding older adults and other vulnerable groups should be followed. For ensuring the practical approach on these laws, it is important to make rules that assure that whosoever deviate from the regulations against abuse and neglect will be punished or even fired. The independent Safeguarding Authority (ISA) is a very good initiative in ensuring better safeguarding of vulnerable individuals (Sarah, 2009). The ward manager should cooperate with the police to identify the person causing financial abuse to the patient and give his statement (Solihull Local Practice Guidance, 2013). Staff training and awareness programs should be conducted to improve the outcomes (Faulkner & Sweeney, 2011). The hospital management should train the medical staff, particularly nurses for implementing and practicing safeguarding principles and prevent abuse and neglect. This will protect Tim from further abuse and also help in safeguarding other older adults in the ward. The progress and performance of nurses should be evaluated based on how closely they follow the rules related to patient care and safeguarding. Members from the law governing authorities, social work agencies and health sector should be invited in hospitals to address the nurses on the benefits of safeguarding and discuss the issues the nursing staff face during safeguarding older adults like Tim. The ward manager and hospital administration are liable for ensuring that the nurses are ensuring safeguarding and avoiding neglect in patient care. For this purpose performance evaluation of the staff should be conducted along with patient physical and medical condition monitoring. The management should also encourage nursing staff to discuss the problems they face while safeguarding older adults in the acute adult ward and also suggest their solutions and improvements. Learning Outcomes With this experience I gained extensive knowledge on safeguarding patients from different types of abuse particularly from financial abuse. I learned the role of ward manager and understood my future liabilities being a nurse. I learned the challenges and issues faced by health professionals in handling and safeguarding older adults with mental diseases. This learning will help me perform my duties in a better way, while facilitating older adults. I will be able to ensure practicing and implementing safeguarding principles with the understanding of the legislations in future practice as a nurse. Conclusion From the research and case study analysis, it has been concluded that there are multiple laws for the protection of patients’ rights and safeguarding against financial abuse and neglect, but cases like Mr. Tim Candy are still appearing because these laws and regulations are not properly followed. Every health care set up, nursing homes and hospitals should ensure strict implementation of safeguarding principles to accomplish patient safety from financial abuse and neglect. If the regulations are followed keenly the patients can be safeguarded from all types of abuse, and the hospital staff would perform their duties more vigilantly. Reference List Age UK, 2013. Safeguarding older people from abuse. Scotland: Age Cymru. Ash, A., 2014. Safeguarding Older People from Abuse. New york: Policy Press. Callaway, L. & Jerry, B., 2011. Stopping the finaicial abuse of Elders. [Online] ABA bank compliance Available at: [Accessed 1 September 2014]. Centre for Addiction and Mental Health, 2010. Background: Older adults. [Online] Available at: [Accessed 13 August 2014]. Faulkner, A. & Sweeney, A., 2011. Safeguarding Adults:the role of health services; Analysis of the impact on equality. London: Social care institute of excelence. Heath, H. & Sturdy, D., 2007. Vulnerable adults; the prevention, recongnition and management of abuse. 1st ed. Harrow: RCN Publishing Company NHS. Olson, E., 2011. When Abuse of Older Patients Is Financial. [Online] The New York Times Available at: [Accessed 1 September 2014]. Pritchard, J., 2008. Good Practice in Safeguarding Adults: Working Effectively in Adult Protection. 1st ed. London: Jessica Kingsley Publishers. Sarah, 2009. Safeguarding Vulnerable Older People (Abuse and Neglect). [Online] Available at: [Accessed 13 August 2014]. SCIE, 2014. Commissioning care homes: common safeguarding challenges. [Online] Available at: [Accessed 18 September 2014]. Medical News Today (MNT), 2014. What is dementia? The signs, symptoms and causes of dementia. [Online] Available at: http://www.medicalnewstoday.com/articles/142214.php [Accessed 13 August 2014]. Social Care Institute of Excellence (SCIE), 2011. Prevention in adult safeguarding. London: Social Care Institute of Excellence Social Care Institute of Excellence. Solihull Local Practice Guidance, 2013. Financial Abuse and Safeguarding Adults. Guidelines. Solihull: Solihull Local Practice Guidance Solihull Local Practice Guidance 21. Tidy, C., 2013. Safeguarding Adults. [Online] Available at: [Accessed 13 August 2014]. Read More