Care professional/service user relationships

1. Care professional/service user relationships www.educationforum.co.uk

2. From Patient to Client • The word ‘patient’ was used because in the past people had to wait around ‘being patient’ for busy health care professionals to find time to treat them. • Today we talk about ‘clients’ and care aims to be must more ‘person centred’ than ‘professional centred’

3. Person Centred Care • Places the client at the centre of decision making in their care and is care which values and respects client’s rights, culture, identity and well being. • A key idea being this is the concept of ‘personhood’

4. Personhood • Personhood recognises and respects the self concept and self esteem of the client regardless of their background or medical condition. • A belief in the importance of personhood has led to individualised care replacing task orientation care in health settings

5. Task Orientated Care • Up until the 1980's the preferred method of delivering health care was called "Task orientated care". Care workers would deliver care by carrying out a set of specified tasks during their working day - for example a carer in a care home might have had on their task list checking all patients were washed and fed, checking medication, checking everyone had been given the opportunity to go to the toilet in the morning etc. The medical care of patients was largely the responsibility of the highest qualified medical professionals with all decisions being made by them.

6. Individualised Care • In more recent times task orientated care has been criticised for being impersonal and insensitive to the needs and wishes of clients. Today in stead of task orientation we have a strong emphasis on individualised care with each patient having their own individualised care plan. Although this is certainly more time consuming than a task orientated approach it is arguably more effective as it takes into account the needs and wishes of the patient him or herself.

7. Care Plans • In order to establish a care plan for a patient care workers must work through what is down as the care planning cycle. The stages in this are • Assessing needs - this is done through observations by care workers and professionals, discussions with client family and friends, reference to medical notes and earlier history, and through conversations with the individual patient • Care Planning - where a detailed, time bound care plan is established for the patient. There will be specific objectives within the care plan and clear guidelines as to what interventions are required and by whom • Implementation/Intervention - which involves the actual delivery of the care plan and the monitoring of what effect the care plan is having on the patient. • Evaluation of the care plan - where a care professional responsible or the team responsible evaluate whether the care objectives have been met or not

8. Barriers to person centred care • The two main barriers are stereotyping and discrimination • A stereotype is when a person may have a fixed prejudiced view of what a certain type of person is like – child, disabled, elderly, black, Islamic etc. • Stereotyping is very common in everyday life. Understanding it, avoiding it and promoting anti discriminatory practice are therefore big features of all health and social care training and policies within health care organisations (remember the CVB and remember your portfolio work on care settings!) • Discrimination is when a stereotype leads to a client receiving worse care than they have a right to expect • Discrimination damages client self concept and self esteem (if you’ve ever been bullied remember what that felt like and you’ve got the idea!)

9. Empowerment • Empowerment allows clients to make choices and take control of their own lives. • Clients in care settings should be empowered – this means they need to have accurate information from professionals with good communication skills about their care plans and their options • The opposite of empowerment is dependency – the old way when ‘patients’ had to accept the care and decisions that were given to them