Psychosis Anxiousness · Stress · Frustration · Fear

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Last updated: May 2, 2019

Psychosisaffects people in a way that they are out of touch with the real world oraren’t ‘grounded’. Psychosis can be caused by depression, anxiety or bipolar.Someone with psychosis may feel:·        Out of touch·        Feeling like everyone is against them·        Depression·        Loneliness·        Confusion·        Anxiousness·        ParanoiaDepressionis described as having a constant or on-going low mood – not just ‘feeling blue’.It can affect anyone of any age, gender or religion. Someone with depression mayfeel:·        Lack of energy·        Lethargic·        Not being able to concentrate·        Insomnia or lack of sleep·        Anxiousness·        Guilty·        Feeling suicidal·        Disorganisation of thoughts·        Lack of motivation·        Stress·        LonelinessAnxiety can cause physical and mental symptoms and isdescribed as either a mild or severe worry about something.

A person withanxiety may feel:·        A sense of guilt·        Worry·        Anxiousness·        Stress·        Frustration·        Fear ·        Depression·        ExhaustionPhysical things may be:·        Shaking·        Sweating·        Pounding heart·        Nausea·        TensionDementiais a long-term condition that causes many problems with a person’s cognitivefunctions. A person with dementia may feel:·        Confused·        Frustrated·        Anxious·        Lonely ·        Depressed·        Angry·        In denial·        Fearful·        On edge·        DisorientatedHavinga learning disability means that a person has difficulty in learning new skillsor information and are struggling to understand or comprehend more complicatedthings. Someone who has a learning disability may feel:·        Frustrated·        Lonely·        Scared/Fearful·        Difficulty in concentrating·        Anxious·        WorriedAllindividuals will need different care, regardless of the situation. Anindividual with dementia may need more patience and focus in regards to theirindividual care as they may be forgetful, confused or emotional. A person withdementia may feel overwhelmed with a large amount of information or a change ofevery day routine, so the care they will receive will need to be altered toensure that we do not make individuals feel worse.

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They may also need moreencouragement and reminding. An individual with learning difficulties may findit difficult to understand certain information or certain members of staff orparticular routines (such as taking medicine at certain times of the day).Being able to understand this will allow us to learn how we can provide carethat is person centred to that individual, i.e., using certain members of staffthat the individual(s) are comfortable with or allowing extra time andattention for daily routines to ensure that the individual feels comfortable.

Aperson with depression may need their care monitored in a way that is differentfrom the others that have been discussed. Individuals that have depression orpsychosis may need their care altered as they may be triggered by certainthings, objects, people or time of the day. By changing our care we can reducethese triggers for these individuals helps them to feel more relaxed andcomfortable being in hospital. We may need to change our choice of language,tone, volume or choice of conversation as this may also be a trigger to anindividual. In general, we may need to alter our care to provide the very bestperson centred care we can give to the individual. By learning about anindividuals’ background or brief history, this enables us to learn specificallyabout the individual and allows us to alter our care to the way they need inorder to feel safe, comfortable and confident. Understanding the causes andsupport allows us to understand how and why an individual may be acting orfeeling and allows us to change our way of care effectively.

Itis important to keep a good and positive view on mental health, learningdisabilities and dementia, as it comes off as a domino effect. If a carer showsand demonstrates a positive view on mental health, leaning disabilities anddementia, then the person receiving the care will also have a positive outlookand attitude. By ensuring that I am enabling individuals to have opportunities,stay social and feel positive, this will positively impact their health andenable us to build good relationships with the people in our care. Enabling andshowing positive views towards an individual will make them feel respected andtreated as an individual and as a person. Keeping a good and positive view alsosets a good example for other colleagues too. It sets out a positiveenvironment and allows for the stigma around such issues to be removed.Allowing for a positive attitude changes the views of my colleagues, enablingfor a more positive, person centred care.

Thesocial model of disability is presented by explaining that we have disabled andexcluded people and that society is one of the main contributing factors of exclusion.The main concept of the social model of disability is that negative attitudesand perspectives in society exist because of these barriers between people.There are a variety of ways and are the result of society disabling. Thebarriers that are included may not just be physical but may also be emotional.

Attitudescould be stereotyping, sexism, prejudice or disablism. The social model of disabilityfocusing on breaking down the barriers in society to ensure equality. Breakingdown barriers like accessibility – wheelchair friendly buildings,person-centred service (e.g. Makaton for people in society for those who chooseto use a different form of communication) and ensuring that support it availablefor everyone who wants/needs it. Removing barriers for social model ofdisability ensures and encourages being social and gaining access to educationand employment without being discriminated, stereotyped or to be exposed toprejudice.Peoplewith psychosis, depression or anxiety may feel abnormal and may feel confusedand paranoid. Some adjustments may need to be made by ensuring that theindividual is involved with everything in regards to their care (for example,not whispering around them and showing and explaining certain results) as thismay reduce their paranoia.

The individual may need more than one person toassist them if they may be having an episode (violence, extreme paranoia) andmay need a more senior member of staff. Adjustments may need to be made byensuring that some or all members of staff to attend a mental healthunderstanding learning course. Adjustments made for people with anxiety caninclude having a set of notes for staff to read to try and avoid triggers thatcould heighten their anxiety. Adjustments may need to be made such as hourlyobservations to keep a check on their heartrate (for example, anxiety causes anincreased heartrate). Individuals with anxiety may require more time for thingsto be explained correctly so not to cause heightened anxiety and ensure thatthey are able to ask questions about anything.

Adjustments for individuals withdepression could be such things as allowing for more time for the individualand enabling and allowing for a large portion of the conversation to staypositive and optimistic – but always trying to converse about smaller tasks tolook forward to in the future, such as having a favourite food or a soon tearound on the ward.Anindividual with dementia may need their care adjusting by allowing more time tobe dedicated to the individual. A person with dementia may feel confused,scared, emotional or anxious so it is important that we can allow for us togive them our full attention. They may also come across as though they are notmaking sense, but to themselves they are so it is important that we go alongwith this and reduce their confusion.

A person with dementia may needsupervision with certain tasks (taking medicine, brushing teeth) as they mayforget how to do it or what they are doing. Due to dementia affecting a part ofthe cognitive ability, it is important that we can adjust our care andencourage brain stimulating activities and exercise such as word searches,colouring, small puzzles or taking a small walk to the end of the ward andback.Adjustmentsmay need to be made in regards of a person’s care if they have learningdisabilities.

They may need specialist equipment such as bigger cutlery andindividual specific equipment to help with communication and movement. We wouldneed to make adjustments by learning how to use the equipment correctly.Adjustments may need to be made with communication as individuals with learningdisabilities may communicate differently, so we may need a particular member ofstaff, for example a member of staff may be able to sign so can converse withthe individual. Individuals with learning disabilities may need extra time,attention or support when doing every day activities to include encouragementand full concentration.Itis important to identify if an individual is not having their needs met as itcontributes to their wellbeing. The first port of call I would turn to would beto report concerns to the nurse/head nurse. They may be able to advise me onwhat can be done, what I can do and what to do next.

The nurse in charge mayalso be able to report concerns to the Dr, or may also be able to refer theindividual to have their care plan reviewed to assess what their needs may be.If this fails, I would report concerns to my ward sister who can overvieweverything in regards of the correct people to contact or the best plan ofaction for that individual. If nothing happens or I do not feel satisfied,there are legislations and policies within the company that I can follow andfind on the ward in regards to the care of the individual. Earlydetection of an individual’s needs is vital to ensure that they are receivingthe care that is most effective to them and will allow them to not only keeptheir independence but also to stay social and allow for them to have a goodwellbeing. Early detection for an individual may allow them to have medicationto control some symptoms (such as swelling or headaches), or allow for theirpresent medication to be reviewed in case they may be dealing with side effectsand results of this. An early detection of individuals’ needs allows for areview care plan to be re-reviewed, changed or for one to be put in to place inregards to improving the health and wellbeing of an individual. By finding andreporting concerns due to an individual’s needs, we may find a diagnosis whichallows us to find the best path to helping an individual and will help us toalter and adjust our case to the individual as soon as possible. Adjustmentswill need to be made in regards to someone’s care if they have a mental healthcondition, learning disability or if they have dementia.

Each situation andindividual is different and adjustments need to be made accordingly. Someonewith dementia will need to have their care plan adjusted to suit their needsand wellbeing more. They may need extra support, 1:1 support and guidance andopportunities to attend support groups, staying social and promoting a sense ofindependence. Adjustments to their medications may also be needed to bettertheir wellbeing.

Their everyday routine may need to be changed also, such ashaving a carer at home, as dementia can cause memory loss (‘forgetfulness’). Inthe hospital setting, adjustments may be needed in regards to an individual’scare such as reviewing someone’s care plan to see if they need extra support,assessments or a general change to the way that their care is given andreceived. A person with mental health conditions may need many adjustments withtheir care. For example, they may be experiencing certain side effects,possibly due to their new medications, and so their medications may need to bereviewed or changed to reduce this. Another way their care could be changed isby raising awareness of the individual’s triggers within the hospital –reducing the stress of the individual and enabling the positivity of theirwellbeing. Their care plan may also be reviewed to try and provide the bestextra services for the individuals such as support groups, one-to-one sessionsor therapy. Reviewing their care plan allows for us to try and find the bestcourse of action for the individual.

A person with learning difficulties mayalso need adjustments to their care, such as a change of medication to regulateor reduce possible side effects. An individual may need extra support witheducational situations, such as 1:1, or with general life skills. They may alsoneed extra adjustments to their home, such as accessible bathrooms ortechnology to assist them. They may also need adjustments in the way that theyindividual may communication, such as reviewing the present choice ofcommunicating and assisting in finding the most effective way for thatparticular individual. TheHuman Rights Act 1998 includes 16 rights that we can in the UK. It allows forus to be treated fairly and equally. Rights can include the right to life,right to express and the right to not be discriminated against. Legal actioncan be taken if these rights are broken.

ØTheMental Capacity Act 2005 (MCA) protects individuals who may lack capacity inregards to decision making. MCA helps to promote independence in regards toindividual’s making decisions where possible. Decisions that are made forpeople who lack capacity are made fairly and staying effective and in theindividual’s best interest in regards to their care and wellbeing. EqualityAct 2010 protects individuals from discrimination when in education, being aconsumer, education and more. Protection from discrimination is from:Gender,race, religion, disability, nationality, relationship status and much more. Theequality act protects individuals from discrimination where ever they are orwhat they are doing in the UK. It protects individuals with mental healthconditions, learning difficulties and dementia.

From discrimination in regardsto their care ensuring that they receive the best possible care. TheCare Act 2014 enables individuals to safeguard adults and prevent them fromharm, abuse and neglect. The care act enables individuals with mental healthconditions, learning difficulties and dementia to receive the best care andensuring that the most efficient decisions are made with the best supportavailable. Thisact allows for individuals to access information about themselves fromcompanies and organisations.

This act allows for individuals with mental healthconditions, learning difficulties and dementia to stay included with their careand allows them to be aware of the information that is held about them.


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