In a large-scale group study in 50 patients with Alzheimer’s disease (AD), Cuddy et al. (2012) showed that both familiar tunes and familiar lyrics were well recognized across all stages of AD. Due to close associative bonds formed early in life between highly familiar song tunes and lyrics, the ability to recognize such information seems to be still functional in patients with AD.

My mentor asked if I would assist her in helping Mrs Meredith get out of bed explaining that Mrs Meredith did not like waking up and would often be distressed and uncooperative. Mrs Meredith was disorientated in time, place and person as well as difficulties in communicating verbally. 

It was decided we would not wake Mrs Meredith but carry on assisting other patients until she woke up naturally. When Mrs Meredith woke we quietly entered her room. I noticed that my mentor was smiling and spoke in a soft voice; she introduced herself and explained that it was Friday morning and that she was there to help her get up from bed.  My mentor knelt down by the side of the bed and asked if she could pull back the blankets and help her to sit up. Mrs Meredith did not seem to understand and just looked at my mentor. After a few minutes my mentor began to slowly pull back the blankets explaining what she was doing.  She placed her hand around the back of Mrs Meredith and supported her whilst she sat up. She explained that this was a hospital and reassured her that she was in a safe place. 

My mentor asked Mrs Meredith if she would like to listen to the radio and Mrs Meredith smiled warmly. The radio was switched on and played quietly in the background. She asked Mrs Meredith if she would like a cup of tea whilst she listened to the music. Mrs Meredith smiled and my mentor asked if I would sit with Mrs Meredith whilst she made a cup of tea. I did this and we listened to the radio together whilst Mrs Meredith occasionally hummed to the music.

Good communication skills: Verbal - introducing herself, explaining each process, providing reassurance. Non-verbal – smiling, soft voice, knelt down by bed so the patient could see her.

Empathy: Reassured her she’s in a safe place. It’s important as she may have had many falls which she may now be scared of. She’s confused so explaining the day and where she is is important.

Dignity and Respect were remained at all times.

Autonomy: whilst she lost some independence such as her mobility, it was ensured she was always asked for her personal preferences –  the radio on, cup of tea. 

 

The early signs of Alzheimer’s disease are usually minor memory problems, such as forgetting recent events or conversations however as the disease progresses this becomes much more severe. Other symptoms can include an increasing confusion and disorientation, personality changes such as becoming aggressive and low mood and anxiety. In the later stages of the disease, people can also develop problems moving around without assistance and eating and drinking and other day-to-day activities (NHS, 2016) 

 

There is currently no cure for Alzheimer’s disease although the progress of the disease can be slowed with medication for some people. There are also therapies, such as cognitive stimulation therapy which can be beneficial to support speech and language and problem solving skills. The prognosis of Alzheimer’s disease is an average lifespan of between 8 and 10 years following diagnosis (NHS, 2016). 

The morning routine was centred around trying to reassure Mrs Meredith and limit the amount of distress she would feel on waking. This would avoid unnecessarily upsetting her and making her uncooperative at that time.

CARE- care can be described as the core principle of nursing as the care that is provided by various professionals can help the individual patient as well as the local community. It’s important that staff ensure the patient is at the centre of their care and are involved as well as the individual’s support network e.g. family members (Watterson 2013). Throughout the scenario the mentor demonstrated care on multiple occasions an example can be allowing Mrs Meredith to wake up naturally. This allowed Mrs Meredith to wake up in the morning without distress or agitation which she normally became when she was woken up. Another example of the mentor demonstrating care can be allowing Mrs Meredith to get up at her own pace, the mentor waited for Mrs Meredith to respond to certain questions and when it appeared Mrs Meredith had a lack of an understanding she continued to explain what she was doing (Watterson 2013). 

 

COMPASSION – this is the way that care is delivered through rapport with patients that have been built on providing dignity, empathy and respect. By delivering compassion it allows nursing staff to respect the individual needs of the patients equally (Watterson 2013). An example of how the mentor did this can be how she informed the patient of the time and place as the mentor would have known that Mrs Meredith was not aware of time, place or self. Another example can be that the mentor understood that in the morning Mrs Meredith likes to listen to the radio with a cup of tea which can reduce the levels of agitation as it maintains her individual routine. (Watterson 2013)

COMPETENCE – allows nurses and other professionals to have an understanding of the health and social needs and problems patients face. Using recent, relevant and valid research and evidence ca help develop the nurse’s knowledge and apply this to practice. In the scenario the mentor puts the radio on for Mrs Meredith who has Alzheimer’s; research has shown many benefits of patients with dementia listening to music e.g. better mood (Watterson 2013).  

COMMUNICATION –  communication has significance importance to the delivery of care and treatment within health and social care. It allows nurses to build successful relations with patients and to work effectively within a team (Watterson 2013). A way that effective communication is demonstrated in the scenario can be the way the mentor reads Mrs Meredith’s nonverbal communication as she has difficulty communicating verbally. This is shown when Mrs Meredith is asked if she wants a cup of tea, instead of responding yes verbally, Mrs Meredith smiled instead. (Watterson 2013)

COURAGE – allows nurses to act in a way that is ethically right and to report concerns and worries that professionals may have about their patients. It also allows nurses to suggest new care pathways and treatments that could benefit their patients (Watterson 2013). Within the scenario the mentor does this by taking into consideration the autonomy that Mrs Meredith has the right to; the mentor does this by allowing Mrs Meredith to choose when she wakes up, if she wants the radio on and if she wants a cup of tea. Another way the mentor does this is by regularly gaining informed consent from Mrs Meredith (Watterson 2013).

COMMITMENT – being committed also allows nurses to build a relationship with patients whilst leading by example whilst influencing change. In the scenario the mentor does this several times by focusing the care of Mrs Meredith around her individual needs e.g. by helping Mrs Meredith sit up as the mentor recognises that Mrs Meredith needs support with this (Watterson 2013).