What is Record Keeping in Health and Social Care?

Record keeping is an integral part of health and social care work and an essential part of supportive, person-centred care.

Record keeping in health and social care is about writing down what you have done, what you’ve observed, any relevant decisions made and what will happen next. These records may be paper-based or digital, daily notes or formal assessments, but they all have the same aim: to communicate the right information to the right people at the right time.

These days, digital records are increasingly replacing paper records, as it’s much easier to capture and share accurate information this way. Paper records are still used in some settings, however. Examples of the types of records you might need to keep in a health and social care setting, whether digital or paper, include:

• Personal information about patients/residents. 
• Care plans.
• Patient/resident legal documents.
• Accommodation information.
• Financial information.
• Referral information.
• Local authority reports.
• Written correspondence.
• Information shared by family.
• Transcripts of conversations about a patient/resident.
• Safeguarding information, concerns and records.

Why is Record Keeping Important in Health and Social Care?

Keeping good quality, accurate records is an essential part of ensuring good outcomes for the people who use your services. Record keeping is an important part of providing high-quality, safe and effective care to those who need it and ensures everyone has the right information at the right time.

Accurate record keeping benefits everyone, including the people using the service, the care providers, health and social care employees and the wider health and social care system. 

Good record keeping is important in health and social care because it:

• Encourages care and support of patients/residents.
• Promotes continuity of care.
• Helps identify emerging patterns and challenges a person might be having.
• Helps to prioritise interventions.
• Improves patient/resident safety.
• Helps staff to respond more quickly to patient/resident needs.
• Promotes effective communication, both internally and externally.
• Helps to quickly and easily share important information.
• Aids others not involved with the patient/resident to quickly understand the situation.
• Reduces the chances of information duplication and errors.
• Improves accountability and transparency.
• Aids learning and helps identify mistakes, progress and achievements.
• Can be used as evidence in case of complaints, investigations or court cases.
• Ensures staff can easily comply with their legal duty to record information.

Want to Know More?

Everyone working in a health and social care setting must be fully trained in how to perform their role, care for patients and residents safely and comply with legal obligations. Our range of Health and Social Care courses covers all your training needs, from Information Governance to Advanced Safeguarding Adults and Data Protection.

Principles of Good Record Keeping in Social Care

Below are five guiding principles that will help you keep accurate, secure and person-centred records in your health and social care setting:

How to Maintain Records in Health and Social Care

Maintaining records in health and social care is about ensuring the records you create are honest, accurate and up-to-date. It’s vital that recordkeeping is done correctly if the records are to be useful and effective.

Where possible, you should always involve the patient or resident in the creation of the record. All health and social care records should be co-produced between the member of staff writing the record and the person whom the record is about. For example, the care home assistant and the resident or the GP and their patient. This keeps your records person-centred and always in a person’s best interests.

All records should be recorded promptly and as close as possible to the event being recorded. Timely recording helps reduce the chances of inaccuracies or mis-remembered information, prevents delays in action being taken and ensures records are not forgotten about or left incomplete.

As a basic guide, the types of information you need to record includes:

• The time and date of the record.
• Your name and job role.
• The patient/resident’s name.
• The type of communication and who initiated it.
• The names and job roles of anyone else present.
• Details of any discussions had.
• Details of any decisions made or actions taken, and by whom.
• Information on what needs to happen next.
• For paper records, a signature and date.

How Long Should Social Care Records Be Kept For?

The Data Protection Act states that personal information must not be kept for any longer than necessary. By law, all types of health and social care records should only be kept for as long as you need them. They must also only be kept for the purpose for which you recorded the information in the first place and only for as long as their legal retention period allows.

Note that there is no one-size-fits-all minimum retention period for health and social care records, and some records must be kept longer than others. For example, adult social care records (including care plans) must be kept for a minimum of 8 years, children’s records are held until their 25th or 26th birthday and clinical dental records should be retained for 11 years.

When records have come to the end of their minimum retention period, it is a legal requirement that they are permanently destroyed in a manner that continues to protect the personal information contained within them. For example, in confidential waste bins or via a secure electronic data deletion service. Health and social care records of any type must never be thrown away with general waste or paper recycling.

Records can only be kept longer than their retention period in specific circumstances, such as for audits, legal proceedings, inquests, public inquiries or for Subject Access Requests.

Record keeping in health and social care is an important part of the job role and shouldn’t be seen as an administrative burden. When done timely, accurately and correctly, record keeping ensures that patients and residents receive the best possible care as information about them is always correct, up-to-date and shared with the right people at the right time. 

Further Resources:

• Information Governance Training
• What are the 8 Caldicott Principles in Health and Social Care?
• How to Maintain Confidentiality in Health and Social Care

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What is Independence in Health and Social Care?

Having independence in health and social care means having control over your own life and your own decisions when in a health or social care setting, whether it’s control over which food to eat, what activities to join in with or which care option to choose.

Independence means a person is respected as an individual, isn’t subject to the authority of someone else and is always given the support they need to voice their own preferences.

Autonomy is important in health and social care settings as, by their nature, these places can often make residents and patients feel as if they have little control over what’s happening to them. Independence enables people to maintain as much autonomy as possible whilst in these settings.

All residents and patients are individuals with their own, unique views, preferences and experiences – and they all deserve to be treated in this way. Even if the person has reduced capacity, they should still be given as much control as possible and promoting independence will help them to feel included, respected and empowered.

Why is Promoting Independence Important in Health and Social Care?

As well as helping people to feel more in control of their lives, promoting independence in health and social care settings brings many other benefits, to patients, residents, members of staff and the setting as a whole. Here are 10 reasons why promoting independence is important in health and social care:

1. Under the Care Act 2014, all services should aim to keep people well and independent. Empowerment – including independence and person-centred care – is a key principle under the Act, making it a legal requirement as well as a moral one.
2. Because independence increases wellbeing, confidence and autonomy, it has the power to delay future care needs, therefore reducing the burden felt by services and families.
3. Independence enables a better quality of life for the individual, as freedom, confidence and better mental health means more sense of purpose and less chance of loneliness, as they are more likely to join in and continue to be social.
4. Promoting independence in health and social care means that residents and patients are able to do things independently, which enhances their confidence, self-belief and self-image.
5. Independence empowers residents and patients to have a say in their own care, support and treatment, make their own choices and have their voices heard. In turn, this enhances dignity and respect for the individuals.
6. Increased autonomy means reduced dependency on staff and facilities in health and social care settings. If individuals can do as much as possible by themselves, the demands on carers and nurses are lessened.
7. Independence can help to reduce or slow physical and mental decline. Keeping the brain active has been shown to improve wellbeing, alertness, memory and concentration.
8. Promoting independence in health and social care reduces isolation and loneliness and increases a sense of belonging, as confident, independent individuals are more likely to take part in social activities. Loneliness in the elderly is shown to contribute towards further health problems, so it’s important that it’s avoided.
9. Independence empowers people to feel in control of their health and wellbeing, making them more likely to take action if they feel unwell. Therefore, independence can act as a preventative measure against worsening illnesses and conditions.
10. Independence reduces the chances of resistance to care. If patients and residents feel more in control of their life, they’re less likely to refuse healthcare assistance because they understand why it’s needed.

How to Promote Independence in Health and Social Care

Promoting independence in health and social care, whether it’s patients, elderly residents or people with disabilities, is closely linked with person-centred care. This means personalised care planning that focuses on each person as an individual and takes into account their particular needs and preferences. Our article on Why Person-Centred Care is Important will give you more guidance on this topic.

An easy way to promote independence is to enable the person to take part in activities and hobbies that they enjoy. For example, craft clubs, reading groups, gardening, watching TV or painting are all activities that most care settings are able to provide and which can bring patients and residents a lot of freedom and joy. Our article on Activities for Care Homes will give you some good ideas.

You should also promote independence by allowing the person to choose what they want to eat (or don’t want to eat), pick the time they want to eat (if practical) and select who they want to eat with (or decide if they want to eat alone). Additionally, enabling the person to have control over who they socialise with can be empowering for the individual.

In terms of a person’s healthcare, medication and support, promoting independence in care requires clear communication and active listening. Never assume that a person prefers a particular method of care or type of medication – always allow them to choose what suits them best wherever possible. Furthermore, all members of staff that care for the individual should be aware of the person’s individual preferences, so good communication between colleagues and care providers is essential. Our article on How to Improve Active Listening provides some great tips.

You can also promote independence in care by helping patients and residents to manage their own health and wellbeing. Alongside giving them control over their medication and support preferences, teach them about the importance of regular movement, a good diet, involvement in social activities and keeping their brain active. If a person is able to maintain their own health, they’re more likely to get better, have a better quality of life and even live longer.

Another idea is to help improve digital literacy amongst patients and residents. Technology plays an important role in modern day healthcare, so if residents and patients understand more about how to use it, they’ll feel more in control and more independent. For example, assistive technology and communication technology all enable a person to live more independently, but only if they fully understand how to operate them.

Promoting independence in health and social care is all about seeing the person as an individual, empowering them to make their own choices and helping them to do things for themselves. In turn, independence improves mental wellbeing, makes loneliness less likely, slows down physical and mental decline and gives a person more confidence and control over their lives. This is why promoting independence is so important for health and social care providers.

Further Resources:

• Introduction to Safeguarding Adults (Level 1)
• What is Person-Centred Care and Why is it Important?
• Using Technology in Health and Social Care
• Person-Centred Care Quiz
• 9 Ways to Help Promote Dignity in Your Care Home
• Risk Enablement: Making Safeguarding Personal

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What is Advocacy in Health and Social Care?

Advocacy in health and social care is when a patient gets support from someone else – an advocate – to help them express their views, wishes, feelings and concerns and to stand up for their rights on their behalf. Advocacy is required when the patient lacks the ability to do these things on their own (self-advocacy).

Advocates ensure a patient’s rights and best interests are upheld throughout their interactions with the health and social care system. They are an independent individual and act separately from the NHS, council and other healthcare services the person accesses.

An advocate can be appointed from a professional advocacy service or they can be a friend, family member or unpaid carer that the patient has chosen themselves. Note that paid carers cannot act as advocates.

In some situations, patients are legally entitled to an advocate. In England and Wales this is known as ‘statutory advocacy’ and includes:

1. Independent Mental Health Advocates (IMHAs) who support patients currently being assessed or receiving treatment under the Mental Health Act 1983.
2. Independent Mental Capacity Advocates (IMCAs) who support patients who lack capacity to make certain decisions under the Mental Capacity Act 2005.
3. Social care advocates who support patients who have difficulty understanding, retaining or using information, or who have difficulty communicating their views, wishes and feelings, under the Care Act 2014 or Social Services and Wellbeing Act (Wales).

What is the Role of an Advocate?

The exact role of an advocate in health and social care depends on the patient’s specific needs but, in general, they are there to support the choices, views, interests and wellbeing of the individual when it comes to decisions about their care. In all circumstances, the advocate should get to know the patient so they can truly support and represent them. 

The role of an advocate includes:

• Actively listening to the views and concerns of the patient.
• Helping the patient to find information they need.
• Discussing different options with the patient.
• Providing information in a format the patient can understand.
• Helping the patient to make informed decisions.
• Encouraging active participation wherever possible.
• Contacting people on behalf of the patient.
• Explaining the patient’s wishes and views to others.
• Making phone calls or sending emails on behalf of the patient.
• Accompanying the patient to appointments and meetings.
• Supporting, reassuring and empowering the patient.

On the other hand, an advocate cannot and should not:

• Make decisions on behalf of a patient without consulting them first.
• Tell the patient what to do.
• Give their personal opinion on what the patient should do.
• Make judgments about the patient’s choices, wishes and feelings.
• Make assumptions about what’s best for the patient.
• Argue with the patient if they disagree with their choices.
• Act in a manner that could surmount to discrimination.

Examples of Advocacy in Health and Social Care

There are many examples of ways an advocate can help support a patient in a health and social care setting, including:

• Accompanying the patient to their medical appointments to ensure they’re receiving the right care.
• Speaking to the patient’s doctor on their behalf, whether on the phone, in person or via letter, to explain the patient’s needs.
• Helping the patient understand the benefits they’re entitled to and helping them make claims or attend meetings.
• Assisting the patient to create a residential care home or nursing home plan and ensuring it matches their individual needs and wishes.
• Helping the patient with budget management and paying their healthcare bills.
• Carrying out a care needs assessment with the best interests of the patient in mind.
• Acting as a point of contact for the patient if a healthcare professional needs to communicate information to them.
• Explaining the different options available to the patient in a manner they can understand, such as options for residential care, appointments or medication changes.
• Speaking on behalf of the patient to make a formal complaint about the health and social care system, ensuring their rights are upheld.
• Representing the patient in meetings to ensure all their questions are answered, all points are covered, the patient is given all available options and the rights and dignity of the patient involved are upheld at all times.
• In the case of independent mental capacity advocates, making decisions about the patient’s care and treatment on their behalf and in their best interests.

Why is Advocacy Important in Health and Social Care?

Advocacy is an important part of many people’s health and social care arrangements as it enables them to maintain their independence, dignity and basic rights throughout all stages of the health and social care system.

Dignity in care is vital for patient wellbeing, as it helps people retain control over their independence whilst in a care environment. Having an advocate does not remove a patient’s control and should not restrict a patient’s independence: the advocate is there to support the patient and ensure their dignity, individuality and wishes are maintained.

Another reason advocacy is important in health and social care is because, under the Mental Capacity Act 2005, patients are given legal protection if they are unable to make their own decisions about their care because they lack capacity to do so. This might be because of a disability, mental health condition, illness or injury which makes it difficult to make informed choices about where to live and what medication to take, for example. These people are entitled to an independent mental capacity advocate (IMCA) who will represent the patient and support them in any decision-making processes.

How Can an Advocate Support an Individual?

The following top tips for advocates will help you understand more about your role as an advocate and how you can help support the person you’re advocating for:

1. Ask lots of questions – ask questions to the person you’re representing, to the people you’re speaking with on their behalf and to the healthcare professionals involved in their care. You can never know too much.
2. Be assertive – especially in meetings and appointments, it’s important that you stand up for the person you’re advocating for, fight for their views and ensure they are heard.
3. Communicate well – communication needs to be clear and regular between you, the person you’re advocating for and all healthcare professionals involved with the person. Effective communication in health and social care is about more than just the words you use, but also your body language, tone of voice and listening skills.
4. Know the system – ensure you’re familiar with the health and social care services the person uses, how it works and who’s involved. You need to understand everything about the person’s daily routines and experiences.
5. Document everything – it’s a good idea to keep a written or typed note of everything you’ve done on behalf of a person, including actions taken, decisions reached and information given, in case you need to refer back to it at a later date. Include names, dates and times of events.
6. Build relationships with everyone – it’s important that you have a positive relationship with the person you’re advocating for but also with the healthcare professionals they encounter. Get to know the names of the nurses, doctors, carers and therapists the person deals with to help you better support the person you’re working with.
7. Listen well – active listening means truly hearing what the person you’re advocating for is saying. Pick a method of communication that works best for them, whether that’s verbal or non-verbal, to ensure you’ve really heard their views and wishes.
8. Be creative and adaptable – advocacy can be challenging for everyone involved and it can require you to think on your feet to come up with new solutions and methods.
9. Follow up on everything – if you’ve spoken to someone or attended a meeting or appointment on behalf of a person, then ensure you follow up with them to ensure the agreed actions have been completed and the appropriate decisions have been made.
10. Remember there’s no right way to advocate – there’s no rulebook explaining exactly how to be an advocate, so often it’s up to you and the person you’re advocating for to come up with methods that work best for the both of you.

Advocacy in health and social care is when a person supports a patient to have their views and wishes heard and their rights upheld. A good advocate listens well to their subject and really gets to know them, so they can successfully represent them in meetings, appointments and in all decisions relating to their care. Advocates play an important role in maintaining a patient’s dignity and rights in all aspects of health and social care.

Further Resources:

• Safeguarding Online Courses
• What is the Mental Capacity Act?
• Restrictive Practices in Health and Social Care
• How Can We Work Together to Safeguard Adults?
• Safeguarding Adults at Risk: What is it and Who is it For?
• Risk Enablement: Making Safeguarding Personal
• Promoting Independence in Health and Social Care

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What is the Mental Capacity Act?

The Mental Capacity Act 2005 (MCA) is a UK law designed to empower and protect people in care who lack the capacity to make their own decisions. For example, choosing anything from what to eat and what to wear to deciding which care home to move to or whether to have surgery or new medication.

‘Mental capacity’ refers to a person’s ability to make decisions, whether in day-to-day life or one-off, more serious decisions about their care, treatment or finances. A person with good mental capacity is able to make choices, understand information about the choices and communicate their decisions. Someone who lacks mental capacity is unable to do these things, often as a result of illness, injury, a mental health condition or medication.

The Mental Capacity Act has a two-stage test to determine capacity:

1. Does the person have an impairment of their mind or brain, whether as a result of an illness or external factors, such as alcohol or drug use?
2. Does the impairment mean the person is unable to make a specific decision when they need to? People can lack capacity to make some decisions but have capacity to make others. Their mental capacity can also change over time.

In all situations, a person should be enabled to make their own decisions. They’re also allowed to nominate someone else to make decisions on their behalf if they become unable in the future, and this person should always be consulted if you need to make a choice on behalf of a patient.

If a person lacks capacity to make decisions, and you need to make a decision for them, then it must always be in their best interests. Section 4 of the Mental Capacity Act contains a checklist that outlines what you need to consider to ensure you’re acting in a person’s best interests:

• Consider a person’s past and present wishes, feelings, beliefs and values.
• Consider the specific type of condition, illness or injury the person has, how long it’s likely to last for and the person’s age.
• Consider if the person is likely to regain capacity to make the decision in the future. If so, postpone the decision until that point (wherever possible).
• Encourage the person to take part in the decision, doing whatever you can to help them be involved and to communicate in a way that works for them.
• Consider the views of the person’s family, carers or nominated person/s.
• Never make assumptions about a person that could be discriminatory, i.e decisions based on their age, disability, race or sex.

In specific cases, decisions may need to be made on behalf of a person which restrict their personal freedom. This is known as a deprivation of liberty and can only happen in very specific circumstances. If a deprivation of liberty is required, the care provider must first apply to their local authority for legal authorisation, as depriving someone of their freedom can infringe on a person’s basic human rights.

Who Does the Mental Capacity Act Apply to?

Everyone who works or cares for someone who may lack capacity to make decisions must comply with the Mental Capacity Act. This applies to all types of job roles in health and social care, including nurses, doctors, therapists, assistants, support workers, social workers and many more.

The Mental Capacity Act itself applies to all people aged 16 or over and who may lack capacity to make decisions for one or more reasons. This includes people with:

• An illness, such as dementia or stroke.
• A brain injury.
• A learning disability.
• A mental health condition.
• Unconsciousness, such as from anaesthetic or an accident.

These conditions don’t necessarily mean a person lacks the capacity to make all decisions. In some instances, they may be unable to make specific decisions but are able to decide on others. For example, they’re able to choose their clothing but unable to choose their care environment. The key is to never assume someone lacks capacity and never to make all decisions on behalf of a person.

The Mental Capacity Act defines someone as ‘unable to make a decision’ if they cannot:

• Understand the information relevant to the decision.
• Retain information to make a decision.
• Use or weigh up information to make a decision.
• Communicate their decision in any way.

5 Principles of the Mental Capacity Act

There are five principles of the Mental Capacity Act that must be considered before any action is taken on behalf of a person. The five principles are:

1. Always assume a person has the capacity to make a decision, unless it’s proved otherwise.
2. Always help people to make their own decisions wherever possible. Support the person in all ways you can to make the choice themselves.
3. Never assume someone doesn’t have capacity to make a decision, just because you think their choice is wrong or unwise.
4. All decisions made on a person’s behalf must be in their best interests.
5. Always opt for the least restrictive alternative if a decision needs to be made on someone’s behalf.  Decisions must not restrict someone’s basic rights or freedoms and, where there are multiple options, the least restrictive option must be chosen.

If you work in health and social care, then an understanding of the Mental Capacity Act is an important part of your role. People who lack capacity must be fully supported to make their own decisions where possible, and you should only ever make choices on their behalf if everything else has been tried first. As a caregiver, acting in a person’s best interests is one of the most important things you can do, and this includes empowering them to make their own decisions.

Further Resources:

• Introduction to Safeguarding Adults (Level 1)
• Restrictive Practices in Health and Social Care
• How Can We Work Together to Safeguard Adults?
• Safeguarding Adults at Risk: What is it and Who is it For?

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What is Restrictive Practice?

A restrictive practice is an action that prevents a person from doing something. They’re often used in health and social care settings to keep patients safe from something that may cause them serious harm or distress and are also known as restraints.

Restrictive practices can be controversial as they can often stop a person from doing something they want to do, or can be seen as controlling. For this reason, there are strict rules around when restrictive practices can be used and they should only be used as a last resort. They should never be used to punish someone, control someone or handle difficult behaviour.

A restrictive practice should only be used if:

• It’s needed to keep someone safe.
• It’s done for the right reasons and in the right way.
• The patient is fully involved in the decision.
• The practice is used for the minimum amount of time possible.
• The practice is regularly reviewed for effectiveness and suitability.
• The patient’s human rights are upheld.
• All other options have been tried first.

Types of Restrictive Practices

There are many different types of restrictive practices that health and social care settings may opt to use depending on the particular patient and the dangers present. Remember, a restrictive practice must only ever be used as a last resort, after consulting with the patient and in a manner that upholds a patient’s basic human rights. Below are some restrictive practices examples:

Blanket restrictive practices

Blanket rules are when everyone is treated the same and a restrictive practice applies to all patients in the setting, rather than to individuals. Blanket rules often restrict a person’s liberty. For example, requiring all patients to have their lights turned off for bed at the same time or not allowing anyone access to their own medication. Instead, an individual risk assessment should be done for each person and restrictive practices only applied on a case-by-case basis.

Chemical restrictive practices

A chemical restriction is when medication is used to keep a patient safe from harm, often to subdue violent behaviour. This is in addition to any drugs the patient is on for a health condition. For example, using sleeping tablets or injections to send someone to sleep or using rapid tranquillisation to lightly sedate someone, reduce agitation or reduce aggression.

Cultural restrictive practices

A cultural restraint is when a person is prevented from doing something related to their culture. This can be a highly controversial practice and can easily contravene a person’s basic human rights, if not be discriminatory. Examples include not allowing someone to pray at a certain time or stopping someone from expressing their cultural views.

Environmental restrictive practices

An environmental restrictive practice is related to the physical environment the patient is in. Keeping a person in their bedroom at all times, locking their door, making someone go for time-out to calm down, isolating someone, preventing access to outside areas or using solitary confinement are all examples of environmental restraints.

Equipment/mechanical restrictive practices

A mechanical restraint is when equipment is used to stop someone from doing something. Mechanical interventions are usually used to restrict a person’s movement with the aim of controlling their behaviour. For example, using cuffs or belts when moving a patient from one mental health hospital to another.

Observational/surveillance restrictive practices

An observational restrictive practice is where a member of staff watches a patient at all times to keep track of what they’re doing, such as by using cameras in rooms, CCTV in hallways, sitting near them, using GPS trackers or keeping a patient in ‘eyesight’ or at ‘arm’s length’. However, observational restraints can prevent a person from having any privacy, so should be used with care. 

Psychological restrictive practices

A psychological restraint is any sort of communication – verbal or non-verbal – that puts pressure on a patient to do something or stop doing something. It might include routine shouting, telling off, making fun or ignoring someone in order to control their behaviour.

Physical restrictive practices

A physical restraint, also known as manual restraint, is when a patient is physically held in order to control their movement. Examples of physical restrictive practices are holding someone down in a chair, holding someone’s hands back or holding someone on the ground in order to subdue them or restrict their physical movements.

Social restrictive practices

Social restraints are used to prevent a patient from interacting with other service users, often because they’re seen as a danger to others or might be verbally abusive to them. Examples include preventing a patient from joining in with activities with other people and seclusion – keeping them away from others completely.

What are the Rules in Using Restrictive Practice?

Restrictive practices should only ever be used as a last resort and when all other options have been tried, as they can have a significant impact on a patient’s mental health and wellbeing and may even contravene their basic human rights. Restrictive practices must never be used to cause pain, suffering, humiliation or as a punishment.

Before using a restrictive practice or restraint, you must ensure:

1. All other options have been tried first.
2. Patients are asked for their views.
3. Patients’ rights are upheld.
4. There are clean plans for how the restrictive practice should be used.
5. Staff are trained in how to use restrictive practices correctly.

The Mental Health Units (Use of Force) Act 2018 is in place to ensure restrictive practices are not used unfairly. All patients have the right to be treated with dignity and respect, so the use of force as a restrictive practice must always be used proportionately, in accordance with the law and only ever as a last resort. The Act defines use of force as the physical, mechanical or chemical restraint of a patient, or the isolation of a patient (which includes seclusion and segregation).

Want to Learn More?

Increasing your understanding and awareness of mental health is vital for someone who works in health and social care. Take a look at our Mental Health Awareness Training to learn how you can initiate conversations about mental health, and where to go for additional support.

Furthermore, the Human Rights Act 1988 gives those living in the UK legal protection if any of their 16 basic human rights are contravened through the use of restrictive practices. You must keep a patient’s human rights in mind when determining whether a restrictive practice is necessary, as human rights can only be restricted in very specific circumstances.

Below are some additional rules in using restrictive practice that should be considered:

• If a restraint has to be used, it must be done in the best way possible for the patient.
• Only the minimal amount of restraint should be used.
• Where possible, find another way to solve the problem before using a restrictive practice or restraints.
• Consider the needs of the individual patient before using a restrictive practice, as they may need reasonable adjustments for their condition or disability.
• Ensure the details of any restrictive practices used are recorded in a patient’s personal care plan.

All patients deserve to be treated with dignity and respect, kept comfortable and have their rights upheld at all times. For this reason, restrictive practices can be highly controversial and should only be used as a last resort when all other efforts have been exhausted. If you work in health and social care, then it’s essential that you understand the rules for restrictive practices so you can truly look after the patients in your care.

Further Resources:

• Introduction to Safeguarding Adults
• Signs of Abuse in Adults 
• How to Deal with Resistance to Care
• Ensuring Human Dignity and Respect in Nursing: A Checklist
• What is the Mental Capacity Act?

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What is Resistance to Care?

Resistance to care is when somebody refuses healthcare assistance, whether that’s by pulling away from their nurse, trying to leave the room, refusing to take medicine or becoming annoyed or aggressive when you try to help them. It is a common behaviour amongst people in later life or those with dementia or Alzheimer’s, especially when it comes to personal care.

Resistance to care is most common in healthcare settings but it can also happen at home. For example, a wife with early stages of dementia may be resistant to the extra help offered by her husband, or an elderly grandfather may act aggressively when his son suggests he hires a cleaner to help take care of the house.

In a healthcare setting, resistance to care might take the form of refusing to take medicine, refusing to eat, pulling out equipment or tubes, wandering out of their ward or leaving the healthcare facility completely.

Why Might Someone Be Resistive to Care?

Resistance to care usually happens because the person doesn’t understand why they need help, is afraid of the new situation or feels uncomfortable, whether physically or psychologically.

Resistance to care is particularly common with hands-on, personal care tasks, such as washing and bathing, toilering, administering medicines and feeding – especially if the person feels undignified because of the situation.

Amongst people in later life, fear of losing their independence can be a key reason why they resist care. Everyone wants to be autonomous and no one wants to rely on someone to take care of them, especially if it involves personal care tasks. Accepting help from a healthcare professional can feel offensive to older people, as if they’re ‘giving in’ to ageing, harmful to their pride or, more often than not, an interference.

For those living with dementia, resistance to care is often due to a lack of understanding about what’s happening to them. The person may be aware that they’re struggling with simple tasks but unaware of how significantly it actually impacts their daily life. They may believe they can do more than they’re able to in reality and get irritated when people try to help. This is sometimes referred to as ‘lack of insight’, because the person with dementia cannot recognise they need assistance with tasks and will therefore refuse to accept any help given to them.

How to Deal with Resistance to Care

When someone is resisting care, it can sometimes feel like an uphill battle. You want to act in the best interests of the patient and do all you can to help them, yet they’re behaving combatively and it’s hard to maintain positivity. With the right techniques, however, you can deal with resistance to care in a compassionate and constructive way.

Looking for a Course?

Communication skills are essential to help any patient that is resisting care. Our Communication Skills in Health and Social Care Course will teach you about the different barriers to communication and how to overcome them, as well as how to respond to conflict appropriately and efficiently.

To handle resistance to care, try the following tips:

• Encourage the person to do as much as they can by themselves before you step in to help.
• Involve the person in the conversation about their care – avoid making decisions on their behalf if they have the capacity to choose themselves. Always strive for person-centred care.
• Put objects, activities, food and medicines within sight of the person, so they can do things themselves and see what’s going to happen next.
• Be consistent as much as possible, so the person knows what to expect and your care becomes just another part of their daily routine.
• For a person refusing to eat, tailor food and drink to the individual where possible, offering them choices you know they prefer and will be more likely to accept, such as adjusting portion sizes, chopping or not chopping foods up, putting gravy in a jug rather than on the plate, etc.
• Avoid arguing with the person if they’re refusing to eat, drink or take medicine. Instead, politely ask that they eat/drink/medicate, leave the item near to them, then walk away.
• Listen to complaints from the person and don’t be dismissive, even if their grumble seems very minor to you.
• If the person is resistant to washing or bathing, make the experience more appealing to them using aromas and bath products they like, improving cleanliness of the bathroom and using their favourite music.
• For a person refusing medication, be patient, positive and polite. Explain why the medication is necessary, politely remind them to take it, then leave the medicine within sight of the person whilst you get on with something else. Never force a person to take medication or threaten them with consequences.
• Always maintain the dignity of the person you’re providing personal care for by staying out of their personal space as much as possible, giving them privacy where you can, keeping them covered and allowing them to do as much of the care as they can on their own.
• Compliment and praise the person once they’ve allowed you to assist them with something – positive words go a long way in gaining your trust.

For the person in later life or the person with dementia, refusing help can be a matter of pride. They may be in denial that they can no longer live independently and be resistant to care for a long time before they admit that extra help is needed. No matter their situation, it’s essential that you always involve the person in the conversation and act in their best interests. Always be patient, compassionate and positive – even when this feels challenging.

Resistance to care can be hard work, for both the person resisting and the person trying to offer care. What’s important to recognise is that the person resisting care isn’t trying to be difficult or combative – they are simply reacting to their lack of understanding, discomfort or confusion about the situation. As a healthcare professional, you can help by understanding why a person may be resistive to care, then supporting them with compassion and kindness to overcome their barriers.

Further Resources

• Health and Social Care Courses
• Carers’ Breaks and Respite Care for Caregivers
• What is Delirium?
• What are Difficult Conversations in Health and Social Care?
• Restrictive Practices in Health and Social Care
• Promoting Independence in Health and Social Care

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If you work with adults who experience sensory overload – particularly those with autism, ADHD or another neurodivergence – then it’s important to understand the condition so you can offer the support they need. In this article, we’ll look at what causes sensory overload in adults, list some things that may trigger it and help you recognise how to help someone struggling with overstimulation.

What Causes Sensory Overload in Adults?

Sensory overload, also known as overstimulation, occurs when your brain takes in more information than it can process, causing you to feel overwhelmed. It’s triggered by external stimulation of the five senses – sight, sound, touch, taste and smell – and this feeling of overload or overwhelm triggers your body to enter ‘fight, flight or freeze’ mode as it prepares to react to the perceived threat.

Sensory overload in adults can feel like an assault on the senses. It may be one specific sense that causes the problem – like places with loud music (sound) – or multiple senses being overloaded all at once, such as in a busy supermarket with lots to look at (sight), noisy customers (sound) and multiple aromas from the bakery, coffee stand and cleaning aisle (smell).

Common things that may overstimulate an adult include:

• Bright lights, such as those used in supermarkets and shopping centres.
• Background music, particularly if it’s too loud/too quiet to hear.
• Echoing sounds.
• Busy environments with lots of people or lots going on.
• Noisy environments, like festivals, children’s parties and busy restaurants.
• Sudden strong smells, like perfumes, smoke or chemicals. 
• A plate of food with too many different flavours or textures.
• Sudden loud noises, like a crying child, noisy traffic or an alarm.
• Unexpected or unfamiliar textures, such as animal fur, clothing or food.
• Environments with lots to look at, such as a messy kitchen.

Looking to Learn More?

If you work with adults who need further support with sensory overload and overstimulation, then take a look at our full range of Health and Social Care courses. In particular, our Mental Health Awareness training and Introduction to Safeguarding Adults courses.

Signs of Overstimulation in Adults

If someone encounters an environment where they experience sensory overload, then it immediately triggers their brain to feel threatened, they begin to panic and their body prepares them for fight, flight or freeze.

A fight, flight or freeze response is an unconscious reaction by the brain to a perceived threat. When we feel threatened by a situation, we tend to instinctively respond in one of three ways: we either prepare to fight the threat head on, get ready to flee the situation or completely freeze and are unable to respond at all. This response is completely natural and we often feel it in a variety of situations.

This unconscious reaction to overstimulation leads to various physical symptoms, such as:

• An increased heart rate.
• Sweaty hands.
• Pale skin, particularly the face.
• Shaking.
• Restlessness and being unable to sit still.
• Feeling scared, wary and unsafe.
• Withdrawal and refusal to interact.
• Panic, crying or anger.
• Anxiety.
• Irritability.

How to Deal with Sensory Overload in Adults

It’s important to recognise that the physical response to sensory overload is not a conscious decision by the adult, and it’s not simply an overreaction to a situation. Sensory overload happens unconsciously when the brain feels threatened by the environment, usually within a split second of encountering the ‘threat’. However, the symptoms of overstimulation in adults can be controlled and managed by avoiding triggers and knowing how to calm a person down.

A few useful tips for helping an adult experiencing sensory overload include:

• Using earplugs or noise-cancelling headphones to reduce noise.
• Listening to music through headphones to distract the brain.
• Wearing sunglasses to shield from bright lights.
• Dimming the lighting in particular rooms or areas.
• Creating a designated ‘quiet zone’ with familiar items for the person.
• Practising mindfulness and other self-calming activities to help reduce anxiety, such as meditation, reading, yoga or controlled breathing.
• Taking part in talking therapy or cognitive behavioural therapy (CBT) to help reduce anxiety or fear and manage the symptoms.
• Setting boundaries and knowing it’s OK to leave the room when the situation becomes triggering.
• Encouraging exercise, healthy eating and consistent sleep.
• As someone who cares for the adult – remaining calm, kind and considerate, as what they’re experiencing is likely to be much worse than what you’re dealing with.

Sensory overload can happen to any adult but is more common amongst those with a neurodiversity, such as autism or ADHD. The key is to recognise what the triggers of overstimulation are for each particular person, know how to identify the symptoms that may suggest they’re struggling, and to react with kindness should sensory overload occur. Whilst sensory overload can be overwhelming, there are coping strategies available for every adult.

Further Resources

• Introduction to Safeguarding Adults (Level 1)
• Autism in Females: Is it Different?
• ADHD Myths and Facts

The post Sensory Overload in Adults appeared first on The Hub | High Speed Training.

This article will explain what respite care and carers’ breaks are, including the different types of respite care available, the responsibilities of a respite carer and how to arrange respite care and take a break from being a caregiver.

What is Respite Care?

Carers look after someone regularly because they have a long term illness, are disabled or are an older person. This includes family members, who are most often unpaid.

For many, providing care can be exhausting, isolating and challenging at times. To enable caregivers to take a step back from their responsibilities, there is support available in the form of respite care to provide a carers’ break. Respite care can help ease the burden of caregiving and promote balance in the carer’s life. It is also beneficial for the person being cared for, as it gives them some variety, introduces them to new activities and environments and brings positive change to their routine.

Respite care refers to the services that can be accessed to allow a caregiver a break from their caring responsibilities. It is a service which is provided to the person being cared for to replace the care usually provided by their caregiver. Carers’ breaks refers to the break from caring that the caregiver is able to have as a result of the respite care provided.

Want to Learn More?

One of the main reasons to take a carers’ break is to take some time out and look after your own wellbeing. If you’re a caregiver and are struggling to look after yourself as well as the person you care for, you are not alone. We suggest ways in which you can manage and recover from stress and burnout in our article ‘Recovering from Caregiver Stress and Burnout’.

Types of Respite Care

If someone wants to take a carers’ break, there are many respite care options available. Which will be most suitable will depend on the needs of the caregiver and the person receiving the care. Respite care can be either a short term or long term arrangement. Short term respite care could be a one-off week long holiday. Or, the respite care may initially be intended as a one-off break but become a regular, long term occurrence. Types of respite care include the following:

Homecare

Homecare refers to the help at home provided by a paid carer which can be arranged through an agency or directly with the carer. The carer may visit on a regular, long term basis, such as once a week. Alternatively, they may provide temporary support during a carers’ break to allow the usual carer to have some time to themselves, such as for a holiday.

Homecare is a flexible form of respite care. Depending on the needs of the person being cared for, paid carers may provide live-in care and 24-hour supervision. Some paid carers offer specialist nursing care, such as if the person they are caring for has dementia.

Sitting Services

Sitting services are where a trained volunteer sits with someone who needs caring for and keeps them company. The volunteer is usually from, or trained by, a charity or carers’ organisations. The volunteer may stay for a few hours at a time and provide this service on a regular basis. Sitting services are often free of charge, or there may be a small fee.

Family and Friends

The friends and family of an unpaid carer or the person they are caring for may be able to help with respite care. They may be able to routinely spend a couple of hours with the person requiring care, or support a longer carers’ break by either moving into the home of the person being cared for or moving them into their home on a temporary basis.

Day Care Centres

Day care centres offer a supportive environment for people who struggle to socialise and participate in activities. They’re also referred to as day services. Different centres provide a range of opportunities such as arts and crafts, baking, dancing, singing, games, pottery, gardening, swimming and theatre trips. Alongside these activities, some day care centres offer personal care services including hairdressing and barbering.

A Short Stay in a Care Home or Nursing Home

Some care homes and nursing homes provide short term respite care. This arrangement would enable the caregiver to take a longer break, such as a holiday. Care providers would need to plan a stay well in advance, so this may not be an option if needed at short notice. Some care and nursing homes take bookings in advance which can help with forward planning.

If you want to arrange for the person you care for to temporarily stay in a care home or nursing home, you should reach out to those locally to find out if it’s a service they offer.

Respite Holidays

Respite holidays provide carers and the people they care for with a break from their every day routine. This gives caregivers and the person they care for the chance to relax and spend quality time together in a supportive environment. Some respite holidays are just for the person being cared for, where they will be looked after by other carers. Here, they have the opportunity to get involved in a range of activities alongside other people with a long term illness or disability.

Emergency Respite Care

If you are a caregiver, it’s important that there is someone nominated to contact if you are unable to get to the person needing care due to an accident or emergency. For example, if you suddenly need to receive medical attention. The person providing emergency respite care could be a relative, neighbour or friend. They would be responsible for looking after the person who is being cared for while alternative arrangements are made. 

The nominated person will need to be aware of key information including how to access the property and what type of care they will need to give. The NHS suggests keeping a clear written list of information about what care the person being looked after needs. This should include details on any mediation they will need to take and what assistance they will require.

Respite Caregiver Duties

The main goal of a respite caregiver is to temporarily relieve the responsibilities of the primary caregiver. The care they give will be similar to that given by the usual caregiver who is taking a break. As such, respite caregivers have a range of duties which will depend on the needs of the individual who needs to be cared for. Respite caregiver duties may include helping with: 

• Washing, getting dressed or using the toilet. 
• Cleaning, doing laundry or cooking.
• Shopping for food or other items.
• Administering medication.
• Leaving their home and accompanying them on journeys, such as to appointments.
• Providing emotional support, such as by keeping them company.

These are just some examples of the care which a respite caregiver may deliver. Some individuals will require more assistance and may need to be monitored at all times, while others may be able to carry out some tasks independently. This is why it is essential that the care and additional support provided is person-centred and tailored to meet the needs of the individual.

How to Arrange Respite Care

If you need a break from caring, there are different ways you can arrange this, depending on what type of respite care you want. You can access respite care by contacting the service to arrange directly, going through your local council or arranging care through a charity or organisation. We will discuss funding for respite care services later.

Visits to day care centres, for example, are usually run by councils or local charities. You can find out which day care centres are local to you by contacting your local council or charities, including Sense and Age UK. 

To arrange homecare from a paid carer, you should contact your local council for further information if you are eligible for funded support, or you can arrange your own homecare by finding a local agency. Information on homecare services and providers can be found on the NHS website, through your local authority, on the Care Quality Commision (CQC) website and on the Homecare Association members’ website. You can then contact those which interest you and get more information to find out if they will be suitable.

For a temporary stay in a care or nursing home, you can discuss your needs and arrange a stay directly with a home of your choice. Have a look at the NHS website to find local care homes with nursing and local care homes without nursing.

You can contact some charities and organisations directly to arrange respite holidays, or to get financial support for them. The NHS lists the following on their website: MindforYou (the dementia holiday charity), Revitalise (a provider of respite breaks and holidays for disabled people and their carers), Family Fund (a grant-making charity for families raising a disabled or seriously ill child, on low income) and Family Holiday Charity (a charity providing breaks at holiday sites or grants to help with the cost of a holiday, for low-income families).
Sitting services are offered by various organisations and can be arranged directly with them. This includes Carers Trust, Age UK and Royal Voluntary Service.

Who Pays for Respite Care?

Respite care can be very expensive for the carer to cover themselves. The UK Care Guide estimates that respite care costs £700 to £800 a week on average. For live-in care or stays at a care home, this cost can reach £1,500 a week.

To help with this, most respite care is funded by local councils who provide it to those who have been assessed as needing it. In order to be eligible for funded respite care, carers should undergo a carer’s assessment, while the person they care for should have a needs assessment. It’s important that you both are assessed because your eligibility for financial help with respite care may be determined by either assessment. The financial support you are eligible for will be means-tested, which means that you or the person you care for might need to contribute towards the cost of respite care. It’s recommended that the person looked after has a needs assessment, even if they don’t want council funding. This is because the results of the assessment will indicate which type of respite care will be most suitable for their needs.

If the outcome of the assessments shows that the caregiver or the person they care for is eligible for respite care, the local council will then carry out a financial assessment to determine if they will pay towards it. If so, the council can either arrange respite care on their behalf, or the caregiver has the option to arrange it themselves through a personal budget or direct payment, paid for by the local council.

You may be able to access charity funding to help with the cost of respite care. The Carers Trust has useful information on their website about grants that are available to carers who need respite. Similarly, Turn2us can help you if you have a financial need to access welfare benefits, charitable grants and other financial help. The charity Disability Grants lists information on charities and trusts which offer grants to disabled people and their families and carers.

Caregivers and the person being cared for also have the option to pay for respite care themselves but, as mentioned, this can be very costly and simply isn’t an option for many people. You may be able to raise some of the funds through savings, benefits and income.

Will a Carers’ Break Affect My Carer’s Allowance?

Caregivers are entitled to Carer’s Allowance as the main welfare benefit to financially support them and the person who they care for. If you take time away from your caring responsibilities, there are rules around the financial support you are entitled to. You can continue to receive your Carer’s Allowance for up to four weeks in any six-month period if you take a break from caring.

You are required to report certain changes to the care you give, including if you go on holiday, into hospital or stop providing at least 35 hours of care a week. You can do this online on the Carer’s Allowance Service, or by informing the Carer’s Allowance Unit by post or telephone. The Carers UK website provides useful information about your eligibility for Carer’s Allowance if you take a break from caring due to different circumstances.
The conditions of the Carer’s Allowance are complicated, so you should seek advice from the Carer’s Allowance Unit. They will be able to offer you advice based on your situation.

Though often rewarding, being a caregiver can be exhausting at times, particularly if you are unable to dedicate time to look after yourself. Carers’ breaks and respite care gives caregivers and the person they are looking after a much needed break and a chance to recharge. There are many different types of respite care available, with different ways to access these. When deciding which type, you must consider the needs of the person you care for as well as your own. Support is available to enable you to have some time to yourself and to return to your caregiving responsibilities feeling positive and refreshed.

Further Resources

• Health and Social Care Courses
• Recovering from Caregiver Stress and Burnout
• How to Promote Positive Mental Health for Healthcare Workers
• Safeguarding Adults at Risk: What is it and Who is it For?
• Person-Centred Care Quiz

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In this article, we will define what attachment disorder in adults is, explain the different types they may experience and outline the signs and symptoms of the disorder and how it can be treated.

What is Attachment Disorder in Adults?

The term attachment disorder refers to the emotional and behavioural issues that develop in children who have difficulty forming a secure bond with their primary caregiver, which is often their parents. This connection may not be formed for various reasons, including an absent caregiver, neglect or abuse. In some situations, the caregiver may not be able to physically be with their baby or child, such as if either one is unwell and has to stay in hospital for a sustained duration. This may result in the child not receiving the care and attention needed to form a close attachment with their parents or caregiver. For most people, the experience with their parents or other caregiver is their first example of a secure, loving and trusting relationship. If a child doesn’t have this experience, they may grow up with different expectations of what relationships are like and struggle to form and maintain healthy relationships as an adult.

Although attachment disorder can only be diagnosed in children, adults can experience attachment issues resulting from untreated or undiagnosed attachment disorders from their childhood. For example, someone with attachment disorder may, as an adult, feel as though they cannot trust a romantic partner and struggle to communicate their emotions in an effective way. This can result in them being unable to form meaningful relationships and may cause them to experience commitment problems.

Types of Attachment Disorders in Adults

Different types of attachment disorders may develop as a result of an individual not forming a strong attachment to their primary caregiver as a child. As mentioned, attachment disorders are not formally diagnosed in adults. However, if attachment disorder is left unresolved as a child, they may experience significant difficulties relating to this in adulthood.

Reactive Attachment Disorder (RAD)

Reactive attachment disorder (RAD) is a rare condition that can result from neglect or mistreatment during early childhood. It can persist in adulthood if the individual is not successfully treated for the condition in their early years.

Signs and symptoms of RAD in adults may include having difficulty with the following:

• Forming attachments with other people and maintaining relationships.
• Showing or accepting affection.
• Trusting others.
• Understanding how others are feeling.
• Controlling feelings of anger.

Someone with RAD may also experience feelings of low self-esteem, display impulsive or detached behaviours and have issues with control. They may be more at risk of developing a mental health condition, such as anxiety or depression.

Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder (DSED) is a type of attachment disorder which tends to develop as a result of neglect or unsuitable care during the first two years of an individual’s life. A child may try to gain the attention of strangers and not display the usual fear associated with being introduced to new people. If left untreated, DSED can result in the individual struggling to create and maintain healthy long-term relationships with other people.

Signs and symptoms of DSED in adults may include:

• A limited understanding of social boundaries, such as excessive friendliness or touching strangers.
• Quickly placing trust in people they do not know well.
• Hyperactivity and becoming overly excited when meeting new people.
• Acting impulsively or showing a lack of inhibition.
• Displaying other behaviours that are not considered to be socially acceptable.

In some cases, RAD or DSED can result in someone developing an obsessive love disorder (OLD). This is an intense fixation with someone that can result in thoughts and behaviours that can be damaging to both people involved. Symptoms and behaviours may include extreme jealousy, controlling behaviour, possessiveness and an inability to accept rejection. Untreated, it can result in extremely serious behaviours such as abuse, stalking and violence. It’s worth noting that clinicians do not widely recognise obsessive love disorder, and there is discussion over whether it can be considered a mental health condition. However, attachment issues that aren’t resolved can manifest in various ways in someone’s emotions and behaviours, including those associated with OLD.

Signs and Symptoms of Attachment Disorder in Adults

Unresolved attachment disorder in childhood can lead to adults experiencing a range of symptoms and behaviours. These can vary depending on factors, including the reason for the attachment not forming as a child (for example, abuse), as well as individual differences. Although research into attachment disorder in adults is limited, there is strong evidence that certain family problems in early life can have a significant, lasting impact on an individual.

Some of the common signs and symptoms of attachment disorder in adults include:

• An inability to form and maintain healthy romantic relationships.
• Difficulty with responding to their emotions.
• Mood swings.
• An inability to trust people.
• Avoidance of intimacy.
• A feeling of low self-esteem.
• Withdrawal and avoidance of social events.
• Difficulty in certain social situations and interpreting social cues.
• Mental health conditions, including anxiety, depression or post-traumatic stress disorder (PTSD).

It’s important to recognise that attachment problems may make mental health conditions such as depression or anxiety worse rather than be a direct cause, though many mental conditions are linked.

An adult with attachment disorder will likely experience challenges with relationships. They may find it difficult to communicate effectively and voice their feelings to a romantic partner, resulting in feelings of paranoia, insecurity, jealousy and anxiety. If these feelings aren’t discussed and resolved healthily, the individual may express their feelings in an unproductive manner, such as through anger and accusations. Some people may become withdrawn and find commitment challenging, while others may feel that they need excessive attention and validation from their partner.

Someone with an attachment disorder may also find other relationships difficult, such as those with friends and family. If the individual experienced significant trauma as a child and continues to see those involved as an adult, these relationships can be strained and difficult. This will depend on the specific circumstances, but these interactions can cause stress and anxiety. Many of the signs and symptoms people experience can make it difficult to form and maintain any type of relationship. Someone may find it challenging to maintain strong friendships if they tend to withdraw from social situations or their mental health makes it difficult for them to function well.

Attachment disorder can affect all aspects of someone’s life, from their ability to work effectively to everyday interactions. It can be very difficult for someone to get the help they need, but if these problems aren’t addressed, the individual’s mental wellbeing can rapidly decline.

Want to Learn More?

At High Speed Training, we offer a range of Health and Social Care courses on topics including Advanced Safeguarding Adults and Communication Skills in Health and Social Care. Our courses are designed to support you whether you’re just starting in the industry or are experienced practitioners.

How to Treat Attachment Disorder in Adults

If an attachment disorder isn’t addressed and resolved during childhood, support can be sought in adulthood. Often, a form of therapy or counselling is an effective approach to managing attachment disorder and the behaviours and conditions that can result from it.

Psychotherapy, also referred to as talking therapy, is a type of psychological treatment for mental and emotional problems. Working with a qualified therapist can help someone identify and understand their thought patterns and behaviours. Attachment-based therapy is a specific type which is intended for children, adolescents and adults who have an attachment disorder. For adults, it involves discussing their childhood and past experiences and identifying unresolved trauma impacting their lives. This can help them to understand why they feel or act a particular way, particularly when in romantic relationships. For example, they may find it difficult to trust their partner and receive and/or reciprocate affection.

By addressing these issues, an adult with attachment disorder can work with their therapist to overcome the impact of their early experiences. They may be able to change these aspects which are affecting them negatively by developing techniques and strategies that work for them, such as establishing clear boundaries with their parents.

Alongside therapy tailored to the individual, couple therapy can also be an effective way to treat attachment disorder in adults. Or, some people may find it beneficial for their partner to attend some of their personal therapy sessions. Most people with attachment disorder will benefit from focusing on themselves and considering why they think and behave the way they do independently before introducing their partner to later sessions once they feel comfortable in doing so. Involving a partner in these discussions can help them to understand why their partner behaves in certain ways. As a result, they will likely want to be more accommodating and encouraging of their partner’s circumstances and support them in developing positive thoughts and behaviours. Together with the therapist, couples can build on techniques to strengthen their relationship, supporting the individual with attachment problems to overcome these issues.

Another type of talking therapy that could be useful for someone with attachment disorder is cognitive behaviour therapy (CBT). CBT can be an effective tool to enable someone to understand and change how they think about their life and manage any unhealthy behaviours. Evidence shows it can be an effective treatment for mental health conditions, including depression, anxiety, post-traumatic stress disorder (PTSD) and more. As attachment issues may worsen someone’s mental health, CBT can be used to help manage and treat both their attachment disorder and some conditions exacerbated by it. CBT involves a series of sessions with a therapist during which milestones may be set, and the individual may be required to complete tasks between the sessions.

Conversations about conditions and disorders can be difficult to broach. However, it is important that these topics are talked about and that other people understand what these experiences can be like for someone as best as possible. Our article here provides some conversation topics and tips on talking about mental health, which you may find useful.

Expand Your Knowledge

If you work in health and social care, you need to know how to communicate effectively in a range of situations and with different people, which may include adults with attachment disorder. Take a look at our Promoting Effective Communication article to learn more.

If someone you know or care for is experiencing difficulties that you think may result from attachment disorder as a child, medical advice should be sought, such as through a GP or a therapist. It’s important to remember that attachment disorder is only clinically recognised in children, and adults are unlikely to be given this diagnosis. However, if attachment disorder as a child isn’t treated, it can result in various difficulties in later life, predominantly with relationships and social interactions. Addressing this as an adult can result in an individual developing positive thought patterns and behaviours, enabling them to successfully form long-lasting, happy relationships.

Further Resources:

• Health and Social Care Courses
• Promoting Effective Communication in Health and Social Care
• How to Help Someone With Loneliness
• Safeguarding Adults at Risk: What is it and Who is it For?

The post Understanding Attachment Disorder in Adults appeared first on The Hub | High Speed Training.

In this article, we will define what delirium is and how it differs from dementia in the elderly, explore the challenges it creates for those suffering from delirium, list the common symptoms and causes and provide guidance on caring for people with delirium.

What is Delirium in the Elderly?

Delirium is more than a fleeting confusion; it is a rapid and profound decline in mental clarity, usually occurring over one to two days. This condition is often a response to various medical issues, making it imperative for healthcare providers to identify and address the underlying problems.

Individuals at risk typically face multiple medical challenges simultaneously, heightening the urgency for proactive care. By understanding the nature of delirium, professionals can tailor their approach to the specific needs of each affected individual.

Symptoms of Delirium

Recognising delirium demands a keen understanding of its varied symptoms. Beyond the commonly observed traits, such as heightened distractibility, reduced awareness of surroundings and confusion, individuals may also exhibit difficulties performing routine tasks or tasks they were previously able to complete with ease.

Furthermore, infections, particularly UTIs, are common culprits in triggering sudden confusion associated with delirium. To deepen your understanding, refer to our article on Urinary Tract Infections in the Elderly, which explores the correlation between infections and delirium, offering valuable insights for healthcare practitioners.

Difference Between Dementia and Delirium

Understanding the disparities between dementia and delirium is crucial for healthcare professionals working in care. While both dementia and delirium can coexist and may share some common symptoms, understanding the differences in their nature and causes is important for accurate diagnosis and tailored care. Dementia is a chronic, progressive condition, while delirium is an acute, reversible state often linked to specific medical issues. 

Onset and Duration

Dementia: Typically, dementia has a gradual onset and progresses over an extended period. It is a chronic condition that involves a decline in cognitive abilities, memory loss, and changes in behaviour. The effects are persistent and may worsen over time.

Delirium: In contrast, delirium manifests suddenly, often within hours or days. It is an acute state of confusion with rapid onset and tends to fluctuate throughout the day. Delirium is usually reversible when the underlying cause is identified and addressed.

Cognitive Impairment

Dementia: Cognitive impairment in dementia is persistent and often includes memory loss, language difficulties, and challenges in problem-solving. The decline is gradual and may not be related to a specific medical event.

Delirium: Cognitive impairment in delirium is characterised by fluctuating attention, disorientation, and confusion. It is usually reversible and linked to an underlying medical condition or environmental factors.

Fluctuation in Symptoms

Dementia: Symptoms typically remain relatively stable over time, with gradual progression. Day-to-day variations are minimal.

Delirium Symptoms can fluctuate throughout the day, often worsening at night. The individual may experience periods of clarity followed by increased confusion.

Underlying Causes

Dementia: The primary cause of dementia is neurodegenerative, such as Alzheimer’s disease, vascular dementia, or other progressive brain disorders. An acute medical issue does not typically trigger it.

Delirium: Often a response to an acute medical problem or multiple medical issues occurring simultaneously. Common triggers include infections, medication side effects, metabolic imbalances, or surgery.

Reversibility

Dementia: Dementia is generally irreversible, with treatment focusing on symptom management and support to enhance quality of life.

Delirium: Delirium is often reversible when the underlying cause is identified and addressed promptly. Effective management of the triggering factors can lead to a full recovery.

Need a Training Course?

Our Health and Social Care courses, notably Dementia Awareness, provide targeted training to equip professionals with the knowledge needed to achieve a more accurate diagnosis and tailored care plan for individuals with either condition.

How to Help Someone with Delirium

Providing effective care for delirium involves a multifaceted approach. Identifying and treating the underlying cause is paramount, as delirium often improves with targeted interventions. Delirium usually lasts for one to two days, and creating a supportive and calm environment is crucial to facilitating the individual’s recovery process.

Alzheimers.uk lists some tips on how to help support the wellbeing of those with delirium, these include:

• Ensuring they are wearing any hearing aids and glasses they may have.
• Providing a 24-hour clock and calendar that is easily visible.
• Encouraging a good sleep routine. Reducing noise and dimming lights at night where possible.
• Reassuring the person if they have delusions and/or hallucinations.
• Helping and encouraging the person to be as active as is safe and appropriate.
• Helping them to regularly drink and eat.
• Refraining from moving the person unnecessarily – either within and between hospital wards or into the hospital if delirium is being managed at home.

Exploring relevant research findings is essential for those seeking insights into the duration of delirium. Additionally, our articles on effective communication and active participation offer practical guidance, aiding professionals in reassuring and supporting individuals during their recovery from delirium.

By understanding the nuances of delirium, healthcare professionals can enhance their ability to recognise, understand, and respond effectively to this often misunderstood condition, ultimately contributing to improved outcomes and quality of life for those under their care.

Further Resources: 

• Health and Social Care Courses
• Duty of Care in Health and Social Care: Responsibilities & Examples
• Urinary Tract Infections in the Elderly: A Guide for Healthcare Professionals
• How to Deal with Resistance to Care

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