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Person-Centered Assessment

Person-centered assessment prioritizes the experiences of the individual who is receiving care. It is based on therapeutic relationships which consist of respect and trust. The assessment process does not only include researches that have been published or clinical expertise but also human encounters that are authentic. The word assessment here refers to the set of activities which are goal-oriented and task-centric in a context where the center of attention is the patient or the person who is receiving care. The assessment process starts with evaluating the experiences of the person and trying to know and understand those experiences from their point of view. It also involves knowing what the person has in him which makes him unique or different from others. The aim of this kind of assessment is to provide support to the person and his family in the way which is best possible for him. The person-centered assessment has various components. They are relationship-based and personhood care, meaningful engagement and individual care and positive social environment and relationship-based care (Molony, Kolanowski, Van Haitsma & Rooney, 2018). In my essay, I will first look at the positive and negative key issues that are faced by older patients generally. I will look deep into their problems and will notice the root cause of their troubles. I would also focus on their interaction with other people and communities and will pay attention to their past experiences. Then, I would discuss the points one by one which creates problems for the person. After that, I will discuss the key issues that are face by them and also the strategies of person-centered assessment which could be used to solve their problems. By doing this, I would try to give proper solutions by making use of person-centered care because that will help in promoting the good experience of the patient.

The person who is taken for the study was Kooncha Brown who was also an Aboriginal woman and is of 58 years old. There are multiple negative and positives issues faced by her all over her life. The key negative issues that are identified by examining her case were that she has no money for herself. This was because of her mother who 15 years ago became ill and Kooncha has to take care of her and for that, she becomes a full-time carer for her mother. After taking this role, she had to quit her job and therefore was not left with any money. Because of the financial problem, she could not perform the tasks that she likes to do for example she was fond of buying clothes and also likes to go on trips on the weekends. She also likes to catch up with her friends and always look forward to eating out. Moreover, she was very much interested in getting her nails, facials and hair done. She likes to maintain herself but now because of the money problem she could not do any of it. She was also very fond of putting makeup but now cannot even afford it. Another key issue with Kooncha is that she feels low and depressed because she no longer can perform her favourite activities such as catching with her friends and having a yarn. She also cannot see her grannies. This was all because she does not have any finances and have a problem in mobility as there was no one who can help her move from one place to another. She also explained that she is homeless and have left with no income at this crucial stage of her life. Moreover, she also had to face racism and discrimination because she belongs to the Aboriginal community and was a transgender woman. She also complained that doctors and nurses would speak and treat her in a bad way and also look down at her. This all has made an impact on her mental, emotional and social wellbeing. Another problem which was experienced by Kooncha was social isolation. She was left with no friends as she was admitted to a medical institute. Her wellbeing was not given much importance as when she was transported to another facility to get an eye injection, she was often left there because she did not have any access to transport facility to come back to her institute. She also describes that her healthy ageing is having someone who helps with services and could make living less stressful for her. 

The positive issue which is faced by her was that she was admitted to Aboriginal Medical Service Redfern where most of the staff was belonging to the Aboriginal community. She felt comfortable and good between her community people as no one would talk to her in a bad way or would be looked down at her. She also liked that the facility had other departments also which could manage her medical conditions as she was diabetic and have multiple other problems like fasciitis, glaucoma, plantafacitis and a half liver. She could also use the help of dieticians, physiologist and many other healthcare professionals at a single place.

In the old age, emotional and social functioning of the person changes with time. The need to be involved in a large group is not lessened in any point in life. Also, people face implications in an equal manner in their lives because of social isolation problem. Emotions could be very intense and can affect the facial, subjective and psychological feelings in the old age. Negative emotions with that also impact on psychological functioning and physical health of the older people (Charles & Carstensen, 2010). Psychological distress in people is also associated with an increase in the numbers of mortality and morbidity. Increased vulnerability also leads to anxiety, loneliness and depression (Dong, Chen, Chang & Simon, 2013). To support Kooncha and her case, the care which should be given to her should be person-centered. It is important to maintain her self-esteem which relates to the process of the ageing. For this, she should also be involved in her own care plan which will help in promoting her self-esteem. Healthcare professionals should also consider her life experiences while making the treatment plan for her. There should also be effective communication and exchange of information so that her needs could be managed. Lack of proper communication indicates that her feelings and emotions are not valued and therefore older patient becomes passive. The place of care should be given importance so that she would feel less vulnerable and more in charge of her condition and disease. Independent housing will be suitable for her emotional wellbeing and services which could be provided to her home could also add benefits to her mental wellbeing. She should also be provided with the option of having a personal care manager that would take care of her. A registered nurse could also help her with her daily needs and could provide person-centered care to her (Norell Pejner, Ziegert & Kihlgren, 2015). Therefore, providing personal help to Ms. Kooncha and taking care of her mental well-being results in her stable emotional and social wellbeing. She would not feel depressed and lonely.

Older people also feel distressed due to financial troubles (MacLeod, Musich, Hawkins & Armstrong, 2017). They have problems in making sound decisions due to their illnesses about their finances and regarding other matters like investments, housing and long-term savings. For taking care of Ms. Kooncha and her condition it is important to look at her financial problems as well because it creates mental distress also. For that, she should be provided with health insurance so that her medical expenses and her personal expenses could be handled. She should also be given information about health plans. Moreover, it is important to give her knowledge about finances so that she could be able to make decisions on her savings. She should be given the knowledge about effective budgeting so that she can manage her healthcare bills and other living expenses (MacLeod et al., 2017). By doing all this, she would fell less financial burden and could also perform the activities that she likes to do earlier in her life.

In conclusion, it could be said that person-centered assessment helps in giving priority to the people who are receiving the care. It focuses on human encounters and building relationships with trust and respect. The assessment process initiates by learning about the life experiences of the patient and is based on person-hood, meaningful engagements and individual care. It also pays attention to the social environment of the patient. In the case scenario of Ms. Koocha Brown, her past life experiences were assessed and it was known that she is suffering from various problems. The key issues that were highlighted were financial problems, troubles related to social and emotional wellbeing and also social isolation. Because of all these problems, she was suffering. Therefore, steps were elucidated out to help with her condition. Those steps were providing her personal care with the help of a nurse and also including her in care plan so that her self-esteem could be promoted. Educating her on financial subjects would also reduce her financial distress. 

References for Elder Abuse and Psychological Well-Being

Charles, S. T., & Carstensen, L. L. (2010). Social and emotional aging. Annual Review of Psychology61, 383–409. https://doi.org/10.1146/annurev.psych.093008.100448

Dong, X., Chen, R., Chang, E. S., & Simon, M. (2013). Elder abuse and psychological well-being: A systematic review and implications for research and policy-A mini review. Gerontology59(2), 132-142. https://doi.org/10.1159/000341652

MacLeod, S., Musich, S., Hawkins, K., & Armstrong, D. G. (2017). The growing need for resources to help older adults manage their financial and healthcare choices. BMC Geriatrics17(1), 84. https://doi.org/10.1186/s12877-017-0477-5

Molony, S. L., Kolanowski, A., Van Haitsma, K., & Rooney, K. E. (2018). Person-centered assessment and care planning. The Gerontologist58(suppl_1), S32-S47. https://doi.org/10.1093/geront/gnx173

Norell Pejner, M., Ziegert, K., & Kihlgren, A. (2015). Older patients’ in Sweden and their experience of the emotional support received from the registered nurse–a grounded theory study. Aging & Mental Health19(1), 79-85.

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