Happy New Year

Merry Christmas from All the Team at The Edith Ellen Foundation

Maslow’s Hierarchy of Needs in Social Care

Is it time to rethink our currently outdated culture of Care?

As a former Nursing student and later a Business student I am familiar with Maslow’s Hierarchy of Needs, a theory in psychology that demonstrates the theory of Human Motivation.

Maslow’s theory focuses on describing the basic motivational stages of growth in humans, using the terms "physiological", "safety", "belonging" and "love", "esteem", and "self-actualisation".

Portrayed in the shape of a pyramid with the largest, most fundamental needs at the bottom and the need for self-actualisation and self-transcendence at the top. The belief is that as humans we need to fulfil these basic needs to prevent us from feeling tense or anxious.

This can be applied to Health and Social Care, Nurses/Healthcare Professionals can apply Maslow’s hierarchy of basic needs in the assessment, planning, implementation, and evaluation of patient care. It would help the nurse identify unmet needs as they become health care needs, and allows the nurse to locate the patient on the health-illness continuum and to incorporate the human dimensions and health models into meeting needs.

The fulfilment of the lower level needs is essential to a person’s health and well-being.  This principle encourages professionals across the scale to look beyond their particular area of expertise; patients or clients will be evaluated in the context of their physical health, their family and career situation, their ability to communicate meaningfully with family members, and their ability to work.

All basic human needs are interrelated and may require nursing actions at more than one level at a given time. For example, in caring for a person coming into A&E with a heart attack, the nurse’s immediate concern in the patient’s physiologic needs (e.g., oxygen and pain relief). At the same time, safety needs (e.g., for ensuring that the person does not fall off the examining table) and love and belonging needs (e.g., for having a family member nearby if possible) are still major considerations.

Physiologic	Breathing, circulation, temperature, intake of food and fluids, elimination of wastes, movement.
Safety & security	Housing, community, climate.
Love & belonging	Relationships with others, communications with others, support systems, being part of community, feeling loved by others.
Self-esteem	Hope, joy, curiosity, happiness, accepting Self.
Self-actualisation	Thinking, learning, decision making, values, beliefs, fulfilment, helping others.

These can become the motivators, but in addition if you deprive someone of any of these a deficiency of needs will arise.  This deficiency will motivate people to act when they are unmet – if you deprive someone of their liberty, their safety, their security, they and their loved ones will strive to meet that need.  Such needs will become stronger the longer the duration they are denied. For example, the longer a person goes without food, the hungrier they will become.

With Maslow’s model in mind, health-care workers can assess an individual as a whole person – a physical, intellectual, social, emotional, and moral being whose physicality cannot be separated from psychology and feeling.  At each stage of treatment, a patient’s basic physical needs must be accounted for, whether by a physician, a social worker, a psychologist, or even a speech-language pathologist.

Carers should be Valued

At the Edith Ellen Foundation, we work tirelessly to ensure that those needing care are not isolated from neighbours and friends.

We are increasingly becoming more and more aware of the need to provide excellent and consistent care as people’s confidence in the Care system falls.

In addition, we also appreciate that the Carer needs to be appreciated, valued even.

Morale in the care sector is low.

The media tends to concentrate on stories of poor care – and of course these must be told. But this often means that we do not get to hear the marvellous stories of the many people who work in the care sector who show loving kindness to their clients every day and go the extra mile to support and care for their clients.

The vision for social care must not be lost through an inability or unwillingness to pay a living wage which properly reflects the value of those whose job is to care for the vulnerable.

The care sector is an area where employers are struggling to pay the living wage for various reasons. I hoped that this was not because of an unwillingness in principle, or a sense that the workers were not worth higher salaries, but more and more it becomes clear that it is just about profit.  We know that the quality of care will be better if people can be better paid.

These care workers are paid the minimum wage, and many work unsocial hours so that 24-hour care can be provided 365 days a year.

Sometimes for the carer, it is simply not about the wage, for the carer it is the basic need to be appreciated, valued, to reach self-actualisation, and to purely be thanked for the work they do for whose work we are so thankful.

So, this Christmas, take time out to simply say “Thank You” to a Carer.

#carer #social #thankyou

Can Cognitive Behaviour Therapy Help Dementia Patients?

Whilst visiting my nana at the weekend, I saw that her motivation had gone and that she seemed to be finding comfort in doing the same routine everyday – almost as though she has intentionally isolated herself or even institutionalised herself!

It made me think about how I could support my nana better and I thought out cognitive behaviour therapy.

However, is there such as thing as cognitive behavioural therapy for people with dementia?

With Dementia and dementia related illnesses such as MCI, there is a large proportion of patients suffering underlying issues such as anxiety and depression, in fact there is an estimated 50% of patients experiencing some symptoms of depression.

Depression can decrease quality of life, worsen dementia symptoms and increase carer stress.  Anxiety is also common in people with dementia and has a similarly negative impact.  Therefore, can Cognitive Behaviour Therapy help?  And if it can how would it need adapting to ensure the best possible outcome for the patient?

What is Cognitive Behaviour Therapy?

Cognitive behavioural therapy (CBT) is a widely used psychological therapy. It was initially developed to treat depression in adults without dementia and can be effective in treating both anxiety and depression. 

I believe that in its current form it cannot be used to help people with dementia as it requires thinking and memory abilities that may be affected by the condition.  But that is just my opinion.

Adapting Cognitive Behaviour Therapy

There has been some research into adapting CBT to help those with dementia, but this is still in the early stages.

Dr Stott has already undertaken some preliminary work on this project, including consulting with experts in CBT and people affected by dementia to determine the aims of the project.

Dr Stott aims to better understand the skills that people with dementia need in order to take part in CBT.

I believe that once this study is completed then Dr Stott will conclude that CBT is feasible for people with mild to moderate dementia and clinically significant anxiety.