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'Use communication and intuition' in assessments, say senior care home nurses

Care home nurses need to ensure they are putting the patient at the heart of any decision about their care from admission onwards, according to two senior nurses in the field.

Care home nurses need to ensure they are putting the patient at the heart of any decision about their care from admission onwards, according to two senior nurses in the field

Care home
Four Seasons Health Care research lead Gary Mitchell urged nurses to put residents at the centre
of care: 'There is only one expert and that is the resident themselves.' Picture: iStock

Four Seasons Health Care (FSHC) head of nursing Joanne Strain also urged nurses to use their 'nursing intuition' when getting to know a person during assessments.

Speaking at the RCN congress in Liverpool on Monday, Ms Strain said involving patients directly in decisions at a pre-admission stage was vital to their care.

'Find out about the person, and if you cannot find out from the patient themselves, then ask family, ask people who know them – relatives, social workers and care managers. It is about communication.'

Important phase

FSHC research lead Gary Mitchell added that the pre-admission stage was arguably the most important part of the three phases of moving to live in a care home:

  • Admission.
  • Maintaining well-being.
  • End of life care.

He said: 'As a nurse, we often meet residents in a vulnerable stage of their life with a high need.

'The patient needs to be in the right place so they can flourish well.'

Undervalued resource

Mr Mitchell said the best ways to get this right were through a combination of nurses' effective documentation, communication and intuition.

'There is only one expert and that is the resident themselves – talk to that person and glean what you can from that person.'

He added that family members were an undervalued resource for care home nurses.

'Family members have a background in the patient's life history – 80% of people who live in care homes will develop dementia, and family and friends can provide a level of information that person cannot articulate.'

Number one 'domain of care'

FSHC has developed 16 'domains of care' which staff work with – the number one being that of capacity.

'That's not by chance,' said Mr Mitchell. 'It's really important that we help empower and enable residents to speak for themselves.

'Just because someone has dementia – or a condition that prohibits them – that doesn't mean we don't try to make sure that person contributes to their lives.

'This is more than just nursing – this is their life, even if it is non-complex decision making.'

Ms Strain added: 'It is our privilege to work in the residents' homes, they don't live in our workplace.'


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