Individualized Care

Individualized care is one of the most important topics and techniques pushed during nursing school. Even more so once working in the long term care setting, but how individualized is our care really? How much do we actually know about these people we are caring for in the final jouneys of their life to provide true individualized care?

As a CNA/CMA I worked in long term care and was so consumed by getting my work completed to my superiors standards that my residents "individualized" care was mostly just how they prefer their nightly routine. Brush teeth, wash face, facial cream, night cap, into bed with three blankets and done. What do they like their medication mixed with to make it easier to go down. Sure there were those that always liked their make up on and the one who always had to have their bed a certain way or else there was heck to pay but that was just the way they liked it I did not see this as "individualized" care nor did I ever stop to think why they preferd it that way. Had I of asked my self what in this person's past caused these habbits I might have realized a long time ago how to provide individualized care. But in a fast paced world where you have so much to do in 8 hours that just was not a possibility.

I'm a nurse now have been for three years. I've been in this position where "individualized" care has been push on me so much that it pretty much consumed my life. The resident has the right to refuse their meal and request another, the resident has the right stare out the window all day and refuse activities. Beacuse it is individualized care. What the resident wants. Right? We "individualize" the care plan because they are unique but the options for plan of action are so standard. Resident education, follow doctor instructions, check labs routinely, reposition every two hours. I recently learned that a resident whom has dementia was an accomplished artist and was known famously for his work. It was a form of art not widely popular unmongst the general population but for those who studied the form it was a huge success. This man whom once told me he was a teacher one time. Just an artist that dabbled a little. Was actually a very accomplished man. He could not remember his accomplishments and here I was as his nurse providing "individualized" care. Crushing his meds the way he liked and setting him in front of the television to keep him occupied watching his favorite shows while I did my paperwork. I was failing this man so horribly.

To my defence I did not know about this man's far past and as you may know in Long term care we mainly only look at the last couple of years. We look for falls and decline. We take a social history...married, children, DPOA. But oh so much we miss. Once I realized what this man had accomplished I realized the enrichment I could provide. Instead of favorite shows why not let him try his craft, give him a brush to paint, crayons to color, books of art to look through. Something this man could appreciate and while he may not remember his accomplishments shame on me for not treating this every unique individual with truly individualized care.

I learned such a lesson from this man. That these residents have a past. They all have accomplishments and our "Individualized" care should truly speak to these people. To their past and their accomplishments. To the people they truly are. Not the elderly person we see.