Reflective Account Following Gibbs Model Of Reflection For A Patient With Dementia

Description

Write the reflective account following the Gibbs model of reflection.

Here to write the Reflective accounts I am following the Gibbs model of reflection (Lawrence et al., 2013).

This is the Gibbs model of reflection (1988). The report is written by following the model.

Dr. A is practicing from last year. He lives with his family. He is a complete family man and he lives with his family. He has faced a patient few months ago, Mr. B. He was 65 years old. He has faced Dementia a few months ago (Incorrect Description, 2013).

When he came to my chamber he was complaining that he is forgetting things frequently and this thing is giving him a severe headache. He is facing this from last few weeks. He is weak person by heart. So, it is well enough to frighten him. He entered in chamber with a threatened face and with a mild ache in his head.

The family doesn’t have that kind of diseases. He is first person in his family who is having such problems. He was forced to come to my chamber. His son said that Mr. B is forgetting few things and he was now not that able to think and make perfect plans. Mr. B was ignoring this signs but his is son is aware about the disease and he forced him to visit the doctors chamber.

I discussed the social situation with him and I came to know that he was a retired person. He has a married son. But he was working in an organisation to help the needy people. For this purpose he had to make some effective plans. He was not able to make those plans though he was an expert in making those plans.  Last thing which I came to know is that he had lost his wife a few months before.

While examining Mr. B I pointed out the problems.  Being a doctor I knew that the dementia is increasing day by day. The higher population of the older people made that count larger. This disease doesn’t show its negative aspects in earlier stages but it gives its worst result at last. So, my main motive was to identify the primary symptoms. I found that Mr. B is having some mental problems. They are-

Mr. B is losing his memory (Announcement, 2015).

He is having some difficulties in communicating with people.

Feelings

He was losing his mental ability to pay serious attention to any project. He was very good in such works but he was not able to do those works.

He was in a post where he had to make decisions, give judgements. He was not that expert in our first meeting (Value judgements, 2011).

He was losing his visual power which is natural after a certain period, but here in this case i thought that it is a symptom of dementia.

The symptoms I got from his daily life. This is not that disease which gives the patients too much headache or stomach ache or any kind of pain. This disease increases in the brain slowly and makes its worst result with the time. Mr. B often forgot to take his wallet. He was facing some difficulty while talking to me. I asked few questions to him for which he had to think properly. He didn’t make that. Last thing what I did, I took an examination of his eyes. I noticed that he is facing some disability in that part also (Barile, 2014).

Looking in the symptoms and at the present condition in Australia I thought that it is case of dementia. I felt that I have made a proper diagnosis and the next thing hic hi had to do the proper treatment of the patient, Mr. B. This was the first case of dementia to me. So, it was a challenge to me that I had to the best possible treatment which a doctor can give to his patients.

While giving treatment to Mr. B I faced both type of experience. Sometimes I felt like I was in heaven and sometimes I thought this is the worst thing which I am facing right now (Evaluation Sources, 2015).

I prescribed some medicine and some therapy to Mr. B. Sometimes they worked properly. The sign of this thing is he entered my chamber with a smile. After that what he he picked out his wallet and used to say me that he didn’t forget to take his wallet that day and any prescribed medicines were working properly. That smile was the real fees to me. Some recovery was done according to me (Jing, 2015).

The good thing to any kind of professional that they are doing the appropriate thing what they have leant from the past. They are here to apply those studies in real life. The best experience in that case was I detected the disease at the very earlier stage. This helps me in the treatment very much.

Evaluation

Apart from that Mr. B was getting busy in his daily life. There was a time where he lost himself but he is coming back into his normal life. Though it is a disease which cannot be cure properly, it can be reduced only. I think I did my best to reduce the effect of this disease.

The bad thing in this case what I experienced the violence of the patient. This decease make the patient to forget the bad memories and the patients only remembers the good things in their life. Often Mr. B forgets that his wife was no more. He thought that my treatment makes him to stay away from his wife. Some times when the decease shows its presence Mr. B wants to meet his wife and when he didn’t find his wife he used to say bad words to me. It was not his fault. The decease forced him to do such things. But still when you are helping someone and he is saying bad words to you it hurts (Vestal, 2012).

 In this part of the analysis of the whole part is done. What I have experienced what steps I have taken to make the diagnosis. While examining Mr. B I pointed out the problems.  Being a doctor I knew that the dementia is increasing day by day. The higher population of the older people made that count larger. This disease doesn’t show its negative aspects in earlier stages but it gives its worst result at last. So, my main motive was to identify the primary symptoms. I found that Mr. B is having some mental problems. I have experienced both good and bad experience. Mr. B was getting busy in his daily life. There was a time where he lost himself but he is coming back into his normal life. Though it is a disease which cannot be cure properly, it can be reduced only. I think I did my best to reduce the effect of this disease (Analysis Title Page, 2014).

In this step I have done some tests to know the actual condition of my patient. There are some tests which are very much essential to do. These tests took only 5-15 minutes to complete. These help me to monitor my patient and to prescribe him he needs. I have done three tests mainly. These are Mini Mental State Examination (MMSE), Abbreviated Mental Test Core (AMTS) (Lam, Wong and Woo, 2010) and the Modified Mini Mental State Examination (3MS) (Karch, 2015). These were the prime tests which I have done. I have done other tests like Cognitive Abilities Screening instrument (CASI), the Trail-making Test and the Montreal Cognitive Assessment (MOCA) test. These tests helped me to reach at a better conclusion. Among the tests the MOCA is the test which used to make some screening test. It is a liable test too. The MMSE test is a common test which is done every where dementia found. These tests are to check the sensitivity of the patients and to identify the exact problematic area. All the tests were done successfully (Rosa da Silva, 2010).

Good Experience

Apart from this I had know the daily habits of Mr. B. Because of that I made a questioner which I gave to Mr. B to fill that up. The Questioner helped me a lot to know about the daily life of my patient. This process is called Informant Questioner on Cognitive Decline in the Elderly. This is tool of this treatment and this is a successful tool. A survey said that in 90% case the tool has made an effective result (Clements and Stoye, 2014).

There are some laboratory tests also like routine blood tests (Lab on a Chip 200th Issue, 2014). This test is done to know about the vitamin level in the blood. The decease occurs because the brain doesn’t get its food and become ill. So, it is necessary to know about the vitamin levels in the blood (Shankar, 2013). This ensures that the brain is getting its food and no further damage is done. The blood test includes vitamin B12, folic acid test, full blood count, TSH, calcium, renal function and the lever enzymes. These entire tests are done. Another reason of the blood test is to monitor that the prescribed medicines are harmful to the body or not. Is the medicines are harmful. Monitoring the small steps assures that the worst result will not come soon (Mastilovic, 2010). 

 I have done the CT scan and the MRI scan to the Pressure hydrocephalus. Is the pressure is normal. . The change doesn’t show the neurological problems it is done to know the above mentioned pressure is normal or not. This pressure is a main reason of the decease. So, it was obvious to check the pressure, if it is normal or not. The test shows that which type of dementia the patient have (Rahme and Bojanowski, 2010).

There are so many tests like the SPECT and the PET test. These are also the clinical tests but I felt that these are not necessary. From the above tests I have got all of my information. These are done to examine the carbon-11 (Kenny and Kelly, 2003).

I prescribed some medicine to maintain the normal vitamin level in the body. By analysing his questioner I prescribed him to make some change in the daily life. I told him to medicate. Not only that I guided him in some healthy computerised training. I thought this process will help my patient in improving his memory. I put my best effort to make my patient out of this decease (Baarda, 2012).

Bad Experience

For this kind of treatment palliative care is most important. These help the patient to improve mental condition. This dementia leads the patients to a mental and physical loss. So, care is very important in this case. They have to treat with great care. They need mental support in this stage. By way of counselling I did my best and I thought that the result will be positive and it was a positive outcome. From the questioner from I came to know about the goals of my patient. This helps me to make the counselling more effective (McKenna and Clark, 2015).

The therapy includes the music therapy, reminiscence therapy etc. These type of therapy helps to give a better atmosphere to the patient. I prescribed it also. This improves the mental condition of the mental condition to the victims. So, I referred this also. The abnormal activity of the persons in reduced in this process. The music therapy also helps to maintain the pressure of the patients. It helps the patients to control their anger. My patient often remembered his dead wife and this not possible to produce her in front of him. At that time my patient acted like a wild animal. He was on fire at that time. Even my counselling was ineffective at that particular time. So, I prescribed music therapy to my patient. It helps me a lot in this case. By listening the music the rude behaviour was reduced a lot. Thus I got help from that therapy (Maguire, 2012).

Conclusion

In the above part I have made described what I have done earlier. In this part of Gibbs model of reflection (1988) I will discuss what steps were there which I could take. As I said before there are so many tests like the SPECT and the PET test (Krause, 2008). These are also the clinical tests but I felt that these are not necessary. From the above tests I have got all of my information. These are done to examine the carbon-11. I didn’t think that the test is required.

My patient often makes trouble while eating. This was vey injurious to his physical and mental health. Lack of vitamins in the body allows the decease to make his appearance in a better way. It was possible to feed him with feeding tube. But I didn’t do that. I thought it can injure him. The tube could increase the vitamins and it could improve the health also. But I didn’t (Richardson et al., 2015).

Analysis

This is a common thing that the old aged people face a severe pain in their body. Like all other older people my patient was also suffering from this. Like all other he was also avoiding this and at time of treatment he didn’t tell me that. That can happen that he is suffering from the decease dementia, and this decease kill the felling of pain. So, he didn’t have that idea that he is suffering from pain. So, I prescribed him some therapy to take on.  I didn’t think that he took those therapies. I think that I could have done much better in this particular case (Bowsher, 2005).

In this part of the Gibbs’ model of reflection (1988) it is said that the future measurement plans in case of the decease come again (Allergy action plan, 2013).

If the decease come again I shall take the authentically steps of treatment. I will not take any kind of steps which is injurious to the patient or which is not acceptable according to me. I shall take the following steps.

Step 1

I will make proper diagnosis to know the actual reasons behind this. I shall look for those particular points of dementia. The symptoms are

Mr. B is losing his memory or not (DOE’s Losing Gamble, 2002).

Is he having some difficulties in communicating with people?

Is he losing his mental ability to pay serious attention to any project?

Is he giving a fare judgement or is he doing his works with full attention?

Is he was losing his visual power than before?

Is his body is feeling the pain like a normal old man?

Step 2

After that I shall make the tests and analyse the previous reports and compare the new test reports with the older one. The tests I shall prefer these steps to know the actual condition of my patient. There are some tests which are very much essential to do. These tests take only 5-15 minutes to complete. These will help me to monitor my patient and to prescribe him what he needs. I shall make three critical steps.  These are Mini Mental State Examination (MMSE), Abbreviated Mental Test Core (AMTS) and the Modified Mini Mental State Examination (3MS). These are the prime tests which I have to do. I have to done other tests like Cognitive Abilities Screening instrument (CASI), the Trail-making Test and the Montreal Cognitive Assessment (MOCA) test. These tests will surely help me to reach at a better conclusion. Among the tests the MOCA is the test which used to make some screening test. It is a liable test too. The MMSE test is a common test which is done every where dementia found. These tests are to check the sensitivity of the patients and to identify the exact problematic area. All the tests will have to done (Gao, 2012).

If I feel I will make a questioner. I shall make a questioner which will give to Mr. B to fill that up. The Questioner will help me a lot to know about the daily life of my patient. This process is called Informant Questioner on Cognitive Decline in the Elderly. This is tool of this treatment and this is a successful tool.

There are some laboratory tests also like routine blood tests. This test is done to know about the vitamin level in the blood. The decease occurs because the brain doesn’t get its food and become ill. So, it is necessary to know about the vitamin levels in the blood. This ensures that the brain is getting its food and no further damage is done. I have to know about the health condition of Mr. B. So, I have to prescribe the blood test. The blood test includes vitamin B12, folic acid test, full blood count, TSH, calcium, renal function and the lever enzymes. These entire tests are done. Another reason of the blood test is to monitor that the prescribed medicines are harmful to the body or not. Are they helpful? Monitoring the small steps I hope I will protect my patient from severe injury (Pacholok and Stuart, 2005). 

Step 3

In this step I will take help from my previous experience. I faced a mixed type of experience. I have face the good experience and as well as the bad one also. I will take help from the past test report. I will analyse the past reports again and compare the new report with the new one. I will go through the precious prescribed medicine and the result also. If I feel that I have to change those medicines I will do that. If I feel that the past record of that medicines were good I not going to change them. 

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