There are a number of principles that help to promote autonomy and independence that help to promote autonomy and independence that underpin many approaches to help improve the quality of nursing care for older people in care settings. There are three areas of clinical and ethical practice that represent the clinical foundation of people within nursing homes. These include;
· Informed consent
· A therapeutic relationship
· Confidentiality
By having an understanding of these clinical and ethical practices, carers can help assist patients with everyday activities in a respectful manner that creates trust and supports optimal clinical care. Several different attempts can be made to promote patient autonomy and independence for elderly persons
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(UK Essays, 2015)
One of the most important factors within a health care setting is the establishment of effective therapeutic relationships between caregivers/nurses and patients. McKlindon and Barnsteiner (1999) suggest that a therapeutic relationship needs to be a two - way relationship at all times that involves the patient and their family where appropriate and the nursing home staff.
Caring is a key element within this type of relationship that involves positive communication and clear boundaries of both personal and professional interactions. Interaction between residents and carers can be influenced by information transfer, provision of psychological support which may also provide some therapeutic benefits in themselves. The therapeutic relationship includes three important areas of care; physical, psychological and emotional care.
(UK Essays, 2015)
Empathy is a vital element of effective communication. It is important for carers to be able to empathize with residents.
Empathy is defined as "the feeling that you understand and share another person's experiences and emotions".
(Farlex,
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Specific reasons include fall prevention, limiting wondering behaviour and controlling violent or agitated behaviour. The use of restraints can be used in a positive way and in a way that benefits the resident. For example; the use of bed side rails are seen as a form of restraint as it prevents the resident from leaving their bed. However, it can benefit certain residents who use these side rails to help sit up in the bed. They can also be seen in a negative way by residents’ family members especially if there is no proper explanation as to why the restraint is being used and how it can benefit the resident. There is a strong emotional response by family members when they see restraints being used on love ones. This can damage the family-nurse relationship. The main issue with using restraints even if it does benefit the resident is it can cause aggravation. The negative side of using restraints within residential care homes is that the use of restraints can increase the risk of injuries instead of preventing them. Nurses themselves may also have negative feelings about the use of restraints. Feelings of guilt and frustration have been reported by nursing staff related to their