1. Reflective account of experience and learning
In considering my feelings about people with dementia I realise that I very much recognise and
value the individuality of people regardless of medical condition. Perhaps this is due to my having
worked in a caring capacity from a young age and therefore my exposure to differing people with a
variety of medical conditions including those at various stages of their dementia journeys.
Although unaware of the theory behind my thoughts at this stage I sought to find a way to
positively interact and encourage involvement of the individual and this will be discussed further in
this reflective writing.
Prior to my placement I did consider more the number of people who may be there, what the
structure of evening care may be, hoped that I would be able to be involved and not feel as though I
was intruding. Hoping I would fit in. On reflection I realise that perhaps those attending the
evening care session may have felt the same way.
I am an occupational therapist team leader working within medicine for the elderly. I provide
assessment and intervention to facilitate the achievement of optimum levels of independence and to
facilitate safe and effective discharge planning including onward referral for patients with diverse
presentations and complex physical and psychological conditions. I work regularly with people
with dementia, although often not the reason for admission. Within my work I work both within the
ward environment and within a therapies suite.
Patients I work with are at various stages of their dementia diagnosis and in considering how I feel I
will reflect on various experiences. My work has involved considering many different facets of the
individual including loss of memory, disorientation, changes in mood, communication difficulties,
apathy, difficulties in adapting to change, making plans and decisions, grasping complex ideas to
name but a few.
Cognitive assessments can be anxiety provoking and perhaps viewed suspiciously by patients and
so I ensure these are not carried out on first meetings and I attempt to build rapport and a trusting
therapeutic relationship with the individual firstly. Like any assessment I take time to explain both
before and after purposes and outcomes of assessment ensuring the patient is happy to attend, these
assessments can sometimes highlight impairment to patients and I give reassurance and reinforce
positives.
Being in a strange environment can be disorienting and during assessment I am aware of the impact
that this may have on function for patients with for example, dementia and delirium. During
kitchen assessments, I realise put me in an unfamiliar kitchen and I may struggle to locate items,
therefore grading tasks and arranging assessment within the home environment may be required. I
use verbal as well as visual cues such as demonstration during for example functional mobility
assessment being aware that people respond to differing forms of communication. I am aware that
hospital admission can be distressing and I feel in working with all patients I feel that a warm and
friendly approach, treating each person as an individual with the capacity to be involved and engage
and simply a smile can often make a real difference in the building of sound therapeutic
relationships and in the patient hospital journey. Using a patient centred approach is vital.
Responding to people, being patient, reassuring, taking time and being caring is important to the
individual but also ultimately the reason we work in the profession we do.
Working and liaising with families and carers in treatment and discharge planning is also a part of
my role and during this I would ensure that the patient is involved also ensuring consent to liaise
with others involved i.e. care management, CPNs etc. to allow me to develop an awareness of the

2. individuals needs.
For my community placement, I attended an evening care session within a community resource
centre where transport was provided, activities were held and supper was provided. This was a very
social experience and it was so positive to see what giving people a bit of time can do. Meaningful
social interaction was received well in the form of sitting and having a snack together, something
which all members of the group including staff were involved in and was an empowering
experience. Taking part in a quiz group was very positive also using humour and light hearted
discussion to stimulate senses, acknowledge emotions and feelings and encourage creativity. A
client who had been very quiet become animated and discursive during this group and life
experiences were shared, this made me consider that we all need to feel valued.
The level of staffing did make a difference where it was obvious that having time to interact with
people can result in very positive experiences. Individuality was valued, reassurance was given as
and when required and the staff were very aware of the individual group members needs and life
experiences having engaged with carers meaningfully. Although I considered that clients needs
were very diverse within both environments and the resource centre was a secure building where
client, staff ratio was vastly different from that within the hospital. I also consider that just taking
the time speak to patients as individuals and to try to understand people better allows us to meet
their needs better. The increasing use of the 'This is Me' document is encouraging and has allowed
more meaningful interaction and understanding of the individual which all staff should be
encouraged to be aware of.
The environment was also different from a hospital environment it was bright with contrasting
colours, an open plan and clear labelling using pictures and words although at this high standard
due to planning. For orientation purposes this was great and I am pleased to see that these things
are being considered more within the hospital environment to facilitate the patient experience. Both
environments do use cues such as clocks and calendars for orientation. Noise levels and
distractions are also different in comparison to the often busy hospital environment and allow for
more meaningful interactions.
The two environments are very different however they are supposed to be and it is important to
recognise that. I will include the resource information within our information pack for patients and
families and be more aware of the environment I work in to enhance the patient journey.
This has obviously been a overview of my thoughts and feelings and I have not touched upon many
areas which are very relevant to myself and my patients such as rights, dignity, choice, evidence
based best practice, discrimination and stigma, diversity in presentation and experience of dementia,
communication difficulties, carers needs to name but a few but for the purposes of this reflective
piece this was not relevant although all areas vital.