Empowering people with MND to make their own decisions in their care in the inpatient setting
by Harriet Denning-Kemp
Harriet Denning-Kemp is an Occupational Therapist at Calvary Health Care Bethlehem.
She presented a poster - “Creating Better Outcomes Through Teamwork and Collaboration: Empowering people with MND to make their own decisions in their care in the inpatient setting” - at the 10th National MND Australia Conference, which was held virtually in September 2021.
Providing client-centred care in an inpatient setting can be complex and challenging as health professionals need to address multiple factors. It requires managing individuals facing rapid and deteriorating functional changes, providing quality of life care and enabling a person to have their own choice and control to address their different requirements throughout their progression.
When people with MND are admitted to hospital in a time of crisis, it can be challenging for health professionals. There is a fine art balancing the goals of care for the admission and keeping the person with MND as the key stakeholder in the decision-making process. The Multi Disciplinary Team (MDT) need to be flexible in their approach to support the person with MND as they are on their own individual journey.
The MDT at Calvary Health Care Bethlehem (CHCB) draws on evidence and expertise for management of people with MND to enable the person to be informed about options available and empower them make decisions aligning with their values. As a specialist service provider, CHCB supports the transition from hospital to the community through forming relationships with key community stakeholders and providing education about MND best practice.
Building up rapport and trust with the person enables the health professional to accurately determine the approach required to most effectively support them. This includes being able to gauge the level of information necessary to gather at the time of admission as this may be a time of high emotional distress. During such times, the person may not be able to absorb new information - there is an art to moderating the information that needs to be provided and the timing it is delivered.
Some useful tips and tricks to ensure that a person with MND is empowered to make their own decisions and care in their inpatient admission:
- Goals of care for a person in an inpatient setting are a priority. Health professionals need to consider the person as a key stakeholder in any decision making, inclusive of where they would like to live and equipment prescription. Ask yourself if you have done the “granny test” and treating your client how you would treat your own family members.
- Consider that a one size fits all approach does not fit a person living with MND. If a person declines a piece of equipment, have back up options to give a person choice.
- Be PROACTIVE! Think laterally and creatively to find effective solutions and interventions during a person’s inpatient admission.
- Working as part of the MDT is integral to using a holistic approach to considering a person’s 24-hour care needs.
- Be comfortable with the idea that close to perfect solutions are good enough. With regular reviews in goals of care, you will make an impact on meeting the changing needs of a person with MND.
The inpatient MDT have an important role in enabling people with MND and their families adjust and adapt to the impact of their condition in order to live the life they choose to live.