Individuals living with dementia will need some support. People have different views on dementia and can stereotype individuals which can lead to an impact on their rights being met.
The support needed for individuals with dementia depends on their circumstances. Care workers need to be aware of the sensitivities surrounding those with dementia and ensure that their approaches remain professional and supportive.
All those involved in the care of individuals with dementia may require some support. This could be explaining what information and advice is available or planning for the future of the individual.
Conflict and dilemmas can arise when different individuals are involved in the care of the individual. Providing all those around with a greater understanding early on and holding open communication can ensure that the best interests of the individual are the focus.
Enabling the individual to take risks and live their lives as independently as possible promotes their rights.
Bydd angen cymorth ar bobl sy'n byw gyda dementia. Mae gan bobl wahanol safbwyntiau ar ddementia a gallant stereoteipio unigolion, gan arwain at effaith ar eu hawliau.
Mae'r cymorth sydd ei angen ar unigolion â dementia yn dibynnu ar eu hamgylchiadau. Bydd angen i weithwyr gofal fod yn ymwybodol o natur sensitif agweddau ar ddementia a sicrhau bod eu dulliau gweithredu'n broffesiynol ac yn gefnogol bob amser.
Gall fod angen rhywfaint o gymorth ar bawb sy'n ymwneud â gofal unigolion sydd â dementia. Gallai hyn olygu esbonio pa wybodaeth a chyngor sydd ar gael neu gynllunio ar gyfer dyfodol yr unigolyn.
Gall gwrthdaro a chyfyng-gyngor godi pan fydd unigolion gwahanol yn ymwneud â gofal yr unigolyn. Mae gwella dealltwriaeth pawb yn gynnar a chyfathrebu'n agored â nhw yn gallu sicrhau mai gweithredu er budd gorau'r unigolyn yw'r ffocws.
Mae galluogi'r unigolyn i gymryd risgiau a byw ei fywyd mor annibynnol â phosibl yn hybu ei hawliau.
In order to have mental capacity, an individual must understand the implications of decision making. They must be able to remember the information for long enough to make a specific decision, be able to weigh up options around the decision, and communicate their decision in a way that it can be understood. Individuals who cannot do this lack capacity.
A diagnosis of dementia does not make someone incapable of making decisions for themselves. If there is doubt about a person’s capacity to make a specific decision, a capacity assessment will be undertaken.
The Mental Capacity Act 2005 (the Act) aims to protect people who lack capacity, and maximise their ability to make decisions or participate in decision-making. The Act is underpinned by five statutory principles:
Principle 1: A presumption of capacity
Principle 2: Individuals being supported to make their own decisions
Principle 3: Unwise decisions
Principle 4: Best interests
Principle 5: Less restrictive option
These must be incorporated in an assessment and decision in relation to someone’s mental capacity.
Everything that you do must be in accordance with the law.
Er mwyn bod â galluedd meddyliol, rhaid i unigolyn ddeall goblygiadau gwneud penderfyniadau. Rhaid iddynt allu cofio'r wybodaeth yn ddigon hir i wneud penderfyniad penodol, gallu pwyso a mesur opsiynau ynghylch y penderfyniad, a chyfleu eu penderfyniad mewn ffordd y gellir ei deall. Mae gan unigolion na allant wneud hyn ddiffyg galluedd.
Nid yw diagnosis o ddementia yn golygu nad yw rhywun yn gallu gwneud penderfyniadau drosto ei hunan. Os oes amheuaeth ynghylch galluedd unigolyn i wneud penderfyniad penodol, cynhelir asesiad galluedd.
Nod Deddf Galluedd Meddyliol 2005 (y Ddeddf) yw amddiffyn pobl sydd heb alluedd, a chynyddu eu gallu i wneud penderfyniadau neu gymryd rhan yn y broses o wneud penderfyniadau. Yn sail i'r Ddeddf mae pum egwyddor statudol:
Egwyddor 1: Rhagdybiaeth o alluedd
Egwyddor 2: Unigolion yn cael eu cefnogi i wneud eu penderfyniadau eu hunain
Egwyddor 3: Penderfyniadau annoeth
Egwyddor 4: Budd pennaf
Egwyddor 5: Opsiwn llai cyfyngol
Rhaid ymgorffori'r rhain mewn asesiad a phenderfyniad mewn cysylltiad â galluedd meddyliol rhywun.
Rhaid i bopeth a wnewch fod yn unol â'r gyfraith.
Advanced care planning is a way of ensuring everyone knows the individual’s wishes if there were to be a medical crisis and they lacked capacity to make decisions. Individuals can plan for care later on in life or in the event of a crisis at any time in life.
Planning for care can enable the individual to make choices and feel in control of decisions prior to them becoming unable to.
The MCA allows individuals to appoint someone to make decisions on their behalf, if a time comes when they lack capacity. Lasting Power of Attorney (LPA) is a legal tool. The appointed person, or Attorney, may be able to make financial and/or health and welfare decisions.
It can be reassuring for a person to know that someone they have chosen will be making decisions for them in the future.
Mae blaengynllunio gofal yn ffordd o sicrhau bod pawb yn gwybod beth yw dymuniadau'r unigolyn petai argyfwng meddygol a phan nad oes ganddyn nhw’r gallu i wneud penderfyniadau. Gall unigolion gynllunio ar gyfer gofal yn ddiweddarach mewn bywyd neu mewn argyfwng unrhyw bryd yn ystod eu hoes.
Mae cynllunio ar gyfer gofal yn galluogi'r unigolyn i wneud dewisiadau a theimlo bod ganddo reolaeth dros benderfyniadau cyn iddo golli'r gallu i'w gwneud.
Mae'r MCA yn caniatáu i unigolion benodi rhywun i wneud penderfyniadau ar eu rhan, os daw amser pan nad oes ganddynt alluedd. Dull cyfreithiol yw Atwrneiaeth Barhaus. Efallai y bydd y person penodedig, neu'r Atwrnai, yn gallu gwneud penderfyniadau ariannol ac/neu benderfyniadau ynghylch iechyd a lles.
Gall fod yn galonogol i unigolyn wybod y bydd rhywun y mae wedi'i ddewis yn gwneud penderfyniadau drosto yn y dyfodol.
Best interest decisions are made when an individual lacks capacity. The individual must still be involved and informed, as fully as possible. Decisions should be discussed with your employer/professionals and family members and best interest decisions must be recorded.
The individual might have an advanced care plan, so this would need to be checked.
Some decisions in life are of more consequence than others. Making decisions in relation to everyday personal care/support needs have little implications; however, making decisions about an individual’s property, finances etc. has wider reaching consequences and requires legal advice. Making decisions when an individual becomes ill and needs medical interventions can also have implications if they weren’t part of their wishes, or if they go against the wishes of the family. We must always work in the person’s best interest; the more significant the decision, the more people (generally) will be involved in the decision making process.
Caiff penderfyniadau budd gorau eu gwneud pan nad oes gan unigolyn alluedd meddyliol. Rhaid i'r unigolyn gael ei gynnwys a'i hysbysu o hyd, gyda cymaint o wybodaeth a phosib. Dylai penderfyniadau gael eu trafod â'ch cyflogwr/gweithwyr proffesiynol ac aelodau o'r teulu a dylai penderfyniadau budd gorau gael eu cofnodi.
Gallai fod gan yr unigolyn flaengynllun gofal, felly byddai angen cadarnhau hyn.
Mae rhai penderfyniadau sy’n cael eu gwneud mewn bywyd yn achosi mwy o ganlyniadau nac eraill. Nid oes llawer o oblygiadau i wneud penderfyniadau bob dydd ynghylch gofal personol / anghenion gofal; fodd bynnag, mae gwneud penderfyniadau ynghylch eiddo unigolyn, cyllid ac ati gyda llawer yn fwy o ganlyniadau ac mae gofyn am gyngor cyfreithiol yma. Mae goblygiadau hefyd wrth wneud penderfyniadau os fydd yr unigolyn yn cael ei daro’n wael ac angen gofal meddygol os nad ydyn nhw’n rhan o’u dymuniadau, neu’n mynd yn erbyn dymuniadau’r teulu. Mae’n rhaid gweithio tuag at fudd gorau’r unigolyn, y mwyaf arwyddocaol yw’r penderfyniad, (yn gyffredinol) y mwyaf o bobl fydd yn rhan o’r penderfyniad.
An individual with dementia may struggle to make decisions, and family/carers might not always know or agree on the best way to support them. An advocate can help the individual express their choices and rights in their best interests. They will make sure the individual is listened to, spend time getting to know them and build a relationship with them to enable them to be understood.
Gall unigolyn â dementia ei chael hi'n anodd gwneud penderfyniadau, ac efallai na fydd aelodau o'r teulu/gofalwyr bob amser yn gwybod nac yn cytuno ynghylch y ffordd orau o'i gefnogi. Gall eiriolwr helpu'r unigolyn i fynegi ei ddewisiadau a'i hawliau er ei fudd gorau. Bydd yn gwneud yn siŵr bod yr unigolyn yn cael ei glywed, gan dreulio amser yn dod i'w adnabod ac yn meithrin cydberthynas er mwyn ei alluogi i gael ei ddeall.
Sometimes, if an individual lacks capacity and they have not expressed their wishes in the past, families/carers can make decisions for them. In some cases, even if the individual has planned ahead and expressed their wishes, the families/carers could disagree with their choices about the care, support and future needs of the individual.
They may disagree over who has responsibility of caring for the individual, financial support, who might take the individual to any medical/health check appointments, do the household chores etc.
Conflicts must be dealt with in a sensitive and professional manner, in accordance with the law.
Weithiau, os nad oes gan unigolyn alluedd meddyliol ac nad yw wedi mynegi ei ddymuniadau yn y gorffennol, gall aelodau o'r teulu/gofalwyr wneud penderfyniadau ar ei ran. Mewn rhai achosion, hyd yn oed os yw'r unigolyn wedi cynllunio ymlaen llaw a mynegi ei ddymuniadau, gallai aelodau o'r teulu/gofalwyr anghytuno â'i ddewisiadau ynglŷn â'i ofal, ei gymorth a'i anghenion yn y dyfodol.
Efallai y byddant yn anghytuno ynglŷn â phwy sy'n gyfrifol am ofalu am yr unigolyn, cymorth ariannol, pwy allai fynd â'r unigolyn i unrhyw apwyntiadau meddygol/archwiliadau iechyd, gwneud gwaith tŷ ac ati.
Rhaid delio â gwrthdaro mewn modd sensitif a phroffesiynol, yn unol â'r gyfraith.
Abuse can take many forms including physical, psychological, sexual, financial, institutional and the risk of neglect.
People living with dementia are at risk of harm and abuse due to their vulnerability. They may be unable to understand a situation and what ultimately may be causing them harm and abuse. Their memory impairment might make it difficult to remember what happened. Communication changes may make it difficult for the person to express concerns and can make any investigation more complex.
The person can become forgetful with money or trusting of people, which could open up the opportunity for being taken advantage of.
The individual is more prone to falling due to confusion or might forget to turn something off which could lead to physical harm.
Gall cam-drin fod ar sawl ffurf gan gynnwys corfforol, seicolegol, rhywiol, ariannol, sefydliadol a'r risg o esgeulustod.
Mae pobl sy'n byw gyda dementia yn wynebu risg o gael eu niweidio a'u cam-drin oherwydd eu sefyllfa fregus. Efallai na fyddant yn gallu deall sefyllfa, a'r hyn a all achosi niwed iddynt yn y pen draw. Gallai eu nam ar y cof ei wneud yn anodd cofio beth ddigwyddodd. Gall newidiadau ynghylch cyfathrebu ei wneud yn anodd i'r unigolyn fynegi pryderon a gallant wneud unrhyw ymchwiliad yn fwy cymhleth.
Gallant fynd yn anghofus ag arian neu ymddiried mewn pobl, a allai arwain at gyfle i fanteisio arnynt.
Byddant yn fwy tueddol i gwympo am eu bod wedi drysu neu efallai y byddant yn anghofio diffodd rhywbeth, a allai arwain at niwed corfforol.
Individuals might be discouraged from taking risks due to the lack of understanding that some risks can be positive for the individual.
Risks can be defined as environmental, personal, social, organisational and individual.
They might be discouraged from taking risks like cooking for themselves and other daily household tasks, dressing themselves, going out and spending money or even catching public transport.
There might be restrictions due to them living in a care setting where there are policies and regulations to adhere to. Things like cooking are done by the care setting's cook/chef, but other things like personal care are deemed an appropriate risk, with some individuals needing some staff support with assistance to carry out the task whilst still keeping a level of independence.
If they live in their own home or with family, then they might be discouraged from taking risks due to fear of them being harmed or the damage that might occur to the environment if they were, for example, to cause a flood or fire.
If an individual is discouraged from taking risks then they could lose a specific skill altogether or feel unvalued and more dependent on others, which could impact on their physical and mental well-being.
Gallai unigolion gael eu hanghymell rhag cymryd risgiau oherwydd diffyg dealltwriaeth y gall rhai risgiau fod yn gadarnhaol iddynt.
Gellir diffinio risgiau fel rhai amgylcheddol, personol, cymdeithasol, sefydliadol ac unigol.
Gallai unigolion gael eu hanghymell rhag cymryd risgiau fel coginio iddyn nhw eu hunain a chyflawni tasgau beunyddiol eraill yn y cartref, gwisgo, mynd allan a gwario arian neu hyd yn oed deithio ar drafnidiaeth gyhoeddus.
Efallai y bydd cyfyngiadau arnynt am eu bod yn byw mewn lleoliad gofal lle mae'n rhaid cydymffurfio â pholisïau a rheoliadau. Cogydd y sefydliad gofal fydd yn coginio, ond ystyrir bod pethau eraill fel gofal personol yn risg briodol, a bydd angen i rai unigolion gael rhywfaint o gymorth gan staff i gyflawni'r dasg gan gynnal lefel o annibyniaeth.
Os ydynt yn byw ar eu pen eu hunain neu gydag aelodau o'r teulu, efallai y cânt eu hanghymell rhag cymryd risgiau oherwydd ofn y cânt eu niweidio neu ofn y difrod a allai ddigwydd i'r amgylchedd petaent, er enghraifft, yn achosi llifogydd neu dân.
Os caiff unigolyn ei anghymell rhag cymryd risg, gallai golli sgil penodol yn gyfan gwbl, teimlo nad yw'n cael ei werthfawrogi, a bod yn fwy dibynnol ar eraill, a all gael effaith ar ei llesiant corfforol a meddyliol.
What we consider to be “risks” are dependent on the individual and their circumstances. It’s important to be able to continue to take risks every day to still feel part of life, have independence and have an identity. Taking risks will increase a feeling of confidence.
Risk taking has to be managed. The benefits of taking the risk need to be weighed up along with the benefits of carrying out those tasks in everyday life. It’s all about still being able to carry out that activity, with the appropriate level of support.
Mae'r hyn yr ydym yn ei ystyried yn “risgiau” yn dibynnu ar yr unigolyn a'i amgylchiadau. Mae'n bwysig i allu parhau i gymryd risgiau bob dydd i ddal i deimlo'n rhan o fywyd, cael annibyniaeth a bod â hunaniaeth. Bydd cymryd risgiau'n cynyddu teimlad o hyder.
Rhaid rheoli'r broses o gymryd risgiau. Mae angen pwyso a mesur buddion cymryd y risg ynghyd â buddion gwneud y tasgau hynny ym mywyd beunyddiol. Mae'n ymwneud â dal i allu gwneud y gweithgaredd hwnnw, â'r lefel briodol o gefnogaeth.
As a care provider you have a duty of care to protect those under your care from foreseeable harm. There’s a need to balance the risks and benefits for each individual and their situations. The individual needs to be given choices and have the right to make their own decisions on how they wish to be cared for and spend their free time.
They still have the right to enjoy the lifestyle they choose to lead.
Being able to take positive risks can aid the individual’s mental, physical and emotional well-being.
Positive risk taking is about weighing up the benefits of taking the risk which will contribute to an individual’s well-being. This could be something that increases their confidence, social well-being or even provides a new skill for them.
Providing individuals with choice and control over what they do empowers them. Providing a risk enablement approach rather than not doing it or not being risk averse will ensure a rights based approach is maintained and contribute towards positive outcome of the individuals living in their own home.
Fel gofalwr, mae gennych ddyletswydd gofal i ddiogelu'r rhai o dan eich gofal rhag niwed y gellir ei ragweld. Mae angen taro cydbwysedd rhwng y risgiau a'r buddiannau i bob unigolyn a'r sefyllfaoedd dan sylw. Mae angen rhoi dewisiadau i'r unigolyn, ynghyd â'r hawl i wneud ei benderfyniadau ei hun o ran y gofal mae'n dymuno ei gael a sut mae'n dymuno treulio ei amser rhydd.
Mae ganddo hawl i fwynhau'r ffordd o fyw y mae'n dewis ei dilyn o hyd.
Gall cyfleoedd i gymryd risgiau cadarnhaol gefnogi lles meddyliol, corfforol ac emosiynol yr unigolyn.
Yr hyn sy'n bwysig wrth gymryd risgiau cadarnhaol yw pwyso a mesur buddiannau cymryd y risg a fydd yn cyfrannu at les unigolyn. Gallai hyn fod yn rhywbeth sy'n hybu ei hyder, ei les cymdeithasol neu hyd yn oed yn rhoi sgil newydd iddo.
Mae rhoi dewis a rheolaeth i unigolion ynglŷn â'r hyn a wnânt yn eu grymuso. Bydd dilyn dull gweithredu sy'n galluogi risgiau yn hytrach na pheidio â chymryd risgiau neu fod yn wrth-risg yn sicrhau bod dull gweithredu seiliedig ar hawliau yn cael ei ddilyn ac yn cyfrannu at ganlyniadau cadarnhaol i'r unigolion sy'n byw yn eu cartrefi eu hunain.
An individual with dementia still has rights. Hindering their rights can affect their confidence and ability to still lead as active a life as possible.
An individual may walk around for any number of reasons. It could be a pattern at the same time of day as that was the time their children would have come home from school or partner from work. They may have forgotten their children are no longer children and have left home or maybe their partner has died and wouldn’t be home. There could be a link to a previous work role. It may be that they are bored or even trying to relieve pain.
Whilst you may recognise the risks of walking, if their mobility is affected or they are exhausted it doesn’t mean you have to encourage them to sit down or use a wheelchair. Walk with them, keep them company and keep them safe. You may be able to distract them and lessen their anxiety during this time; offer pain relief if they are experiencing pain, or engage in meaningful activity but don’t restrict them.
Mae gan unigolyn â dementia hawliau o hyd. Gall llesteirio ei hawliau effeithio ar ei hyder a'i allu i barhau i fyw bywyd mor egnïol â phosibl.
Gallai unigolyn gerdded o gwmpas am nifer o resymau. Gallai fod yn batrwm ar yr un adeg o'r dydd â dyna'r amser y byddai ei blant wedi dod adref o'r ysgol neu bartner wedi dod adref o'r gwaith. Efallai ei fod wedi anghofio nad yw ei blant bellach yn blant ac wedi gadael cartref neu efallai bod ei bartner wedi marw ac na fyddai gartref. Gallai fod cysylltiad â rôl waith flaenorol. Efallai ei fod wedi diflasu neu hyd yn oed yn ceisio lleddfu poen.
Er y gallech gydnabod risgiau cerdded, os effeithir ar symudedd neu os ydyw wedi blino'n lân, nid yw'n golygu bod rhaid i chi ei annog i eistedd neu ddefnyddio cadair olwyn. Cerddwch gyda nhw, cadwch gwmni iddynt a'u cadw'n ddiogel. Efallai y gallech dynnu eu sylw a lleihau eu pryder yn ystod yr amser hwn; cynigiwch fodd lleddfu poen os ydynt yn profi poen, neu ymgysylltwch â gweithgaredd ystyrlon ond peidiwch â'u cyfyngu.
There are many ways in which we can use technology to safeguard an individual, such as safe walking technologies (electronic monitoring and tracking devices), fall sensors, door sensors and more. These may be of great benefit and when used well can enable people to retain independence whilst offering reassurance that should anything go wrong, help will be arranged.
In line with Principles 4 and 5 of the Mental Capacity Act, if the person lacks capacity to consent to the use of assistive technology, we may make a best interest decision. This must be the least restrictive option. For example, if the person regularly leaves the house during the night and is at risk of harm, we could use a tracking device so that we are able to go and find them; however, a bed sensor mat that alerts their partner to the fact that they have got up, or a door sensor that alerts a telecare responder, may be the least restrictive option.
Every decision will be individual, based on a thorough assessment which takes into account the person’s right to privacy and freedom, balanced with a duty of care.
Mae sawl ffordd y gallwn ni ddefnyddio technoleg i ddiogelu unigolyn, megis technolegau cerdded diogel (dyfeisiau monitro ac olrhain electronig), synwyryddion cwympo, synwyryddion drysau a mwy. Gallai'r rhain fod o fudd mawr a thrwy gael eu defnyddio'n dda, gallant alluogi pobl i gadw annibyniaeth wrth gynnig sicrwydd y bydd help yn cael ei drefnu pe byddai unrhyw beth yn mynd o'i le.
Yn unol ag Egwyddorion 4 a 5 y Ddeddf Galluedd Meddyliol, os nad oes gan yr unigolyn y gallu i gydsynio i ddefnyddio technoleg gynorthwyol, gallwn ni wneud penderfyniad er ei fudd gorau. Rhaid mai hwn yw'r opsiwn lleiaf cyfyngol. Er enghraifft, os yw'r unigolyn yn gadael y tŷ yn rheolaidd yn ystod y nos ac mewn perygl o niwed, gallem ddefnyddio dyfais olrhain fel y gallwn ni fynd i'w canfod; fodd bynnag, efallai mai mat synhwyro wrth ochr y gwely sy'n rhybuddio ei bartner am y ffaith ei fod wedi codi, neu synhwyrydd drws sy'n rhybuddio ymatebydd teleofal, fydd yr opsiwn lleiaf cyfyngol.
Bydd pob penderfyniad yn unigol, wedi'i seilio ar asesiad trylwyr sy'n ystyried hawl yr unigolyn i breifatrwydd a rhyddid, wedi'i gydbwyso â dyletswydd gofal.
Every individual with dementia is different and unique. A fundamental principle of good dementia care is that we see the individual first, not the dementia. This statement is true, whatever an individual’s gender identity or sexual orientation; however, the experience of dementia may be somewhat different for someone who is lesbian, gay, bisexual or transgender.
Some individuals will have experienced stigma and prejudice which might lead to a reluctance to engage in services for fear of discrimination. If the individual is disorientated to time, they may believe that they are in a time and place where their sexuality was hidden, homosexuality was illegal and thought to be a mental illness, or to a time before they transitioned.
Some individuals with dementia may become sexually disinhibited, others may lose an interest in sex. They may fail to recognise a partner or misidentify a younger member of the family as their partner. An individual may forget that their partner has died, or that they have divorced and remarried.
We must ensure that all individuals with dementia are treated with the same care and respect, minimising any distress and protected from damaging prejudices and discriminations.
Mae pob unigolyn â dementia yn wahanol ac yn unigryw. Egwyddor sylfaenol gofal dementia da yw ein bod yn gweld yr unigolyn yn gyntaf, nid y dementia. Mae'r datganiad hwn yn wir, beth bynnag yw hunaniaeth rywedd neu gyfeiriadedd rhywiol unigolyn, ond gall profiad dementia fod ychydig yn wahanol i rywun sy'n lesbiaidd, hoyw, deurywiol neu drawsryweddol.
Bydd rhai unigolion wedi profi gwarthnod a rhagfarn a allai arwain at amharodrwydd i gymryd rhan mewn gwasanaethau rhag ofn gwahaniaethu. Os yw'r unigolyn wedi ei ddrysu ynghylch amser, efallai y bydd yn credu ei fod mewn amser ble yr oedd ei rywioldeb wedi'i guddio, roedd cyfunrhywiaeth yn anghyfreithlon ac roedd pobl yn credu ei fod yn salwch meddwl, neu ynghylch amser cyn iddo drawsnewid.
Efallai y bydd rhai unigolion â dementia yn ddirwystr o ran rhyw, gallai eraill golli diddordeb mewn rhyw. Efallai y byddant yn methu â chydnabod partner, neu'n cam-adnabod aelod iau o'r teulu fel eu partner. Efallai y bydd unigolyn yn anghofio bod ei bartner wedi marw, neu ei fod wedi ysgaru ac ailbriodi.
Rhaid i ni sicrhau bod pob unigolyn â dementia yn cael ei drin â'r un gofal a pharch, gan leihau unrhyw ofid a'i amddiffyn rhag rhagfarnau a gwahaniaethu niweidiol.
In all situations, if an individual does or does not have capacity to take prescribed medication, as a care worker you cannot make decisions in relation to this.
Any decisions for an individual who is deemed to lack capacity to make decisions around medication issues will be made by the prescriber, in the individual’s best interests.
Decisions around withholding medication have to be documented in a legal document when the individual had capacity to make the decision. If a lasting power of attorney for health and welfare decisions has been set up then the decision can be made by them, in consultation with the prescriber, based on what’s best for the individual.
If the decision is based on the need for the individual to continue to take the prescribed medication, then a less restrictive measure can be adopted. All methods should be explored, including the possibility of taking the medication in liquid form, or a topical patch. Some individuals might refuse to take the medication from some members of staff, or if the environment is too distracting, but will for a different person.
As a last resort, the decision will be made to administer medication covertly (without the individual’s knowledge), in their best interests, when the medication is necessary for the individual’s physical or mental health, all other options have been explored, and it is safe to do so. If this is the case, specific guidance will be provided.
Ym mhob sefyllfa, p'un a oes gan unigolyn alluedd i gymryd meddyginiaeth a ragnodwyd ai peidio, ni allwch chi fel gweithiwr gofal wneud penderfyniadau mewn perthynas â hyn.
Bydd y rhagnodwr yn gwneud unrhyw benderfyniadau ar gyfer unigolyn y bernir nad oes ganddo'r galluedd i wneud penderfyniadau ynghylch materion meddyginiaeth, er budd pennaf yr unigolyn.
Rhaid i benderfyniadau ynghylch atal meddyginiaeth gael eu dogfennu mewn dogfen gyfreithiol pan oedd gan yr unigolyn y galluedd i wneud y penderfyniad. Os sefydlwyd atwrneiaeth arhosol ar gyfer penderfyniadau iechyd a lles, yna gallant wneud y penderfyniad, wrth ymgynghori â'r rhagnodwr, yn seiliedig ar yr hyn sydd orau i'r unigolyn.
Os yw'r penderfyniad wedi'i seilio ar yr angen i'r unigolyn barhau i gymryd y feddyginiaeth a ragnodwyd, yna gellir mabwysiadu mesur llai cyfyngol. Dylid archwilio pob dull, gan gynnwys y posibilrwydd o gymryd y feddyginiaeth ar ffurf hylif, neu ddarn lleol. Efallai y bydd rhai unigolion yn gwrthod cymryd y feddyginiaeth gan rai aelodau o staff, neu os yw'r amgylchedd yn tynnu sylw'n ormodol, ond byddant yn ei wneud i unigolyn gwahanol.
Fel dewis olaf, bydd y penderfyniad yn cael ei wneud i roi meddyginiaeth yn gudd (heb yn wybod i'r unigolyn), er ei fudd pennaf, pan fydd y feddyginiaeth yn angenrheidiol ar gyfer iechyd corfforol neu feddyliol yr unigolyn, mae'r holl opsiynau eraill wedi'u harchwilio, ac mae'n ddiogel i wneud hynny. Os yw hyn yn wir, darperir cyfarwyddyd penodol.
All medication should be prescribed to an individual, in their best interests. Some drugs may be used to alleviate some of the behavioural and psychological symptoms of dementia, such as agitation and aggression; however, this should be seen as a “last resort”, when all other interventions have been explored.
Antipsychotic medications are a group of drugs which are designed to treat psychosis, hallucinations or delusional beliefs, commonly used to treat mental health conditions such as schizophrenia. Whilst people with dementia may experience psychosis, antipsychotics (or neuroleptics) have been seen as less beneficial to individuals with dementia. They are sometimes used for the management of behaviour and psychological symptoms in dementia, without first exploring non drug interventions to understand behaviour. The risks and effects of taking the medication could include over sedating an individual, involuntary movements, tremors, difficulties walking, high fever and even damage to the heart, particularly when prescribed for more than 12 weeks. People with Dementia with Lewy Bodies are at particular risk to severe side effects.
Anti-depressants are a group of drugs used to treat depression. Depression is common in people with dementia and should be treated accordingly; however, they can further impair cognitive functions. There have been studies that have showed that the use of anti-depressants can increase the risk of developing dementia.
Antimuscarinic drugs or sedatives have an effect on the cognitive function of an individual with dementia so judgments, orientation and memory can be made worse.
Dylid rhagnodi pob meddyginiaeth i unigolyn, er ei fudd pennaf. Gellir defnyddio rhai cyffuriau i leddfu rhai o symptomau ymddygiadol a seicolegol dementia, megis cynnwrf ac ymddygiad ymosodol, ond dylid ystyried hyn fel “dewis olaf”, pan archwiliwyd yr holl ymyriadau eraill.
Mae meddyginiaethau gwrthseicotig yn grŵp o gyffuriau sydd wedi'u cynllunio i drin seicosis, drychiolaethau neu gredau rhithdybiol, a ddefnyddir yn gyffredin i drin cyflyrau iechyd meddwl fel sgitsoffrenia. Er y gall pobl â dementia brofi seicosis, mae cyffuriau gwrthseicotig (neu niwroleptig) wedi'u hystyried yn llai buddiol i unigolion â dementia. Fe'u defnyddir weithiau ar gyfer rheoli ymddygiad a symptomau seicolegol mewn dementia, heb archwilio ymyriadau heblaw am gyffuriau yn gyntaf i ddeall ymddygiad. Gallai risgiau ac effeithiau cymryd y feddyginiaeth gynnwys gor-dawelu unigolyn, symudiadau anwirfoddol, cryndod, anawsterau wrth gerdded, twymyn uchel a hyd yn oed niwed i'r galon, yn arbennig pan y'i rhagnodir am fwy na 12 wythnos. Mae pobl â Dementia â Chyrff Lewy mewn perygl arbennig o brofi sgîl-effeithiau difrifol.
Mae gwrth-iselyddion yn grŵp o gyffuriau a ddefnyddir i drin iselder. Mae iselder yn gyffredin mewn pobl â dementia a dylid eu trin yn unol â hynny, ond gallant amharu ymhellach ar swyddogaethau gwybyddol. Fe fu astudiaethau sydd wedi dangos y gall defnyddio gwrth-iselyddion gynyddu'r risg o ddatblygu dementia.
Mae cyffuriau gwrthfysgarinig neu dawelyddion yn effeithio ar weithrediad gwybyddol unigolyn â dementia felly gall penderfyniadau, cyfeiriadedd a chof waethygu.
As care workers, it’s sometimes hard to know why certain behaviours are triggered, but having a life story to refer to can create an understanding of the triggers, behaviours, patterns etc., and enable you to work towards reducing the impacts of specific events, situations and ease their anxiety and concerns.
Having an understanding of what they did in their lives can enable relevant activities to be promoted. Seeing the person for what they were and not what they are, knowing about them through their story can enhance their interests and their ability to build better relationships. Encouraging more meaningful communications and interactions gives the individuals more of a sense of identity.
Fel gweithwyr gofal, mae weithiau'n anodd gwybod beth sy'n achosi rhai mathau o ymddygiad, ond mae cael hanes bywyd y gellir cyfeirio ato yn gallu eich helpu i ddeall yr achosion, ymddygiadau, patrymau ac ati a'ch galluogi i weithio tuag at leihau effeithiau digwyddiadau a sefyllfaoedd penodol a lleddfu pryderon a gofidiau'r unigolyn.
Drwy ddeall yr hyn a wnaeth yr unigolyn yn ystod ei fywyd, gellir hybu gweithgareddau perthnasol. Mae gweld pwy oedd y person o'r blaen yn hytrach na phwy ydyw heddiw, a dysgu amdano drwy wybod ei hanes yn gallu gwella ei ddiddordebau a'i allu i feithrin cydberthnasau gwell. Mae annog cyfathrebu a rhyngweithio mwy ystyrlon yn rhoi mwy o ymdeimlad o hunaniaeth i unigolion.
Individuals with dementia can sometimes behave in a physically aggressive manner or may attempt to leave a place of safety.
The Mental Capacity Act (MCA) permits us to legally restrain a person who lacks capacity in situations where we reasonably believe that restraint is necessary to prevent harm, and the amount or type of restraint used, and the amount of time it lasts, must be a proportionate response to the likelihood and seriousness of that harm.
Using restrictive measures can be described as being inhumane and degrading to these vulnerable individuals who don’t understand what they are doing or why people are using the measures; however, this needs to be balanced with a duty of care.
The MCA guides practice and ensures that we use proactive strategies to avoid situations where restraint may be necessary. If we understand why a person is attempting to leave, we can use other strategies to engage, distract or redirect.
Weithiau gall unigolion â dementia ymddwyn mewn modd corfforol ymosodol neu gallant geisio gadael man diogel.
Mae'r Ddeddf Galluedd Meddyliol yn caniatáu i ni rwystro unigolyn yn gyfreithiol os yw heb alluedd mewn sefyllfaoedd lle credwn yn rhesymol fod angen rhwystro i atal niwed, a rhaid i faint neu'r math o rwystro a ddefnyddir, a faint o amser y mae'n parhau, fod yn ymateb cymesur i debygolrwydd a difrifoldeb y niwed hwnnw.
Gellir disgrifio defnyddio mesurau cyfyngol fel rhai annynol a diraddiol i'r unigolion bregus hyn nad ydynt yn deall yr hyn maent yn ei wneud neu pam mae pobl yn defnyddio'r mesurau, ond mae angen cydbwyso hyn â dyletswydd gofal.
Mae'r Deddf Galluedd Meddylion yn arwain ymarfer ac yn sicrhau ein bod yn defnyddio strategaethau rhagweithiol er mwyn osgoi sefyllfaoedd lle gallai fod angen rhwystro. Os ydym yn deall pam mae person yn ceisio gadael, gallwn ni ddefnyddio strategaethau eraill i ymgysylltu, tynnu sylw neu ailgyfeirio.
No matter what an individual’s faith, sexual orientation or history, they still have the right to a service where they are treated as an individual, treated equally, not discriminated against, and respected. They have a right to privacy, to be treated in a dignified way, protected from danger and harm, and supported and cared for in a way that meets their individual needs and takes their choices into account and protects them.
Families and carers have a right to be heard and to continue to contribute to the person with dementia in whatever way they chose or are able to.
As a care worker, using your skills in communication, supporting decision making and choice, and advocating on the person’s behalf where appropriate to do so, is essential in promoting rights-based approaches.
Dim ots beth yw ffydd, cyfeiriadedd rhywiol neu hanes unigolyn, mae ganddo'r hawl o hyd i gael gwasanaeth lle mae'n cael ei drin fel unigolyn, yn cael ei drin yn gyfartal, heb wahaniaethu yn ei erbyn, a'i barchu. Mae ganddynt hawl i breifatrwydd, i gael eu trin mewn ffordd urddasol, eu hamddiffyn rhag perygl a niwed, a chael cefnogaeth a gofal mewn ffordd sy'n diwallu eu hanghenion unigol ac yn cymryd eu dewisiadau i ystyriaeth ac yn eu hamddiffyn.
Mae gan deuluoedd a gofalwyr hawl i gael eu clywed ac i barhau i gyfrannu at yr unigolyn â dementia ym mha ffordd bynnag y maent yn dewis neu'n gallu ei wneud.
Fel gweithiwr gofal, mae defnyddio'ch sgiliau cyfathrebu, cefnogi'r broses o wneud penderfyniadau a dewis, ac eirioli ar ran yr unigolyn lle mae'n briodol gwneud hynny, yn hanfodol wrth hyrwyddo ymagweddau sy'n seiliedig ar hawliau.