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The understanding of Alzheimer’s disease in the old age home is analysed in this study for detecting the accountability as well as the advocacy in the treating plans. Gibb’s reflection method is used eventually to reflect the experiences of treating this kind of patient. It totally exclaims about the health care system of the patients by developing the old age home care systems. 

Part A: Justification for accountability and autonomy 

Evidence-Based Practice

The evaluation of best research evidence followed by the development of better expertise related to the value of patients and associated research is known as Evidence-Based Practice (EBP) (Bosch-Bayard, et al., 2016). The decision taken against proper treatment procedure followed by the association of effective value provided for the patient who requires care can be considered as one of the major aspects of evidence-based practice. 



It is essential as a healthcare professional for implicating the outcome of clients. For Instance, the healthcare setting must be done based on the reason for developing a better approach for managing certain practices. Evidence-based decision making will have a range of conditions that are required to be responded to accordingly for the management of refrain action and developing conditions for patients (Bergman, Graff, Eriksdotter, Fugl-Meyer, & Schuster, 2016). In my experience, during my role as a healthcare professional for Alzheimer’s patients, I have come across a case in which a patient tried to attack me for feeding her early in the afternoon. The usual routine for her lunch was interrupted and for this reason, she felt irritated and angry at me. 


Considering the seriousness of the situation, I have developed a certain feeling of fear and my colleagues who have more experience handling the situation. The aggressive nature of the patient has also provided me with some knowledge regarding the treatment of such patients. Using evidence-based practices, I have come up with better strategies to tackle such situations and the experiences of my colleagues to handle such situations also taught me certain essential things. 

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As a healthcare professional, I have found out that the dependency on the perspective of health and well being of caregivers depends on the better evaluation of incorporated value to progress with certain dependencies. Health professionals including nurses’ manage to practice in the toughest situations (Alzheimer’s New Zealand, 2020). This has provided me with a better strategy to treat such resident patients for my practices. 


The interpretation and communication skills of individual healthcare professionals are important to manage the cooperation and coordination of individuals. One of the major challenges faced by a healthcare professional is to establish better communications with the patient and for this reason, the development of a response to creating certain information assessment is essential to manage the uncertainty of clinical approaches (Al Arifi, 2020). I need to focus on the development of a better communication approach to develop better growth and operation as it will provide me with a better relationship with my client. 


Decisions related to diverse working situations for developing certain practices are required to foster better credibility and trust. The integration of conflicting decisions to manage the EBP of patients will be essential for handling the dementia of the residents. 

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Action plan

The professionals must take appropriate decisions related to diagnostic evaluation as it helps to provide consistent treatment to create ethical value for managing the undue influence of duress. The conflict of decision related to the specific course of action followed by the achievement of the desired outcome to create a better decision-making approach is essential for healthcare professionals to manage certain situations.

Ethical conduct


The ethical conduct present in a situation of caregivers can provide various issues considering the provision of different aspects (Prince, Comas-Herrera, Knapp, Guerchet, & Karagiannidou, 2016). The influence of managing proper situations followed by the development of certain concerns related to the integration of different practices is essential as it provides patients to make decisions regarding their healthcare practices. In my experience, I have come across a situation in which a patient was facing breathing problems and the caregivers were approaching him to implement a pacemaker. However, he did not want to have any mechanical equipment installed in his body. As a result, after the operation, he showed no responses of curing and died within a week.


As a healthcare professional, I have found that patients having issues other than Alzheimer’s must provide consent, and based on their requirements further treatment process must be done. The patient was in his late 90s and for this reason; he was not mentally prepared for the operation, which provided a specific ethical issue related to treating a patient. 

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The entire situation was challenging and difficult as a healthcare professional as the duty and care needed to be provided in an old age home related to patient care must be done based on their concern. The inaccuracy in an evaluation followed by the inability of providing treatment for better responsibility is a sensitive issue that is required to be addressed in a healthcare system (Wang, Xiao, Luo, Xiao, Whitehead, & Davies, 2018). For this reason, it can be said that healthcare professionals must be developed based on better healthcare assistance to manage entire treatment processes. 


Respect for patients followed by addressing their decisions is considered to be one of the major obligations for healthcare professionals to develop better decision-making approaches. The development of primary obligations related to the resident for addressing difficulty is considered to be one of the primary issues that are required to be addressed (Podcasy & Epperson, 2016). Support of life-long value followed by the development of responsibility towards sensitive integration of residents is one of the required features of it. 


As a result, the substituted judgment followed by the process of decision making related to medical professionals must be carried out as an observation of determining the extent that helps to provide better benefits for the residents and it helps to create better consent in the capacity of healthcare.

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Action plan

The Treaty of Waitangi is responsible for developing better protection and participation. Identification of role as well as the development of community and responsibility to address the inequalities will be needed for developing better ethical emphasis. Ethics emphasizing the development of the fundamentals of life and the development of sustainability with the formation of Tikanga is essential for creating primary value (Prins, Veerbeek, Willemse, & Pot, 2020). Inclusion of ethics and development of primary value through the management of fundamental and development of primary value will be responsible for providing better effectiveness in the ethical impact of it. The management of engagement followed by the assessment of developing certain corners of preservation will be effective to create engagement. The proper value of identification, addressing and inequalities will be needed for managing sustainability through the provision of better care for the patients. 

Part B: evaluation of personal professional and cultural standards 

Personal standards


As a healthcare professional in elder age care, I came up with a patient who is having issues with familial Alzheimer’s disease (FAD) (Mental Health Foundation of New Zealand, 2020). It is considered to be one of the rarest cases in which the communication establishment between the patient and the individual family member becomes difficult. The clinical and pharmaceutical trials in this aspect become difficult. The patient has difficulty completing familiar tasks and even the visual images and issues of time or place is one of the challenging aspects of it. 

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I was trained to handle such difficult situations and extreme levels of memory losses in such context create issues to address the requirements of the patients. The patient often forgets to take a meal or bath. I have to explain to him each thing regularly which got me very irritated. However, the ability of thinking as a healthcare professional helped me to manage such challenging situations. 


The handling situation through positive value followed by the development of basic interaction habits is considered to be required to create better integration of different values. The management of better healthcare practices to address the individual ability of logical assessment helped to clarify different frustrations aggressively (Hattink, Droes, Sikkes, Oostra, & Lemstra, 2016). I was able to understand his confusion and developed medical treatment strategies according to the best approach. 


With the help of thorough analysis, I have learned basic and advanced issues of familial Alzheimer’s. Considering the requirements of the scenario, I have also learned certain concerns essential for the management of different elements and concerns of the key-value as it will be required to maintain certainty in business (Health navigator, 2020). I was able to analyze the patient’s situation and the delivery of effectiveness to address different values helped me to provide better treatment. 

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I have learned that, with the help of critical value addressing, the process of providing better medical addressing can be achieved. This helped me to create a better evaluation of healthcare value for the patient affected by FAD.

Action plan 

Development of repetitive practices of establishing better communication and management of anger is required as healthcare professionals. The sense of frustration towards patients must be removed to delete it towards better healthcare provision. 

Professional standards


In professional standards, the development of treatment and communication with the patient must not be limited to basic integration. A 56 years old patient was feeling left-out due to too much professional behaviour. After visiting her for the first time I found that she was very talkative and she has developed better responses for curing. She was diagnosed with early-stage dementia and with better communication; she was able to receive it within a week. 

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Association of delivering higher medical assistance towards individual patients helps them to create a better future ahead. The management professional behaviour must not come between deliveries of treatment processes (Teahan, Fitzgerald, & O’Shea, 2020). The establishment of communication with the patient must be developed on a personal level to deliver a better impression on the patient related to the quick recovery of the patient. 


During the practices, I have learned that the patient was willing to talk about everything but some of my colleagues focused on providing her with basic communication. This made her too sad as her nature was talkative (Cheng, Liu, & Woo, 2018). However, I managed to gain better information regarding her by talking and she felt happy after getting such treatment. 


For developing a healthy community to provide certain development and valuable concern in practices, it is essential to manage the healthcare standards for creating developed opportunities (Betz, et al., 2020). I have learned that caring for patients on both personal and professional levels must be developed to provide them with better assistance. 


Although the patient has a very early stage of dementia, she still requires proper care and the establishment of better communication was essential. For this reason, the medical excerpts must not prioritize treating patients using professional value. 

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Action plan 

It is essential to develop better communication with the patient on both personal and professional level for delivering a higher sense of effectiveness. The management of better effectiveness through the establishment of impactful communication is one of the major requirements. 

Cultural standards


Treaty of Waitangi is one of the major principles followed in the healthcare policy of NZ and such values are considered to be effectively required to manage operations in the healthcare system (Gupta, Gupta, Jaiswal, & Ansari, 2018). The concern of cultural value for Maori patients is considerably higher as I come across cases in which the patient was demanding cultural treatment value rather than technology. She further asked me to talk with her in the Maori language. 


I was well aware of the language and for this reason; I managed to become her favourite to serve her following the cultural aspects. I found out that the patient does not believe in medicine. Rather she prefers to chant different names and tells me that “Tane Mahuta (God of birds) will cure me”. This surprised me to a certain extent as the patient managed to cure in a month. 


In my practices as a healthcare expert, I learned that the awareness of professional value towards individual patients must be provided with the delivery and effectiveness of creating better social meetings. 

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The effectiveness of underpinning relationships between Maori and the health practices under this treaty is required for delivering better fairness and the management of partnership and responsibilities are associatively important (McGough, Kirk-Sanchez, & Liu-Ambrose, 2017). The cultural belief helped her to cure immediately. 


Showing respect for the cultural belief or value of a patient is essential as it helps to provide patients with better value. The management of certain issues and the integration of various concerns in healthcare practices must address cultural requirements. 

Action plan 

It is essential to have a brief knowledge related to the culture of an individual patient. The cultural value for some patients can be important and essential for this reason, the use of such details are equally important.

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Part C Working under Pressure / Stress


I was working for a reputed old age home where I faced a critical scene in which one of the critical Alzheimer patients tried to end her life out of frustration. The concerned woman locked herself within the room and was on the verge of slitting her wrist in case the rescue team failed to reach the location within a short time (Jacobs, 2019).    


I felt extremely terrified by encountering this incident and immediately rushed to seek help from the senior psychiatrists present at the mental healthcare organization located within the vicinity of the old-age home. On the contrary, it was the peak time of the day, when I needed to ensure caregiving to the other critical patients according to the plan finalized by the management authority.    


I needed to seek help from the contemporary caregiving individuals employed at my workplace to ensure efficient handling of the scenario. The suicidal tendency of the patient indicates the presence of irregularities in the consumption of psychiatric drugs as per the prescribed routine of the doctor (Urban, 2017).

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The observed irregularities in terms of drug consumption indicate the shortage of staff within the old age premises for ensuring the effective caregiving of the individuals residing at the old age home. Moreover, the concerned doctor can prescribe some emergency drugs for the patient in case the overall violent nature of the patient increases rapidly without showing any prior symptoms (Kossioni, et al., 2018).  


I need to use suitable time management strategies for the effective handling of such scenarios. The selection of a suitable strategy needs to focus on the overall improvement of the caregiving service offered to the residents of the old age home.   

Action Plan

I need to ensure strict monitoring of the patients allocated to me for the reputation benefit of the concerned old age home. I need to focus on the minute changes observed in critical patients to restrict the occurrence of adverse scenarios as per the requirement. 

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Cultural Differences


I was working for a well-established old-age home having the required capacity of caregiving Alzheimer’s patients as per the requirement. I was in my probationary phase when I faced the critical scenario related to the adverse impact of cultural difference. I was instructed to work as a proxy for one of my colleagues who had to be granted an untimely leave owing to a critical scenario. On that day, I faced significant resistance from a patient in terms of refusing the medicine, prescribed to him by the doctor. This resistance from the patient relates to the presence of cultural differences between us.     


I felt pathetic as well as helpless in that situation as I was instructed to inject the medicine to the patient at the earliest owing to the dynamic mood swing of the patient. In that scenario, I had to rush from the concerned patient ward to the administrative authority to seek help.      


The suitable evaluation of the scenario encouraged me to observe my patients closely before agreeing to take responsibility. This is because; the unprecedented occurrence of critical scenarios can result in an adverse impact on the reputation of the old age home within the healthcare domain (Cook, McNall, Thompson, Hodgson, Shaw, & Cowie, 2017).

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The presence of cultural differences in significant amounts discouraged the concerned patient to seek my assistance as per the prescription of the doctor. This observation determines the seriousness of the scenario and the occurrence of similar incidents in future can tarnish the reputation of the old age home (Lee, Yu, Ip, & Tang, 2017).     


I need to study the medical background of the patients allocated to me before approaching them for medical assistance. This initiative is expected to reduce the overall chances of my exposition to uncomfortable scenarios. The unwanted exposure of caregiving individuals to stressful scenarios can result in the deteriorated performance of the individual as per the overall expectation level (Barken & Sims-Gould, 2020).             

Action Plan

I can study the cases related to the handling of violent patients before approaching my assignment to handle critical patients having a tendency of becoming violent within a short time. Moreover, this practice of the prior study of critical patients can enhance my overall field experience as per the requirement.



I needed to take an urgent leave from my professional field of working for an old age having a record of treating Alzheimer’s patients for a prolonged duration. In that scenario, I had to assign my duty of injecting recovery drugs to a patient to a trainee individual. On the contrary, the concerned individual remained unavailable to take up the charge directly from me. As a result, a significant miscommunication emerged as the doctor suggested a drug without consulting me.         

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I felt helpless in that scenario due to the lack of expert guidance, as I possessed no information about the prescription of new drugs.


The effective evaluation of the concerned scenario encourages the undertaking of suitable strategies that can encourage effective handling of the scenario without the occurrence of any unfortunate incident (Hansen, Hauge, & Bergland, 2017). I needed to submit a suitable explanation describing in detail the cause of the incident from my perspective.


The occurrence of a serious miscommunication can lead to an adverse impact on the reputation of the old-age home in terms of handling critical patients. Moreover, the error in the injection of medicine can result in serious healthcare threats for the concerned patient.     


The presence of effective communication can result in quality care-giving of the patients on behalf of the concerned old-age administration. Moreover, the concerned care-giving nurse can be held responsible for the unintended offence and prosecuted accordingly. 

Action Plan

The presence of an effective action plan can restrict the occurrence of similar incidents in future. As per the adversity of the current scenario, the concerned healthcare representative needs to maintain healthy communication with the other team members for the execution benefit of similar scenarios in the future (Lee & Lim, 2017). I need to ensure the submission of relevant prescription documents to the centralized patient management system at the earliest possible for the recovery benefits of the patients allocated in my schedule. 

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PART D: Reflective Practitioner

a. Reflection

Reflective ideas are the skills of personal ideas and concepts regarding the healthcare problem identified in old age homes. It is being detected that learning from the experiences is needed so that the learning experiences can be grown from such aspects. I have learned about the old age home along with Alzheimer’s disease in terms of promoting my own skills and ideas. I have experienced a lot in my practice time when I have handled an Alzheimer’s patient in the old age home of around 68 years old. It is a common form of dementia, which is very much harmful in nature. It causes the death of the patients severely by increasing the risk with the increase in age. I have seen that it becomes worst over time as the symptoms get very risky however, the disease rate varies progressively. After the diagnosis, the person lived only for five years as the patient was having severe conditions (Azimi & Tamminen, 2019). Generally, I have seen that the disease is regarded as a progressive disorder, which tends to cause wasting away of the brain cells. It had declined the level of thinking, social skills as well as behavioural skills. Furthermore, it disrupts the person’s ability for functioning independently. My experience was handling a patient, named Mr Watson. 

In the old age home, the health care provision was provided to take care of these kinds of patients. Mr Watson was having Alzheimer’s disease in which he used to forget something that is generally cannot be forgettable in the actual mindset. He used to wait for his lunch and asks every time to provide him with lunch even after being taken his lunch. I have even noticed that he could not recognize his own grandson and granddaughter. Along with that, he always used to ask a question about his family even after getting the answer. It means that he used to get forget things even within a second. He has lost all the power of his brain cells because of this disease. I always try to make him remember the family members by showing him with their pictures.        

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b. Feelings

While handling such patients who are 68 years old was very challenging for me. I have not much experience in handling elderly patients. However, normal cases are much easier for me to handle. The case of Alzheimer’s disease is much more complicated. It is because these kinds of patients require more attention and care, as they do not have the mental strength to do their own activities. I feel they require more care because the patients do not consist of the capability to identify their own family members, which results in a lower down of mental conditions. I want to state that handling the patient for me is the toughest job, as the service quality needs to be more advanced rather than providing residential care. Making the recent events to be remembered too that patient is not an easy task (Lange, et al., 2017). I have always been determined to treat these kinds of patients as remembering past memories is such a challenging job. Other than that, treating the old people with the right care at right time needs to be provided with appropriate quality based services. I have also seen that the family member’s support, in this case, is much required. 

The patient’s mental condition was much weak in terms of other patients in old age. This type of disease was very common in old people. However, I find him to be a more risky patient than the others. Sometimes I feel that he might be remembering my name and me or not. However, that certain thing did not happen with me as I thought he might not be remembering me once or twice in a while. It is because I have been providing the care regularly due for this reason he might not have forgotten me.     

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c. Evaluation

At the time of my practices with Alzheimer’s patients, I have learned several things, which I would have not done severely. The elimination of the stresses from the minds is one of the common factors for me to conduct with my patient. I have analysed that the patient was many times lost in his thoughts. When I tried to recognise the problem, it was detected as the verbal assaults and other stressful conditions, which he faced in his life. Several caregivers are involved in implementing their own methods for handling this kind of patient and the situation. However, from this condition, I found that I have to plan various actions for the patient for providing him with small happiness in this old age home. 

According to the code of conduct related to my profession, I think primary care physician practices can be provided to Mr Watson. This will be implementing common practices of the physicians to handle the patients of Alzheimer’s disease. Even I have discussed this case with my senior practitioners to understand and implement any further practices to have better results. After understanding the guidelines and the experiences of the seniors, it can be conducted that the patient with Alzheimer’s disease cannot relive for a longer period of time. It is true that their residential matters can be resolved for their better outcomes however, it is not appropriate at all in terms of using behavioural changes.   

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d. Analysis

From the statistical analysis, Alzheimer’s patients are increasing day by day specifically at old ages. It can be stated that people with such age are not at all fit to adopt any type of mental related activities. Even though their physical conditions are weak, however, their mental conditions are much low influential in nature (Michael, Lenferink, Vrensen, Gelpi, Barraquer, & Otto, 2017). By the year, 2030 it is expected to increase at a higher rate. Most of the old people will be having such disease within themselves even after getting appropriate care. In this case, of Mr Watson, I have understood the conditions and the mental problems arising from this disease.  

I have analysed from my own experiences that each of the patients requires different treatments, as the environment of each of the patients are different in conditions. I have tried to create an environment for my patient to be more relaxing and friendly to he can become comfortable. These types of patients are needed to be handled with care as severe loud noises along with disruption cannot make the treatment successful. Due to this reason, the patient needs to be handled in a calm environment.  

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e. Conclusion

It can be concluded that I have experienced a lot in this case of Mr Watson who is an Alzheimer’s patient. The symptoms of Alzheimer’s disease are related to mental problems. My patient was having severe problems including forgetfulness and loss of thought. Other than that, he used to forget his own family members. These are many extensive symptoms, which focuses on the fact that the patient needs appropriate care services (Yiannopoulou, Anastasiou, Kyrozis, & Anastasiou, 2019). The understanding of the plan to be created for resolving the problems faced by Mr Watson is a significant approach towards obtaining successful outcomes in this area. 

It is significant to detect the strategies to be implemented for overcoming the challenges along with becoming more stressed in a difficult situation. During the time of my confusion to treat the patient I always, consult my seniors for achieving their leanings from their own experiences. It allows being focused on future situations to handle difficult situations very easily. Other than that, it also provides support to handle any type of critical patient situation.    

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f. Action Plan

The action plan for my patient Mr Watson was the implementation of a positive environment and communication technique. I used to create a relaxing environment by using calm music, yoga sessions in the morning and a thorough counselling session as the communication technique. It takes away the mental stress if the patients very easily. Being part of the professional codes of conduct, it is important for me to follow all the guidelines blindly to provide quality services to the patients (Roberts & Kumar, 2020). The residential care involves making the patients communicate with their family members about past events. It enhances the treatment more severely.   

At the time of my practice, I have clearly ensured that I have invested my all time and effort in treating this patient very minutely. Even the following of the codes and guidelines have been maintained by recognising the different patients and their symptoms of the disease carefully.

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Within this particular study, Gibb’s reflection consists of the accountability and the advocacy related to the development of the reflective approaches. All the information is based on previous experiences in the handling of Alzheimer’s patients. The severe conditions of the patient are handled and recorded in this study thoroughly. 

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