Initial Request to Get Access to the Patient Form

2021-05-06 16:34:06
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This form served as my initial request to get access to the patient. Since my subject could not give her own consent, I consulted with her eldest daughter. First, I explained my reasons for my interest in her mother. Second, I explained the benefits of my intervention.

Part 1: Consent Explanation

I am a nursing student doing a study on caring for Alzheimers patients. I wish to get involved in caring for a member of your family who is having dementia. My involvement is limited to social, medical and psychological support, meaning that I will be actively engaged in treatment of your family member.

The benefits of my intervention will be both to you and your patient. You will get a medical advice on caring for your patient as well as psychological support during this period. I will teach you how to give medicines and what danger signs to look for in the patient. Your patient will get five hours of my attention daily. He/she will get the best medicine and psychological counseling while required

Part 2: Seeking For Consent

I ..in my desire to get medical and social support for my patient accept your request for participation in the patient care of my.. (Indicate family relation). I believe that the participation is intended to help the family and the patient in the care process.

Signature..

Date..

References

Alzheimers Australia. 2014. Dementia care in the acute hospital setting. Issues and strategies

Cohen, C., Teresi, J., & Blum, C. (1994). The role of caregiver social networks in Alzheimer's disease. Social Science & Medicine, 38(11), 1483-1490.

Downs, M., Small, N., & Froggatt, K. (2006). Explanatory models of dementia: links to end-of-life care. International Journal of Palliative Nursing, 12(5).Epp, T. D. (2003). Person-centred dementia care: A vision to be refined. The Canadian Alzheimer Disease Review, 5(3), 14-19.

Hinrichsen, G. A., & Niederehe, G. (1994). Dementia management strategies and adjustment of family members of older patients. The Gerontologist, 34(1), 95-102.

Hughes, J., Lloyd-Williams, M., & Sachs, G. (2009). Supportive care for the person with dementia. Oxford University Press.Hughes, J. C., Jolley, D., Jordan, A., & Sampson, E. L. (2007). Palliative care in dementia: issues and evidence. Advances in Psychiatric Treatment, 13(4), 251-260.

Hughes, J. (2014). Models of dementia care: person centered, palliative and supportive. Alzheimers Australia

Lindsay, S., Brittain, K., Jackson, D., Ladha, C., Ladha, K., & Olivier, P. (2012, May). Empathy, participatory design and people with dementia. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (pp. 521-530). ACM.Lyman, K. A. (1989). Bringing the social back in: A critique of the biomedicalization of dementia. The Gerontologist, 29(5), 597-605.

Monahan, D. J., & Hooker, K. (1995). Health of spouse caregivers of dementia patients: The role of personality and social support. Social Work, 40(3), 305-314.

Richard, E., Reitz, C., Honig, L. H., Schupf, N., Tang, M. X., Manly, J. J., ... & Luchsinger, J. A. (2013). Late-life depression, mild cognitive impairment, and dementia. JAMA neurology, 70(3), 383-389.Schulz, R., Belle, S. H., Czaja, S. J., McGinnis, K. A., Stevens, A., & Zhang, S. (2004). Long-term care placement of dementia patients and caregiver health and well-being. Jama, 292(8), 961-967.

Schulz, R., & Martire, L. M. (2004). Family caregiving of persons with dementia: prevalence, health effects, and support strategies. The American journal of geriatric psychiatry, 12(3), 240-249.Sorensen, S., Duberstein, P., Gill, D., & Pinquart, M. (2006). Dementia care: mental health effects, intervention strategies, and clinical implications. The Lancet Neurology, 5(11), 961-973.

Trueland, J. (2014). Not special enough?. Nursing Standard, 28(21).

van der Steen, J. T., Radbruch, L., Hertogh, C. M., de Boer, M. E., Hughes, J. C., Larkin, P., ... & Koopmans, R. T. (2013). White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliative medicine, 0269216313493685.Wegerer, J. (2103). Empathy for Alzheimers: The Validation Method. Alzheimers.Net

Zarit, S. H., Anthony, C. R., & Boutselis, M. (1987). Interventions with care givers of dementia patients: comparison of two approaches. Psychology and aging, 2(3), 225.

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