Dr. Respect Mondli Miya,(D.Lit et Phil), a Senior Lecturer: Psychiatry at Durban University of Technology, Department of Nursing Science, wrote the following interesting article on the national changes in nursing training in South Africa.
A hospital discharge service is necessary to make the transition from hospital to home or a rehabilitation centre easier and less stressful.
The discharge plan can be compiled by a social worker or nurse once the patient has received authorisation from the physician.
Discharge planning will include the following:
- Qualified personnel will have to evaluate the patient;
- A discussion should be held with the patient or representative;
- The return home or the transfer to another facility should be planned;
- Must be ascertained whether the patient required a caregiver or any other support;
- Homecare agencies or appropriate support agencies need to receive referrals;
- Follow-up appointments or tests need to be arranged.
A discussion should take place to determine the specific needs of the patient. It should include detailed information of the patient’s medication prior to hospitalization, as well as new medication. The patient’s diet should be discussed e.g. the patient may be diabetic or suffering from high cholesterol. The appropriate diet should then be planned. One should also determine whether equipment such as walking aid, wheelchair or equipment is needed. Decisions also have to be made regarding me3al preparation, chores and means of transport from the hospital.
AD is a disease of the brain where the nerve cells are destroyed. Caring for someone with AD can be very challenging. The challenges you face vary from day to day. There are 3 stages of AD: the mild stage; the moderate stage and the late stage.
Alzheimer’s affects different people differently and one has to learn coping mechanisms to deal with the challenges you will face while caring for a person with AD.
During the first stage there are small changes in the person’s personality as well as a little memory loss. They do not remember the names of people. Solving mathematical problems may prove to be difficult and they are unable to balance a cheque book for instance. They experience difficulty in planning and organizing. Compiling a grocery list and finding the items on shelves in a store will be challenging for them.
During stage two, memory worsens and confusion occurs. People are unable to organise, plan and follow instructions. They experience problems getting dressed and become incontinent. They may have trouble recognizing family and friends. At this stage they begin to wander. They are unable to remember the date and year. More serious personality changes will be observed – they make threats, accuse people of stealing, kick, scream, bite or grab things.
In stage three the person with AD passes away. They require round the clock care with all their basic daily needs. They will need help sitting and walking. Sometimes they will be unable to talk. They will find it difficult to swallow and as a result refuse to eat. The carer must remember that it is the disease causing the personality changes and not the person with AD.
- Care Management Plan issued by the certified Registered Nurse
- Observe daily medication
- Regular control of blood sugar and blood pressure
- Continuing care
- Wound care
- Intermediate care
- Palliative care
At ProMedCare with nursing care, we offer several services to allow patients to be cared for within their own home by certified Enrolled or Registered Nurses.
Some people with Diabetes need special care. These are usually the elderly and children. They need someone to help them manage their diabetes.
Children with diabetes normally have Type 1 and need to inject regularly. Injections need to be taken at the correct times and the correct dosage has to be given as well. Children need to eat the correct amount of carbohydrates at given times throughout the day. Exercise will help to lower the blood sugar level. Stress or illness will cause the blood sugar to rise.
Older people normally manage their diabetes well. The problem arises when an older person falls ill with a disease e.g. Dementia. They will now require extra care and support so that the situation can be managed.
By managing their disease, the patient will feel in control of their disease. Often with the prognosis of diabetes, depression sets in and the patient feels overwhelmed with the situation. It is imperative to know the level of your blood sugar. Your blood sugar can be measured at home by using a test kit which can be bought at any leading pharmacy. They are accurate and user friendly.
In home care one can purchase various types of equipment to make caring at home and life as an elderly a lot easier and convenient.
Here is a list and brief description of the various types of home care equipment that you as an Elderly can make use of:
- Premium shower chair: This is a plastic chair that one can purchase to be able to sit in a bath or shower, which makes life much easier.
- Slip resistant bath mat: This type of mat is made from anti-bacterial material and prevents an elderly from slipping in the shower or bath.
- Walk in bath tub: This bath tub has a door and enables an elderly person to get into a bath with ease via walking into the bath tub via a door.
- Secure lock: This device locks securely on to almost any metal bar or side of bath , this makes it easier for an elderly person to move around the bathroom.
- Palm hand held shower: This device allows an elderly to wash themselves with ease using their hands therefore making it easier as they do not have to stand when showering/washing themselves, this places less strain on the patients back and joints.
- Toilet seat raiser: This allows an elderly person sit on a toilet with ease without hurting ones back or legs.
- Toilet lift equipment: This piece of equipment physically aids on to be lifted off the toilet seat when done.
In hospitals today, patients are discharged as soon as possible. ProMedCare can provide postoperative or respite care in the patient’s own home where recovery is often hastened by being in a familiar environment. We work very successfully with a multi-disciplinary team who gets called in should the care situation require medical intervention or supervision.
What Is Postoperative Care?
Postoperative care refers to the care you receive following a surgical procedure. This may include pain management and wound care. The type of postoperative care you require depends on the type of surgery you have.
Postoperative care begins immediately after surgery, for the duration of your hospital stay, and may continue after your discharge from the hospital. Part of postoperative care is awareness of the potential side effects and complications of your procedure.
Ask your doctor about postoperative care prior to your procedure so you can prepare as much as possible. Of course, those instructions may be revised based on the details of your surgery.
For care for someone with dementia offers many challenges. There are certain tools that one can use to help the carer cope and manage the patient.
Dementia is a broad term used to describe a deterioration in brain functioning. This deterioration can include the loss of ability to judge, to reason, the loss of memory, your communication and your behaviour. Dementia is a broad term and Alzheimers disease is the most common form of dementia. As people get older their risk of developing dementia will increase. It is however not a normal consequence of getting older.
There are certain medications that can improve cognitive functioning and thereby slow down the rate of dementia.
One can also try the non-medication route e.g. maintain a daily routine, exercise regularly and follow a healthy diet. These could also help to reduce developing Alzheimers and other forms of dementia. The types of food one should eat are greens (kale and broccoli), in other words, leafy vegetables, beans, lentils, wholegrains, fish, poultry, lean meat, olive oil and a glass of red wine per day is recommended. Nuts are also excellent for a healthy mind. They contain fats, fibre and antioxidants. Blueberries are the most potent protectors of the brain. Berries should be eaten at least twice a week. Strawberries are also an excellent source of fibre and are low in carbohydrates.
There can come a time when a house becomes an unfriendly place. Rugs can cause tripping, prescription medication bottles can get mixed up, stairs become barriers, most of all we want to be able to continue to live independently but without all hazards or safety issues. By making these improvements to your house one can live comfortably and safely.
Areas that one needs to check when assessing a home for safety concerns:
In all areas of your home, check all electrical cords and telephone cords, rugs, runners and mats; telephone areas; smoke detectors; electrical outlets and switches; light bulbs; area heaters; wood burning stoves and your emergency exit plan.
Recommendations to ensure that the above areas of concern are made safe:
All cods must either be tied up and far away from any traffic areas, which in turn prevents anybody from falling or tripping. All telephone cords must be glued to wall or length kept to a minimum, this will minimize any chance of falling or better yet install cordless telephones. All loose mats should either be fastened to the surface upon which they lay on or permanently removed. Loose mats are one of the most dangerous icon in an elderly senior’s household. All electrical outlets and switches must be easily accessible and wired properly and thoroughly checked by a qualified electrician. All slippery surfaces need to be clearly marked or coated with a non-slippery surface coating. An emergency exit plan must be easy to execute and effective. One must also make sure that there are zero obstructions in emergency exit route.
Personality traits and Qualities of a good carer
Caregivers need to have a genuine concern for others. Those who need support come from all different backgrounds, and have a range of conditions that make everyday living a challenge. It follows that caregivers must treat all people who use their services equally and with genuine sensitivity – and come to the job without prejudices, or pre-conceptions.
To do their work properly, carers must be able to listen to and empower the person receiving their support. The aim is not to take over but to encourage and support a person in their daily living, so they are able to choose what help they have and how it is carried out, and maintain or increase their independence. Good communication skills are vital in order to have a good carer-patient-relationship.
Caregivers should be conscientious and dependable, arriving punctually and carrying out their tasks to the best of their ability.