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18 Apr

Tips For Successful Transitioning From The Hospital To Home Health Care

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During the transition from hospital to home health care, patients face a significant risk of adverse events which may negatively affect patient safety leading to readmission or even worsening of health and death. Events such as falls and missed doses come to mind. Ensuring that the patient’s transition from home to health goes smoothly care is a collective responsibility for the medical staff, the patient and their intended caregiver. Below are some tips that could help to facilitate the process:

1. Proper information- it is important to get information about various aspects regarding the patient’s condition. These include:

- A detailed listing of diagnosis and all the procedures that were performed. This comes in handy in case the patient has to be readmitted at a different hospital.

- An accurate guide on diet requirements and restrictions, treatments, post-discharge therapy.

- A list of key contacts including doctors, pharmacists and home care agency representatives among others. If possible collect their business cards for safe keeping.

- A realistic assessment of the patient’s outlook- this should include expected recovery time and symptoms of relapses.

- A list of available community and hospital resources. Ensure you have information on all facilities that can handle the patient’s illness.

It is vital that a high level of communication is maintained between the hospital staff and the patient even after they have been discharged.

2. Caregivers are very important- It is not safe for a patient who has just been discharged to be by themselves at home. When a patient returns home from hospital they tend to have lingering effects such as pain, dizziness and muscle weakness. This makes performing certain tasks difficult and they are especially vulnerable to falls. If you are the one being discharged ensure you have a caregiver. This can be a family member, friend or even a hired professional home care attendant. If you have a loved one coming home, consider getting caregiver training. Learn how to take care of them while they are still in the hospital so that you fit into the role seamlessly. Don’t be afraid to ask hospital staff to demonstrate certain tasks and also ask their realistic expectation of what the future will be like.

3. Medication management- this is one of the most vital aspects of home health care. In most cases, once a patient is discharged the medication routine will change leaving room for errors. It is important that you verify medication by brand name before leaving the hospital so that there is no confusion in case you have to buy the medication. Ensure you understand why old medication has been stopped, what new medication does and the kinds of reactions and side effects to expect if any.

4. Prepare the patient’s home and acquire the necessary home care equipment- various adaptations will need to be done to various aspects of the home to ensure the patient is as comfortable and as safe as possible. Remove excess clutter to allow easy passage and clear items such as cords and area rugs that increase the risk of falls. You may need to install a ramp in place of stairs to facilitate movement of a wheel chair. You may also need to bring in equipment such as a hospital bed, stethoscope and wheel chair among others.

5. Prepare for additional expenses- it is important to plan for how to raise additional funds required to sustain various aspects of home health care. Running out of money can be very risky since the patient may be unable to acquire required medication and other needs. Some services of home care are covered by medical insurance which may help to ease the financial burden.

6. Timing of the discharge- the patient should be discharged only when the doctor thinks they are ready to go home. Hasty discharging could prove fatal. Some patients insist on being discharged as soon as possible disregarding what is best for them. In such cases it is up to the doctor to be assertive and do what is in the best interest of the patient. In case of early discharge the hospital staff should take a keen interest in the patient’s welfare. They should only be allowed to leave if there is a suitable post discharge place where they can go to and be assured of good care.

Article Source: http://EzineArticles.com/?expert=Dominic_Maina

11 Apr

How Alzheimer’s Evolves from Early to Late Stages

alzheimer_brainAuthor: Jennifer Wegerer

Alzheimer’s progresses through several different stages, though it’s effects vary from individual to individual. Learn the common symptoms and changes that occur throughout each Alzheimer’s stage.
In the United States, around 5 million seniors have Alzheimer’s disease. That number equates to one in nine (or 11%) of all people age 65 and over.
Currently, experts have identified three major stages of Alzheimer’s: preclinical, mild to moderate, and severe. Here’s a breakdown of the symptoms that occur within each of these major stages, according to information from the National Institute on Aging, WebMD and the Alzheimer’s Association.

Stage 1: Preclinical Alzheimer’s
Symptoms present: None to very mild cognitive decline.
Changes that may occur: Mild memory lapses, such as forgetting everyday words or where things are kept. A medical exam shows no signs of dementia. Studies indicate that brain changes precipitating Alzheimer’s occur during this stage, which may begin as many as 20 years before symptoms are present. So researchers are working to validate biomarker tests that can detect mild cognitive impairment due to Alzheimer’s before the onset of symptoms.

Stage 2: Mild to Moderate Cognitive Decline
Symptoms present: Noticeable difficulty with memory and concentration that progresses over the course of several years.
Changes that may occur: Trouble remembering words and names; greater difficulty performing tasks at work or in social settings; losing or misplacing valuable objects; increasing problems planning and organizing; and personality changes.
A doctor’s exam detects clear-cut Alzheimer’s symptoms, such as challenges remembering recent events or performing math tasks. Individuals in this stage may also forget their own personal history and address, make poor judgments with their health or money, and become moody or withdrawn, particularly in social situations.
As this stage evolves, the person’s struggles with memory and language will worsen more and more. He or she may require a trained caregiver at home or a residential care setting during this stage. 

Stage 3: Severe Cognitive Decline
Symptoms present: Inability to communicate or perform personal care; a decline in physical abilities.
Changes that may occur: Loss of coherent speech; trouble controlling bowels and bladder; wandering or getting lost; groaning or moaning; increased sleeping; forgetting how to swallow; and weight loss.
During severe Alzheimer’s, the brain seems no longer able to tell the body what to do. Individuals become entirely dependent on others for care, including bathing, dressing, eating and other daily tasks. They may recognize familiar faces but not know names and suffer major personality and behavior changes, including delusions and paranoia.
People in this stage typically require assistance walking and may be unable to sit up, smile or hold up their head. Wringing hands and shredding tissues are also common as are abnormal reflexes and rigid muscles.
Eventually, the person may spend the majority of time in bed as the disease reaches its most severe phase.

 Rate of Alzheimer’s Progression
Each case of Alzheimer’s is different. On average, people age 65 and over survive four to eight years after Alzheimer’s diagnosis. However, some live for as many as 20 years. The bulk of that time (around 40%) will be spent in the most severe Alzheimer’s stage.
Researchers continue to try to unravel Alzheimer’s stages, and great strides have been made in early detection and treatments that can slow the disease’s progress. Some of these treatments have the potential to extend earlier Alzheimer’s stages when symptoms are less severe.

Article Source: http://www.alzheimers.net/2014-04-10/how-alzheimers-evolves/

04 Apr

Activities of Daily Living: Recreational Activities

Giant Hedge Balls at Penshurst Place?!
 

People with dementia can still engage in familiar activities—although caregivers may have to adjust them in some way to match the person’s remaining strengths. Participating in various types of recreational activities—from art to poetry—can also be an effective way to help manage behavioral symptoms of Alzheimer’s disease. Many can be done one-on-one in the home setting; other can involve additional family members, including various generations.Here are some steps to get started:

  • Prepare any necessary supplies in advance.
  • Find pastimes that were meaningful to the person prior to the disease.
  • Engage in activities that pose a reasonable chance of success, by taking into consideration a person’s current abilities.
  • Tap into over-learned skills, such as appropriate household chores or work-oriented activities.
  • Plan activities that are short in length and age-appropriate.
  • Keep the environment free of distractions.
  • Include activities with a sense of structure, which provides reassurance.
  • Give directions that are simple and one step at a time, and include non-verbal cues.
  • Limit choices. If you’re going for a walk around the block, allow the person to decide whether you start to the left or right, for instance.
  • Keep conversations structured and families, such as holiday celebrations and music icons.
  • Adjust the activity, based on a person’s verbal and non-verbal responses.
  • Validate any frustrations and try restructuring the activity.
  • Take a multi-sensory approach, especially as sensory functions start to decline.
  • Plan intergenerational activities that foster helping behaviors and are developmentally appropriate for the child and engaging for the person with dementia, and choose a time when both participants will be at their best (for example, after a meal).
  • Be patient and flexible.
  • Focus on enjoyment, not achievement.

Article Source: http://www.alz.org

30 Mar

How You Can Help Facilitate Family Communication

Communication

It’s no secret that your clients are aging, and with their aging comes the aging of their parents. A few families anticipate this eventuality but the majority hope that the issue will look after itself because they cannot face this painful fact of life – losing those who gave them life.

However, clients ignore the issue at their peril; if parents need financial support in their later years it’s wise to accept the reality now and if possible integrate this need into their own financial planning.

In addition, there may be other reasons adult children need to intercede:

  • Medical conditions that need attention and care
  • The inability to perform the Activities of Daily Living or ADLs – bathing, eating, toileting, dressing, continence, mobility
  • A change in behavior or cognitive ability
  • Medication mismanagement
  • The inability to drive safely

Even though there may be a clear need for assistance, many parents refuse to either discuss the need or accept the help. Why? The main reason is the fear of losing whatever independence remains, and the need to retain their dignity and control over a situation that may be spiraling out of control. Aging parents can feel increasingly vulnerable and try to protect themselves by shutting others out.

As an advisor you may be struggling with how to help your clients communicate with aging parents, so here are some suggestions to enable your clients to be proactive.

Before beginning, however, encourage clients to remember the three rules:

  • Don’t treat parents like children
  • Start slowly
  • Make parents part of the decision process

1. Expect and accept that parents will grow old. Aging is not a disease; it is part of the life cycle

2. Put yourself in their shoes by trying to understand the losses that often accompany aging – loss of family, friends, physical or cognitive abilities

3. Remember the 40/70 rule; when adult children are about the age of 40 and parents the age of 70, it’s time to start the conversation, a conversation that could continue for months, even years before it is concluded and all decisions made

4. Encourage clients to have a family meeting BEFORE A CRISIS OCCURS and ask parents questions such as:

  • How do you see yourself aging?
  • What would you like to achieve with your estate?
  • Where are the legal and other documents?
  • Do you want to stay at home if possible? What can I do to help you maintain your independence?
  • How much money is available for your care?

5. Then encourage clients to respond positively:

  • Offer to set up automatic bill payments if parents have trouble remembering to pay bills
  • Research some options – home care, home modification, day programs – so adult children can offer concrete care suggestions
  • Become familiar with new devices or technologies that may help a senior maintain independence

6. If parents are reluctant to communicate, or children do not know where to start, begin with some ‘what ifs’:

  • Dad, what if you have another heart attack?
  • What if mum falls again and breaks a hip?
  • What if something happens to me and I cannot be there for you?
  • What is there is not enough money for your care?

Talking about money is fraught with difficulty at the best of times. Aging children need to remember how hard parents have worked for their money and that for many money means security, independence and a way to help family. Money is something – maybe the last thing – that parents can control, and they may not relinquish this control easily.

It is also wise to remember that having money does not make clients immune to:

  • Having a dysfunctional family
  • The consequences of poor family communication
  • The consequences of poor planning…”not me”
  • To the emotional chaos of caring or being cared for

In the end, it comes down to this: The vast majority of adult children want to help their parents age with grace and dignity, and if there is one question that may enable this it is:

Mum, dad do I know everything I need to know, so that if something happens, I can do what you want me to do?

Enabling your clients to help aging parents can give you many rewards, including the chance to really connect with your clients, the opportunity to build client loyalty and new referrals, and the ability to care for your own family when the time comes.

As the saying goes: Just do it!

Ken Dychtwald, Psychologist/Gerontologist, author of Age Power

 

By Karen Henderson
Speaker, Educator, Author, Consultant, Living Benefits Expert
Founder/CEO Long Term Care Planning Network  www.ltcplanningnetwork.com

 

 

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