NMIH106 Essentials Of Care A
Question:
Ms Marley is an 80 year old woman who was admitted to the Surgical Ward of her local hospital following a fall which resulted in a fractured Right Neck of Femur. She had this surgically repaired 4 days ago and is about to be transferred to a Sub-Acute Rehabilitation Unit with a plan to discharge her home in a week. She has a history of hypertension and osteoporosis and has a significant hearing deficit, requiring bi-lateral hearing aids, which she does not like wearing. She lives with her two dogs and is an enthusiastic volunteer for Meals on Wheels and the local Library. She has a daughter who lives locally.
She tells her story:
“I tripped and fell over one of my dogs as I was going to feed them, such a nuisance, my GP told me to be careful of falling because of my osteoporosis. I am very keen to get back home to my pets and garden though I do feel a bit worried about falling again now. I have had quite a bit of pain with this operation and today it is quite bad again. The nurses are worried about my wound as it is a bit red, I’m sure it will be alright. It’s hard to sleep in here – even with my hearing troubles it is very noisy! I’m feeling very tired but trying to do my best, I want to be able to get back to my busy life, I am very active and need to be able to drive and get around”.
Consider the AoL (activity of living) “Communication”. Using a person-centred approach discuss what you will need to assess and implement to ensure Ms. Marley is fully involved in her care (Consider her story above and her hearing deficit)..
Answer:
Essentials of care
Person centered care is a practice in healthcare that involves making families and patients part of the decision making team. However, this type of care is not all about giving people the freedom to make decisions. It also involves considering their desires, their values, the social circumstances and finally their lifestyles (Kogan, Wilber, & Mosqueda, 2015). Person centered care is important since it improves the quality of services .It also helps people get the type of care they need and it also makes the patients be active in taking care of themselves. In this assignment, there will be an explanation of person centered care to a deaf patient who fall of and got a fracture due to her osteoporosis.
A deaf person is one whose hearing is impaired. It is therefore necessary to employ additional strategies that will make communication effective .For the case of Marley who has sustained fractures after falling on the floor and the fact that she is deaf, there are different assessments that can be done. Environmental assessment is one of them (Oxelmark, Ulin, Chaboyer, Bucknall, & Ringdal, 2017). Under this assessment, I will assess her environment and look out for possible hazards such as obstacles on her pathways. Since she is deaf, I will talk by using a simple language coupled with non-verbal expressions such as gestures. To make her participate in care, I will ask her if she is aware of the dangers posed by those obstacles and how well she can avoid them. I can then propose the use of walking aids and ask for her feedback if it is good idea or not.
Laboratory tests and imaging is another important assessment for Marley. This involves estimating the levels of calcium in the body to assess the extent of osteoporosis .This is a deaf patient and the communication has to be always simple and use of visual aids as well to explain to the patient the importance of this type of assessment.
Functional assessment is important for victims of fall. I will ask the patient simple questions of how well she can perform her daily activities such as taking bath and cooking. This would determine the need to discharge her (Yardley, Morrison, Bradbury, & Muller, 2015) .I will also inquire if she lives independently or dependently so as to find out the need for home based care. During the whole process of assessment, I have to consider that she is deaf and therefore the communication has to be simple with the help of visual aids such as pictures and videos.
The final assessment for Marley would be medical assessment. This includes asking her history of medication. This is because certain class of drugs such as the psychoactive drugs increase the risk of falls .If she has been prescribed this type of drugs, then she will have to seek an alternative(Bunn et al., 2014). Establishing the number of falls is also important in designing the type of care that Marley should be subjected to .Documenting health history is one of the best indicators for prevention and management of falls.
References
Bunn, F., Dickinson, A., Simpson, C., Narayanan, V., Humphrey, D., Griffiths, C., … Victor, C. (2014). Preventing falls among older people with mental health problems: a systematic review. BMC Nursing, 13(1). doi:10.1186/1472-6955-13-4
Kogan, A. C., Wilber, K., & Mosqueda, L. (2015). Person-Centered Care for Older Adults with Chronic Conditions and Functional Impairment: A Systematic Literature Review. Journal of the American Geriatrics Society, 64(1), e1-e7. doi:10.1111/jgs.13873
Oxelmark, L., Ulin, K., Chaboyer, W., Bucknall, T., & Ringdal, M. (2017). Registered Nurses’ experiences of patient participation in hospital care: supporting and hindering factors patient participation in care. Scandinavian Journal of Caring Sciences, 32(2), 612-621. doi:10.1111/scs.12486
Yardley, L., Morrison, L., Bradbury, K., & Muller, I. (2015). The Person-Based Approach to Intervention Development: Application to Digital Health-Related Behavior Change Interventions. Journal of Medical Internet Research, 17(1), e30. doi:10.2196/jmir.4055
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