Care home medicine, carers Flashcards

Question

How to manage continence issues in care home?

Answer 1

* general advice about healthy living, in particular diet and drinking appropriate fluids * * improving access to toilet facilities and wearing easily removable clothing * * reviewing existing medication * * bladder and bowel training programmes * * pelvic floor exercises * * provision of pads, continence aids and other supplies to help manage incontinence.

Answer 2

* ensure safety at the scene * assess for and attend to obvious injury * ask for additional help as required * safely move the resident from the floor (where appropriate) * report and comprehensively record the fall and the consequences of the fall, including completing: – an accident/incident report form required by the organisation Managing Falls and Fractures in Care Homes for Older People – good practice resource 79 – a post falls report – the falls diary/update the database The responses made should be in keeping with an individual’s Palliative Care Summary (PCS), Anticipatory Care Plan (ACP) including Verification of Expected Death and Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) decision recording and guidance.

Answer 3

It is what the maximum therapy which is appropriate for a patient when (s)he becomes unwell I.e whether the patient is for 1. For full escalation 2. For ward based care but for NIV/CPAP but not for CPR, intubation 3. Ward based case only - not for NIV, CPAP and not for CPR/intubation 4. Palliate if deterioates

Answer 4

Based on discussions and decisions that have made. They may have a : 1. DNACPR/ RESPECT form in the community 2. An advanced directive 3. The doctor looking after the patient decides.

Answer 5

A person of any age, adult or child, who provides **unpaid** **support** to a partner, child, relative or friend who wouldn't manage to live independently or whose health or wellbeing would deteriorate without this help.

Answer 6

Everything!

Answer 7

* Frail * disability * serious health condition * mental illness * substance misuse

Answer 8

NICE: * Impact on physical and mental health: 1. neglect own health 2. more likely to report a long term condition, disability, or illness 3. significant distress 4. depression 5. anxiety * Social effects: 1. social isolation 2. loneliness * Financial difficulties 1. higher bills 2. financial pressures * Work and employment 1. more likely to retire early (8 years early on average!!) 2. tiredness and stress takes over

Answer 9

* Improved support with their caring, physical health, and emotional wellbeing needs. * Increased confidence in their caring role and feeling that they are providing safer care. * Reduced anxiety, depression, and stress. * Maintenance of good physical health, for example through improved self-care and being offered health checks. * Lower risk of injury because of improved manual handling techniques. * Improved awareness of available support services. * Feeling enabled to have a life outside the caring role. * Reduced risk of carer/family crisis and breakdown.

Answer 10

a state of emotional, mental, and physical exhaustion. Both carer and the person you’re caring for suffer.

Answer 11

* Anxiety, depression, irritability. * Feeling tired and run down. * Difficulty sleeping. * Overreacting to minor nuisances. * New or worsening health problems. * Trouble concentrating. * Feeling increasingly resentful. * Drinking, smoking, or eating more. * Neglecting responsibilities. * Cutting back on leisure activities.

Answer 12

* You have much less energy than you once had. * It seems like you catch every cold or bout of flu that’s going around. * You’re constantly exhausted, even after sleeping or taking a break. * You neglect your own needs, either because you’re too busy or you don’t care anymore. * Your life revolves around caregiving, but it gives you little satisfaction. * You have trouble relaxing, even when help is available. * You’re increasingly impatient and irritable with the person you’re caring for. * You feel helpless and hopeless.

Answer 13

Average life expectancy: 24 months for residential home 12 months after nursing home But highly variable- some die within a few months and others will live for many months Not a great prognosis.

Answer 14

1. Following a medical crisis - unforeseeable - unexpected or rapidly progressive conditions - foreseeable- unwilling to consider early admission, waiting for social care assessment or bed to become available, family carer burnout or crisis, no opp to discuss increasing needs with HCP/social 2. Planned admission 3. Personal preference 4. Respite care 5. Short term admission for rehabilitation

Answer 15

breathing nutrition (food and drink) continence skin (including wounds and ulcers) mobility communication psychological and emotional needs cognition (understanding) behaviour drug therapies and medicine altered states of consciousness other significant care needs -Assessment weights these as "priority", "severe", "high", "moderate", "low" or "no needs". E.g. 1 priority need, or 2 severe needs = usually eligible for NHS continuing healthcare.

Answer 16

* Lack of information * Reluctance to use services because of a sense of duty * Restrictions in service use due to cost or lack of availability

Answer 17

* what support do you have? * do you have people you can talk to? * what is your greatest worry? * what is the most important issue in your life? * what would be the most helpful thing for you? * what do we need to know about you to give you the best care? * what gives your life meaning? * where do you get your strength from? * is relegion or faith important to you?