Community and care home medicine - inc carers and health inequalities, adv care planning Flashcards
What are the adv of advance care planning?
- Individual able to make decisions while they have capacity in the chance that they may use capacity eg. IV fluids and nutrition, CPR, life saving treatment, other procedures
- Includes preferred place of care and comfort vs care eg. at home no care or in hospital w care
- Can either have legally binding forms like an Advance decision to refuse treatment or just discuss their wishes w their family and dr - reduce potential conflict
- Conversations around advance care planning are difficult, often it falls to a GP
What is continuing healthcare?
Free social care arranged and funded only by the NHS for adults who have long term complex health needs. Depends on MDT assessed needs not a particular diagnosis:
- Breathing
- Nutrition
- Continence
- Skin
- Mobilitiy
- Communication, psychological emotional needs
- Cognition and behaviour, alt states consciousness
- Drugs and medicine
What care can be provided by NHS continuing healthcare?
- Care in a nursing home
- Care in your home
- Can ask for a Personal Health Budget which gives you more choice over services and care you receive
What is the difference between nursing home care and residential care?
Residential care - residents need support w personal care and want a break from ADLs like cleaning and cooking, help w taking meds and toileting, normally cheaper than nursing care
Nursing care - provide personal care but residents also have medical needs and there is medical care 24 hours a day
What is intermediate and interim care?
Intermediate/reablement - after being in hospital you may need short term care to get back to being independent again and back to your baseline
Interim - a person can be discharged safely from hospital back home while long term care options are considered
What is discharge to assess?
People who are clinically optimised and don’t need an acute hospital bed but still need care services are provided w short term funded support to be discharged home or another community setting. Assessment for longer term care and support needs is then undertaken. No longer waiting for assessments in hospital - reduces delayed discharges and improves pt flow. D2A.
Implicit bias vs explicit bias
Explicit bias -
