Frailty Flashcards
What should clinical frailty score be based against?
2 weeks before their deterioration
Who should you refer to if you are suspecting financial abuse?
Safeguarding
What is important to think about when someone has power of attorney?
When the patient signed this did they have capacity to do so?
Ie: if they have delirium they may not have capacity
What does power of attorney mean and what would you do if you are concerned they are not acting in the best interest?
A written authorisation to represent or act on another’s behalf in private affairs
Health and welfare
Property and financial affairs
If concern they are not acting in best interest then you need to apply to court of protection
What deems someone to be lacking capacity?
Someone must have a medical or mental health condition which means they lack the ability to understand the following
- understand information given to them about a particular decision
- retain the information long enough to be able to make the decision
- weigh up the info available to make the decision
- communicate their decision
Capacity is decision specific and is for that decision alone and in that point of time
Capacity can be fluctuant
What is safeguarding?
Used to describe measures to protect the health, well being and human rights of individuals, which allows people- especially children, young people and vulnerable adults to live free from abuse, harm and neglect
Safeguarding concerns can be raised to either the locality safeguarding team or social services
Where a crime has been committed and others may be at risk then police input may be required
What is a best interest decision?
Seek information about the person and what she was like in life from people that they knew
It’s what the person would of wanted if they could decide
What is safest consistency feeding?
This is when the safest swallowing method is chosen when you don’t want an NG tube for the patient, you have to accept the risks
What does feed at risk mean and what are the implications/what needs to be considered?
Risk feeding is when a person ontinues to eat and drink despite a significant risk of aspiration and/or choking. This option is often appropriate when ensuring QOL is the highest priority. It allows continued enjoyment, comfort, pleasure, social interaction associated with eating and drinking
Implications/what needs to be considered- aspiration pneumonia, nutritional deficits,
May be appropriate for one or more of the following reasons…
- advanced stage of illness
- the persons swallow safety is not likely to improve
- when the preference to eat and drink takes priority over swallow safety
- tube feeding options are declined or inappropriate
What is a continuous healthcare checklist?
NHS continuing care is basically for people with long term complex health care, it is when these people qualify for free social care which is arranged and funded solely by the NHS
There needs to be an initial assessment by doctor/nurse and following this there is one by a CCG
How do you assess continence?
Detailed continence history
Review of bladder and bowel diary
Abdo exam
Urine dipstick and MSU
PR exam including prostate assessment in male e
External genitalia review- looking for atrophic vaginitis in females
A post micturition bladder scan- to look for retention
How do you manage incontinence (urinary)?
Drug therapy or pads are not first line
Switch to decaffeinated drinks
Good bowel habit
Improving oral intake
Regular toileting
Pelvic floor exercises and bladder retraining
ANTICHOLINERGICS ARE NOT GOOD IN OLDER PEOPLE, whilst oxybutynin is good for younger patients it’s not good for olde r
Many of the drugs used for bladder stabilisation can also cause postural hypotension leading to increased falls
What is used in anticipatory care?
Midazalam- agitation
Glycopyronium- secretions
Benzos- anxiety
