Health Inequalities / discharge and care Flashcards
List some examples of category 1 hazards, as outlined by the Decent Home Standard
- Fire risk / accidents
- Insecure property e.g. faulty locks
- Damp / mould
- Excess heat / cold
- Dangerous substances e.g. asbestos or carbon monoxide
- Overcrowding
- Risk of infection e.g. insects
- Too much noise / poor lighting
List 4 types of homelessness
- At risk of homelessness
- Hidden homelessness e.g. sofa surfing, hotels etc.
- Statutory homelessness
- Rough sleeping (on the streets)
Describe what is meant by ‘NHS continuing healthcare’
Certain patients with long-term complex health needs qualify for free health and social care arranged / funded solely by the NHS
Package reviewed on a 3-monthly basis
Eligability assessed by the integrated care board (ICB)
When is a ‘discharge to assess (D2A)’ process used
Once a patient is medically fit to leave hospital, but have not yet sorted their care needs
Discharged to a care home for a period of 28 days of assessment - by PT, OT and social workers
List some potential discharge locations for a patient in hospital
- Patient’s own home (family home) +/- POC
- Assisted living facility
- Care home
- Nursing home
- Community hospital
- Discharge to assess pathway
What is meant by rehabilitation following on from hospital discharge
- Usually takes place in the person’s home or in a short-term community setting
- Holistic approach including cognitive and psychological screening, medication review, review of physical functionality and communication needs
- Create an individual rehabilitation plan designed to support the person throughout their intermediate care journey
State what is meant by nursing care home
1 or more qualified nurses on duty to provide nursing care
Also provides accommodation and personal care e.g. washing, dressing etc.
State what is meant by residental (care) home
Residence providing accommodation and personal care e.g.
- washing
- dressing
- taking medicines
- going to the toilet
State what is meant by intermediate care
- Free short term service which provide supports to help patient recovery, run by an MDT
- Patient can remain at home, in a care home or hospital
List some conditions commonly seen in care homes
Dementia
Frailty
Post-stroke
Slow growing cancers
Heart failure
COPD
OA
Osteoporosis
Chronic pain
Outline how care homes are funded
Means tested currently
< £14,250 = fully funded by local authority
Between £14,250 and £23,250 = partially funded
> £23,250 = fully funded by self
Lifetime cap on fees currently at £86,000 (only covers care aspect, not included daily living cost)
State the average life expectancy of those entering a care home
- Residential home
- Nursing home
Residental home = 24 months (2 years)
Nursing home = 12 months (1 year)
But obviously also highly variable
State some causes of malnutrition
- Reduced dietary intake e.g. N&V
- Malabsorption conditions e.g. Coeliac disease
- Increased loss
- Increased requirements
List some consequences of malnutrition
- Weight loss / pressure ulcers
- Reduced muscle mass and strength / increased falls risk
- Fractures and osteoporosis
- Poor healing or recovery
- Immunodeficinecy
- Gingivitis
- Deficiencies e.g. anaemia, B12/folate definiciency
- Anxiety / depression / cognitive impairment
Describe the 4 stages of wound healing
- Haemostasis = vasoconstriction and clot formation to reduce blood flow
- Inflammation (4 days) = invasion of white cells and removal of debris
- Proliferation (2 weeks) = active reconstruction of damaged tissue, fibroblast activity and neovascularisation
- Remodelling (3 weeks to 1 year) = refinement and strengthening of the newly formed tissue, reorganisation of collagen
