Journal ten000hzlegend's Journal: Isabel
(1) - When Isabel is in the ward before discharge, the nursing team can firstly ensure Isabel can regulate and monitor her diabetic condition, in relation to her continuing memory loss, this may prove either difficult for regular monitoring or even impossible. Ensuring she knows if and when to seek advice when diabetic symptoms become worse or erratic must be resolved at the ward level. Along with her renal failure, the ward staff can record when Isabel is able to properly maintain bowel control, noting if she needs changes made to her accommodation when discharged because of that, also related is her bowel movement, whether or not she is either
1 - Regular, able to use the toilet when needed and not when it may become involuntary after long periods
2 - Able to realise she has to go to the toilet when needed
Because her cardiac condition is unstable, her mobility has faltered and as such, the ward team may have been called upon on occasion to help her with more day to day tasks such as a getting out of bed and washing, the nursing team must also in this case, refer any such cases to the social care team so they can forecast changes made to her care plan and accommodation
The ward team must be aware of her physical and mental awareness when she is discharged, which will deteriorate, overall, they must record any and all difficulties Isabel has had and what negative side effects of treatment she has encountered. In the ward, a patients symptoms and difficulties come to light and are a precursor to any problems in their own homes, where these negative effects cannot be resolved so soon or as well, it is important for the nursing staff to then work alongside the social care team in not only highlighting these for reference and to work a solution out, but also continually monitor progress the patient makes in recuperating, unfortunately, in Isabel's case, her conditions have only furthered her deterioration, especially when she was brought to the ward for the pulmonary embolus, this condition can cause very low blood pressure and a near absent pulse, very dangerous for a patient with cardiac trouble
The health and social care team work for Isabel to best integrate her back into the community, any changes and records of her ill health and physical activity from the ward team are used to plan out all changes
1 - Dietary requirements and any changes to her day to day diet
2 - Changes to her home, whether it be safety measures such as emergency alarms, walk-in showers and washing apparel, more stringent security i.e house alarms
3 - Enabling Isabel to find help if needed in neighbours and close friends as her family are not nearby to be called on, as they are elderly themselves, this precaution has to be kept as more of an emergency, although the social workers must be made aware of any close ties to with Isabel and neighbours in this situation
4 - Giving Isabel the chance to become familiar with her physical treatments, diabetic injections that can be carried out in the home etc...
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(2) - The primary health care team for Isabel consists of a district nurse and a health visitor
The district nurse is a general nurse with experience in community work, they are connected to GP's in order to help patients such as Isabel who is increasingly unable to leave her home to receive treatment which doesn't require frequent hospital stays
The health visitor is also registered as social worker, they will provide Isabel with the skills required to treat herself and give health information, they also can warn of potential limiting factors to her mobility around the home and community
---
(3) - As above, beginning with discharge, the social workers assigned to Isabel will make an outline of any safety concerns in her home setting, ensuring maximum mobility, they also work with health visitors to ensure not only is Isabel receiving adequate treatment in her home, but is also administering it correctly due to her failing memory. Once initial treatment is underway, occupational therapists can help "climatise" Isabel to the changes in her home, whether it be a new bathing system or emergency cords and assistance intercoms, her mobility records can be passed onto physiotherapists and any dietary requirements and changes will be made useful by resident dieticians
---
(4) - Isabel is becoming increasingly frail, both physically and mentally, as such, many activities such as washing and cooking become increasingly hazardous
(Risks)
1 - Isabel may find cleaning tiresome and exhausting, over time, her accommodation may become unsuitable, dust and dirt will affect her health over time
2 - Due to her forgetfulness, leaving a bath running or forgetting to turn off the cooker, although rare, can happen
3 - Since her mobility has decreased, moving around her home, if it has steps, can be dangerous, less voluntary motor control can become at the least, a hindrance, and a hazard, leading to accidents, falls and serious injury
4 - Toxic and chemical based substances can be confused with other household items, can lead to digestion or unchecked use
5 - Insecure house equipment such as televisions, light fittings etc... which require irregular maintenance
6 - The increasing treatment she receives and must maintain herself could fall behind and for example, a catheter change may not be followed through properly, although this fully would not be done alone, when it requires drainage, it may be blocked, leading to considerable distress
(Measures Taken)
1 - Her care worker could arrange for regular dusting and cleaning, this would be a considerable improvement over Isabel trying to clean on her own, and would enable her lungs and cardiac condition to not deteriorate further due to external health hazards
2 - In some circumstances, timers can be set on potentially hazardous appliances, but her carers could enforce to her the need to remember when and IF she has ran a bath or turned on the cooker etc...
3 - Allowing guard and grip bars around the wall can enable Isabel to further her "feeling" of safety, if she falters or temporarily unable to walk anywhere, as seen above, if there are steps, the carer can help in the purchase of a stair-lift and a walk in washing facility, which takes the need to be off her feet as much as possible
4 - Labelling of hazardous substances must be made, and all non-vital equipment, products and material must be taken out the house
5 - Safely attaching all large and free utilities will reduce the risk of injury through tipping etc... and also raising the ambient light level at night will allow Isabel to notice any dangers and move more freely around her home
6 - Social and care workers must keep regular health check sessions with Isabel, to ensure she is following her own personal care plan, especially as her memory deteriorates
1 - Regular, able to use the toilet when needed and not when it may become involuntary after long periods
2 - Able to realise she has to go to the toilet when needed
Because her cardiac condition is unstable, her mobility has faltered and as such, the ward team may have been called upon on occasion to help her with more day to day tasks such as a getting out of bed and washing, the nursing team must also in this case, refer any such cases to the social care team so they can forecast changes made to her care plan and accommodation
The ward team must be aware of her physical and mental awareness when she is discharged, which will deteriorate, overall, they must record any and all difficulties Isabel has had and what negative side effects of treatment she has encountered. In the ward, a patients symptoms and difficulties come to light and are a precursor to any problems in their own homes, where these negative effects cannot be resolved so soon or as well, it is important for the nursing staff to then work alongside the social care team in not only highlighting these for reference and to work a solution out, but also continually monitor progress the patient makes in recuperating, unfortunately, in Isabel's case, her conditions have only furthered her deterioration, especially when she was brought to the ward for the pulmonary embolus, this condition can cause very low blood pressure and a near absent pulse, very dangerous for a patient with cardiac trouble
The health and social care team work for Isabel to best integrate her back into the community, any changes and records of her ill health and physical activity from the ward team are used to plan out all changes
1 - Dietary requirements and any changes to her day to day diet
2 - Changes to her home, whether it be safety measures such as emergency alarms, walk-in showers and washing apparel, more stringent security i.e house alarms
3 - Enabling Isabel to find help if needed in neighbours and close friends as her family are not nearby to be called on, as they are elderly themselves, this precaution has to be kept as more of an emergency, although the social workers must be made aware of any close ties to with Isabel and neighbours in this situation
4 - Giving Isabel the chance to become familiar with her physical treatments, diabetic injections that can be carried out in the home etc...
---
(2) - The primary health care team for Isabel consists of a district nurse and a health visitor
The district nurse is a general nurse with experience in community work, they are connected to GP's in order to help patients such as Isabel who is increasingly unable to leave her home to receive treatment which doesn't require frequent hospital stays
The health visitor is also registered as social worker, they will provide Isabel with the skills required to treat herself and give health information, they also can warn of potential limiting factors to her mobility around the home and community
---
(3) - As above, beginning with discharge, the social workers assigned to Isabel will make an outline of any safety concerns in her home setting, ensuring maximum mobility, they also work with health visitors to ensure not only is Isabel receiving adequate treatment in her home, but is also administering it correctly due to her failing memory. Once initial treatment is underway, occupational therapists can help "climatise" Isabel to the changes in her home, whether it be a new bathing system or emergency cords and assistance intercoms, her mobility records can be passed onto physiotherapists and any dietary requirements and changes will be made useful by resident dieticians
---
(4) - Isabel is becoming increasingly frail, both physically and mentally, as such, many activities such as washing and cooking become increasingly hazardous
(Risks)
1 - Isabel may find cleaning tiresome and exhausting, over time, her accommodation may become unsuitable, dust and dirt will affect her health over time
2 - Due to her forgetfulness, leaving a bath running or forgetting to turn off the cooker, although rare, can happen
3 - Since her mobility has decreased, moving around her home, if it has steps, can be dangerous, less voluntary motor control can become at the least, a hindrance, and a hazard, leading to accidents, falls and serious injury
4 - Toxic and chemical based substances can be confused with other household items, can lead to digestion or unchecked use
5 - Insecure house equipment such as televisions, light fittings etc... which require irregular maintenance
6 - The increasing treatment she receives and must maintain herself could fall behind and for example, a catheter change may not be followed through properly, although this fully would not be done alone, when it requires drainage, it may be blocked, leading to considerable distress
(Measures Taken)
1 - Her care worker could arrange for regular dusting and cleaning, this would be a considerable improvement over Isabel trying to clean on her own, and would enable her lungs and cardiac condition to not deteriorate further due to external health hazards
2 - In some circumstances, timers can be set on potentially hazardous appliances, but her carers could enforce to her the need to remember when and IF she has ran a bath or turned on the cooker etc...
3 - Allowing guard and grip bars around the wall can enable Isabel to further her "feeling" of safety, if she falters or temporarily unable to walk anywhere, as seen above, if there are steps, the carer can help in the purchase of a stair-lift and a walk in washing facility, which takes the need to be off her feet as much as possible
4 - Labelling of hazardous substances must be made, and all non-vital equipment, products and material must be taken out the house
5 - Safely attaching all large and free utilities will reduce the risk of injury through tipping etc... and also raising the ambient light level at night will allow Isabel to notice any dangers and move more freely around her home
6 - Social and care workers must keep regular health check sessions with Isabel, to ensure she is following her own personal care plan, especially as her memory deteriorates
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