Nursing For Living A Healthy Life

Discharge Planning

Discuss about the Nursing for Living a Healthy Life.

According to the case study the patient Mrs. Holt is an old lady and she stays all alone in her house. Therefore, the first aspect that needs to be taken care of is that the after the completion of the treatment it should be assured through diagnosis that she should be capable of living a healthy life without any assistance. Second aspect that should be kept in mind is assistance should be given so that she doesn’t face any complications regarding her injury at home.

A discharge for the elder patient is a critical juncture and thus it is planned when there is a mutual coordination between the patient and his family. It is a chalenging task as it influences the patient’s life in future. In this case the discharge planning involves monitoring on a daily basis for their evaluation of the condition of Mrs. Holt. The planning of the discharge involves the psychological, social, medical, and educational requirements of the patients. The key people involved in the discharge planning of this patient are the doctors, nurses and also assistance such as midwifery arranged by the hospital or NGO (Altfeld et al., 2013)

Three services that assist the older people by maintaining a social connection are as follows:

• One of such organization is NHS which continuing healthcare and also the nursing care which is funded and arrangement of equipment such as wheelchairs, beds or aided equipment (Barnett et al.,2016).
• There is state and government funded aged care services available globally. The main aim of such organizations is to meet the challenges of the older people such as providing walking frames and other minor equipments.
• Support services are provided by organizations such as “District Health Boards”. They provide services at home in carer support and household work (Denson et al.,2013).

Urinary incontinence is defined as the loss of bladder control. In this case Mrs. Munyarryun has retired, and she complained of the urinary problem since the last six month. The cause of urinary incontinence generally in old aged females is multi-factorial. In this case it might be due to multiple child birth or hormonal dis-balance of the external and internal factors of the urinary tract. Some other causes are the neurological, urologic environmental, gynecologic, iatrogenic and psychological factors (Clement et al.,2013).

Although this incontinence cannot be prevented, yet Mrs. Munyarryun can be monitored to lead a healthy lifestyle to reduce it. The advices involve

• Healthy weight: the person’s overweight can lead to deterioration in the condition of the patient. Therefore, Mrs. Munyarryun could reduce this by eating healthy food and doing regular exercises. These two things can decrease the chances of incontinence and increases the healthy life.
• Drinking habits: Mrs. Munyarryun who has urine inconsistency should avoid alcohol beverages and any sort of beverages which are hard in nature because it severely affects the urinary bladder. So if the person gives up the drinking habit, then his chance of living is very high.
• Pelvic exercises: Mrs. Munyarryun suffering from urinary inconsistency should always go for the exercises of the pelvic which could improve the elasticity of the bladder and thus of the lower abdomen. Once the elasticity of the bladder is restored, then the patient would have less to suffer from the urinary problems (Dumoulin et al.,2014).

When a person is suffering dementia, then there are many marked changes in the behavior of the patient. The possible cause of this could be divided into three types: biological which refers to the behavioral change, second is psychological where the patient percieves a threat and third being social where the patient feels bored from his society.The patient’s mood swings from time to time. The person may experience many mood changes in themselves. The mood changes are aggression, agitation or anxiety, confusion, repetition, suspicion and trouble to sleep. When a person with dementia mood changes then one should look for certain behavior change. One should see the pain behind this change, which has forced to them to act. One should also have the feelings of this pain or the worse actions. Their distractions should be limited. The patient frustration should be listened so that the patient should be at ease. The patient should be given reassurance, and the patient should be involved in activities. Osteoarthritis is the pain which is caused by the cartilage loss. If the pain of osteoarthritis is not managed properly then it affects the life quality which could lead to pain and depression, or a life which could require long-term care at home (Jutkowitz et al.,2016).

Validation therapy is the therapy for the communication with the old age people suffering from dementia. It is a practical approach to help the people coming out of stress due to behavior change; it enhances the dignity and increases happiness in the life. This theory usually comes into action when the people suffering from dementia are in the final stage, and they are on the verge of dying. This approach helps the patient to express their last wishes through the verbal or non-verbal way of communication. The practitioners of validation are caring, supporting and very open in the feelings. This theory has both psychological and physical features. This theory is based on the certain techniques which could be applicable both individually as well as in the team work. This theory is useful, productive, gives recognition status to the dementia patients. Through this theory, a dementia patient feels nurture and safe (Feil, 2014)

Assessment and Monitoring

The husband can give her the time and memory. The time for her would be different from the normal people and the memory includes that the past would be present for her and vice versa. The memory would be there for one moment and can vanish the next time and the mind plays a hurtful tricks.

There are mainly four types of restraints: physical restraint, chemical restraint, and environmental restraint.

Physical restraint is that type of restraint where the behavior movement is controlled or restricted. It is mainly associated with the person body or the creation of the physical obstruction. (Cleary & Prescott 2015).

Chemical restarint are the medications which strictly resist the behavior modification. This is mainly in a form of tranquilizers and sedatives (Fu et al., 2013).

Environmental restraint is the one which changes a person’s surroundings which restrict the movement (Fleming et al., 2015).

Psychological restraint is the one which is used with the other type of restraint which restrict a person’s mental mobility.

Physical restraint-This is applicable as a lap belt to help the person sit up or sit down.

Chemical restraint – For example use of medication which could stop behavior without any side effects.

Environmental restraint – An example of this that there is a protected garden where a person can have free access to the inside of a building.

Psychological restraint – An example, using soft and soothing voice while gently approaching the patient (Peisah., 2015).

The three alternatives of the restraints attitude, assessment, and anticipation. These are the alternatives which are opposite to the above restraints.

Attitude is the patient last option and not the first choice, and it reduces the restraint uses.

Assessment of the patient is a multidisciplinary of the mental state, behavioral modification which could reduce the restraint use.

Anticipation is having the knowledge of the interventions and those goals which could minimize the restraints use (Fleming et al., 2015).

References:

Altfeld, S. J., Shier, G. E., Rooney, M., Johnson, T. J., Golden, R. L., Karavolos, K., … & Perry, A. J. (2013). Effects of an enhanced discharge planning intervention for hospitalized older adults: a randomized trial. The Gerontologist, 53(3), 430-440.

Cleary, K. K., & Prescott, K. (2015). The Use of Physical Restraints in Acute and Long-term Care: An Updated Review of the Evidence, Regulations, Ethics, and Legality. The Journal of Acute Care Physical Therapy, 6(1), 8-15.

Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet,380(9836), 37-43.

Denson, L. A., Winefield, H. R., & Beilby, J. J. (2013). Dischargeâ€Âplanning for longâ€Âterm care needs: the values and priorities of older people, their younger relatives and health professionals. Scandinavian journal of caring sciences, 27(1), 3-12.

Clement, K. D., Lapitan, M. C. M., Omar, M. I., & Glazener, C. (2013). Urodynamic studies for management of urinary incontinence in children and adults. The Cochrane Library.

Dumoulin, C., Hayâ€ÂSmith, E. J. C., & Mac Habéeâ€ÂSéguin, G. (2014). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. The Cochrane Library.

Jutkowitz, E., MacLehose, R. F., Gaugler, J. E., Dowd, B., Kuntz, K. M., & Kane, R. L. (2016). Risk Factors Associated With Cognitive, Functional, and Behavioral Trajectories of Newly Diagnosed Dementia Patients. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, glw079.

Feil, N. (2014). Validation therapy with late-onset dementia populations.Caregiving in dementia: Research and applications, 199-218.

Fu, C. Y., Moyle, W., & Cooke, M. (2013). A randomised controlled trial of the use of aromatherapy and hand massage to reduce disruptive behaviour in people with dementia. BMC complementary and alternative medicine,13(1), 1.

Fleming, R., Kelly, F., & Stillfried, G. (2015). ‘I want to feel at home’: establishing what aspects of environmental design are important to people with dementia nearing the end of life. BMC palliative care, 14(1), 1.

Peisah, C., Strukovski, J. A., Wijeratne, C., Mulholland, R., Luscombe, G., & Brodaty, H. (2015). The development and testing of the quality use of medications in dementia (QUM-D): a tool for quality prescribing for behavioral and psychological symptoms of dementia (BPSD). International Psychogeriatrics, 27(08), 1313-1322.