ASSIGNMENT 1
Introduction
Mr. James is 83 years old (he was born 22-th of February 1924). He is a widower. He has a 14 children (6 daughters and 8 sons). When he was young, he worked as a civil servant in the Army.
He was admitted in St. James Hospital in June 2007. He has problem with breathing and left side weakness. He spend almost 5 months in the hospital.
His diagnosis are:
- Right CUA Cardioembolic Infarct,
- Respiratory Failure,
- Renal Impairment,
- Anaemia,
- Previons TB and left lobectomy,
- Colonic polyposis,
- Hypertension,
- Head failure,
- Diabetic Type 2.
James was admitted in Elm Hall Nursing Home on the 24.01.2008. In between he went to Connolly Hospital because of Aspiration pneumonia (bronchopneumonia resulting from foreign material entering the bronchi),Hypoglycaemia (abnormally low blood sugar usually resulting from excessive insulin or a poor diet), dehydrated (preserved by removing natural moisture, suffering from excessive loss of water from the body)
For duration:
- He is on the soft diet ( but at this time he can eat normal food) and liquids with thickener,
- He uses nebulizer and oxygen,
- He needs 2 carers for personal care,
- He has special chairs and he has to use air mattress,
- Staff have to use hoist for him.
- He is on Physiotherapist.
Physical
James is unable to continue his personal care. He needs help for washing, dressing, changing his incontince wear. He needs assistance of 2 persons and hoist. He has special chairs. The resident usually spends time on his armchairs about 2-3 hours in the morning (after that he goes back to bed). He is on the air mattress. He feels better and more comfortable in his own bed. He wishes to be covered with a blanket. James likes to put the pillows under his legs and arms. He is on normal food but sometimes he eats large soft diet. He can drink and eat himself (only needs assistance for cutting the foods).
The head end of bed should be elevated because he has a problem with breathing. Also he coughs often. He can not eat bread with crust. He is sitting in upright position when eating and drinking to prevent choking. Staff have to ensure that James sits fully back in his chair at all times not slumped or leaning to the side also that James’s foot is on the plate at all times. We have to remind James to push his heel towards the floor to stretch his calf muscle.
Emotional
Mr James likes to call him Jim or James never Jimmy. He has got a big family. They visit him very often.
Sometimes he feels lonely especially when his family can’t come to him (then he uses the alarm bell a lot of time because he likes that he is very important person and he needs more attention).
Social
James likes to watch TV (his passion is football matches). He loves to talk about news, politics with people especially with family and staff. Because of spend more time in his own room, not in the day room he does not like to talk with others residents.
Sometimes he feels weak and he needs to take rest. When his family are unable to visit him he feels lonely and depressed. He asks about reason why they can’t come to visit him but he wants to be alone in the room always and doesn’t like to communicate with other residents. James doesn’t like to go outside to the garden but he likes to spend a lot of time in his rooms beside an open window.
Intellectual
James is a very intellectual person. He can remember the names of all the staff. He likes to watch TV. After he loves to give opinions and suggestions about that. James is not very cooperative especially while giving daily care in the morning, but he will understand after explaining the needs of the each procedure.
Spiritual
James is devoted R. C. and his usual observed practices was attending mass on every Friday in Nursing Home, but now he is attending occasionally with other residents.
Level of assistance required:
James needs help for washing, dressing, changing his pads. He needs two persons to transfer with hoist from bed to special armchair and vice versa. He uses: nebulizer, oxygen and air mattress. We are also using sliding sheets. He is available to drink and eat by himself. He prefers to eat with a spoon from a deep bowl. At this time he can eat normal food after cutting it and liquids with thickener. He has no hearing aids and glasses. His teeth should be cleaned daily and more often if required.
Course of actions:
1. James is pleased man and try to make him more independent always and give assistance or supervision if needed.
2. To keep his room clean and tidy.
3. Remember the staff to use thickener while giving fluids.
4. Ensure that James sits fully back in his chairs at all times not slumped or leaning to the side also that James’a foot is on the plate at all times.
5. We have to remind James to push his heel towers the floor stretch his calf muscle.
6. Try to give him some more exercise during the day.
7. Provide emotional and psychological support.
8. Always encourage him to participate in some activities to make him more pleasant.
Reflections:
This project gives me a general introduction to stroke. It has advice on what I can do to help recovery and rehabilitation from stroke and explains which professionals are likely to be involved in providing health care.
The FETAC course step by step show me the best ways to carry out daily activates such as communication, personal hygiene, nutrison and mobility. It offers practical advice, emotional support and essential information helps me provide the best quality of care as possible. I learned to prioritise and organise my time at work efficiently. I am able to take pride and satisfaction in the fact that my patient is receiving the best care that I can provide.
Bibliography:
1. Coyne P, Mares P., Caring for someone who has had a stroke- Highly commended by the British Medical Association, 1995.
2. D.M.Hinds., After stroke, 200.
3. Helping You to care- Irish Red Cross, 2007.
gusiaczek123