merawat lansia di rumah

8/8/2019 Merawat Lansia Di Rumah

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HOME CARE OF THE ELDERLY


2/30

Tujuan pembelajaran

• Tipe kunjungan rumah

• Indikasi kunjungan rumah

•

Saisik kunjungan rumah• !eunungan"kerugian

• #erlengkapan

•

#engkajian lansia• Isu keselamaan


3/30

Tipe kunjungan rumah

• Saki

keika pasien mengalamikesakian"kegagalan$ungsi akiba pen%aki

kr&nis aau aku• #r&ses

kemaian"meninggal

pera'aan H&spi(e)dukungan kehilangan)pengumuman kemaian)kunjungan dukunganangg&a keluarga %angdiinggal


4/30

Tipe kunjungan rumah

• #engkajian

Dilakukan unukpasien %ang mungkinaau idak mungkin

menerima pela%anankesehaan di rumah*

#emeriksaan +sik)e,aluasi keamanan

rumah) e,aluasikeselamaan pasiendapa dilakukan padaberbagai jeniskunjungan*


5/30

T%pes &$ H&me -isis

• H&spial $&ll&'.up

Ma% help & pre,en/b&un(e ba(k0 &

h&spial premaurel%*Helps & assure hahe paien isre(ei,ing all &$ he&rdered supplies)ser,i(es) andadhering &medi(ai&ns(hedules*


6/30

Indi(ai&ns $&r H&me -isis

• An% (&ndii&n (reaing ph%si(alimpairmen &r limiai&n &$ m&bili%1La(k &$ ransp&rai&n

• Caregi,er burden (&n(ern•

Suspe(ed elder abuse &r negle(• #&l%pharma(% &r medi(ai&n

(&mplian(e issues• Failure & hri,e"gagal ugas

perkembangan• Re$usal & keep &2(e ,isi

app&inmens• Re(en his&r% &$ $alls a h&me• #s%(hiari( illness &r beha,i&rall%

di2(ul


7/30

Saisi(s

• L&' $re3uen(% &$ h&me,isis is due &4

5*De+(is in nurse

(&mpensai&n $&r ,isis6*Time (&nsrains

7*#er(ei,ed limiai&ns &$e(hn&l&gi( supp&r

8*C&n(erns ab&u risk &$liigai&n

9*La(k &$ nurses raining ande:p&sure

;*C&rp&rae and indi,idualaiudinal biases


8/30

Saisi(s &n H&me HealhCare

•


9/30

Saisi(s &n H&me HealhCare• 9.5>= &$ paiens in a primar% (are

pra(i(e re(ei,e h&me healh (are*

•

7>=? &$ paiens age @9 &r &lderre3uire a leas &ne h&me healh (are,isi per %ear*

• 6= &$ h&me (are paiens re(ei,edph%si(ian h&me ,isis*


10/30

Ad,anages

• Impr&,ed healh (are hr&ugh he re,ealing&$ unkn&'n healh (are needs

• Abili% & assess he en,ir&nmen 'hi(h (an

lead & design and implemenai&n &$ h&me.based iner,eni&ns ha pre,en $alls and&her sel$.injur%

• Insigh in& ps%(h&s&(ial issues

• Enhan(emen &$ nurse.paien relai&nship


11/30

Ad,anages

• H&me.based assessmens in(rease he pr&spe(&$ elderl% paiens remaining a h&me*

• Assessmens are d&ne in $amiliar surr&undings

• OT) #T (an ail&r rehab &a paiens h&me

• Burses rep&r a higherle,el &$ pra(i(e sais$a(i&n

han h&se 'h& d& n&&er his ser,i(e


12/30

Disad,anages

• Time inensi,e

• Less e(hn&l&gi(al

supp&r• Finan(ial issues

• #r&,ider sa$e%


13/30

E3uipmen

• Essential

5* Seh&s(&pe

6* O&s(&pe"Ophhalm&s(&pe

7* Sph%gm&man&meer

8* T&ngue depress&rs

9* B&n.serile &r serile gl&,es;* Lubri(an

* S&&l guaia( (ardsGde,el&per

@* Serile spe(imen (ups

* Disp&sable herm&meers

5>* Ree: hammer"uning $&rk

55* Jrine dipsi(ks

56* #res(ripi&n pad

• Optional

5* Klu(&meer

6* Di(aph&ne

7* Lap&p (&mpuer

8* #aien edu(ai&n maerials9* Tape measure

;* andage s(iss&rs

* 8:8 gaue and ape

@* Disp&sable suure rem&,al ki

* Sublingual nir&gl%(erin5>*Klu(&meer

55*#&rable &:imer% uni

56*#&rable ECK


14/30

E3uipmen

• Ani(ipae he need $&r pr&(edures

5* Debridemen

6* Dressing (hange7* #hleb&&m%

8* Suure rem&,al


15/30

Assessing he #aien

• Jse he /IBHOMES0 mnem&ni( & help re(allhe areas &$ $&(us $&r he h&me ,isi

I Imm&bili%

B Burii&nH H&me En,ir&nmen

O Oher #e&ple

M Medi(ai&ns

E E:aminai&nS Sa$e%) Spiriual healh) Ser,i(es


16/30

Assessing he #aien

• I.IMMOILITY5* Assess ADLs and iADLs6* Ask $&r a &ur &$ he h&me7* Obser,e gai and ambulai&n hr&ugh hall'a%s)

bedr&&m) and neg&iaing sairs8* Ask he paien & a( &u heir r&uines geing in

and &u &$ bed) &pening medi(ai&n b&les)per$&rming pers&nal h%giene

9* Talk 'ih &her members &$ he h&useh&ld ab&u

$un(i&nal (&n(erns


17/30

Assessing he #aien

• B.BJTRITIOB5* Ask ab&u $&&d pre$eren(es*

6* Ask $&r permissi&n & l&&k in here$rigera&r) (upb&ards) and"&rpanr%

7* Ask ab&u $&&d preparai&n4 'h&

prepares iN H&' &$en d&es hepaien ea during he da%N H&' issh&pping $&r $&&d a((&mplishedNH&' is i deli,eredN


18/30

Assessing he #aien

• H.HOME EB-IROBMEBT

5* Sa$e neighb&rh&&d

6* #r&:imi% & ser,i(es7* Ambien emperaure are he

heaing and air (&ndii&ning

(&nr&ls a((essible and eas% &readN

8* Jiliies4 running 'aer andemperaure


19/30

Assessing he #aien

• O.OTHER #EO#LE5* S&(ial supp&r s%sem4 $amil%

members) neighb&rs) $riends

6* Emergen(% help

7* Ideni+(ai&n &$ pers&n 'h& 'illser,e as surr&gae $&r he paien

D#OA) li,ing 'ill8* Assessmen &$ (aregi,er

sress"burn&u


20/30

Assessing he #aien

• M.MEDICATIOB5* Kaher ALL &$ he paiens medi(ai&ns in he h&me

medi(ine (abine) re$rigera&r) dra'ers) (&uners)e(*

6* E,aluae he %pe) am&un) and $re3uen(% &$medi(ai&n use) n&ing he &rganiai&n and meh&d&$ deli,er% sel$.adminisered &r help $r&m$amil%"$riends

7* Re,ie' indi(ai&ns $&r medi(ai&ns

8* C&nsider p&enial $&r drug.drug &r drug.$&&dinera(i&ns

9* Assess paien (&mplian(e

;* Re(&gnie he p&enial &r presen(e &$ abuse &$ OTCpreparai&ns and herbal remedies i*e*

diphenh%dramine


21/30

Assessing he #aien

• E.E:aminai&n5* F&(used e:aminai&n based &n paiens needs

6* -ial signs

7* Cardi&pulm&nar% G neur&l&gi( e:am8* Skin"'&und assessmen

9* M&bili%"Imm&bili% assessmen

;* C&gnii,e assessmen MMSE) KDS) S#MS

* l&&d glu(&se m&ni&ring p sh&ulddem&nsrae pr&per e(hni3ue


22/30

Assessing he #aien

• S.S#IRITJAL HEALTH " SER-ICES " SAFETY5* #eruse"elii he h&me $&r religi&us

&bje(s"reading maerials* This (&uld

iniiae a dis(ussi&n &$ spiriuali% as ahealing and (&ping sraeg%

6* C&&rdinaing he h&me ,isi 'ih h&mehealh agen(ies and ha,ing heir nurses

presen (an $a(iliae (&mmuni(ai&n and(&&perai&n be'een paien) ph%si(ian)and &her agen(ies* uesi&ns (an beans'ered) &rders (lari+ed) pri&riies andperspe(i,es dis(ussed) e(*


23/30

Sa$e% issues

5* Jiliies4 running 'aerand emperaure1 h&'aer emperaure

P8&

C 56>&

F6* Rumah eranakan)

meja) dan(&uner&ps

hambaan unukpenggunaan &ngka)pejalan kaki) aaukursi r&daN

7* Lighing sairs)hall'a%s) e(*


24/30

Sa$e% issues

5* Sea ele,a&r in bahr&&m

6* Tables) (hairs) and &her $urniuresurd% and 'ell.balan(edN

7* L&(ks &n d&&rs and 'ind&'s1 ease &$ es(ape in (ase &$ +re &r &heremergen(%

8* Ask 4 /Qha number d& %&u dial in(ase &$ emergen(%N0


25/30

Sa$e% issues

5* Ele(ri(al (&rds and applian(es

6* Fl&&ring) hr&' rugs) n&n.slipsur$a(es in ub"sh&'er) and

bahr&&m &&r7* Sm&ke dee(&rs) +re e:inguishers

baeriesN

8* urners &n s&,e easil% le$ &nN9* #es

;* Handrails in bahr&&m and &n sairs


26/30

#ers&nal Sa$e%

• Take a map and %&ur (ell ph&ne

• C&na( he paien &r (aregi,er 'hen %&uare en r&ue $&r a ,isi

• I$ %&ure g&ing & a kn&'n high (rime area)s(hedule ,isis in he A*M*) a,&id 'earing a'hie (&a) use alernai,e (arr%ing ,ehi(leinsead &$ he /bla(k bag0 i*e +shing a(kle

b&:• I$ %&u 3uesi&n %&ur sa$e%) !EE# DRI-IBK


27/30

Impr&,ing E2(ien(%

• Limi ge&graphi(al area & be (&,ered

• #lan a hal$.da% &$ r&uine h&me ,isisappr&:* 8 paiens in &ne general

neighb&rh&&d• Sar 'ih he address $urhes a'a% and

'&rk &'ards &2(e &r h&me

• D&(umen he reas&n $&r he h&me ,isi and

his&r% and e:aminai&n as medi(all%appr&priae


28/30

Summar%

• Is assisan(e a,ailable & (&mpensae $&rhe paiens $un(i&nal limiai&nsN

• Deermine g&als &$ reamen and heirrisks

• Implemen iner,eni&ns 'here indi(aed• Address ps%(h&s&(ial issues• e prepared $&r min&r pr&(edures• Jilie sraegies & impr&,e e2(ien(%• Jse he h&me ,isi (he(klis


29/30

-isi he $&ll&'ing 'ebsies & (he(k%&ur skills

• '''*riskd&m*(&m

• '''*en,ir&nmenalgeriari(s*&rg

http://www.riskdom.com/http://www.environmentalgeriatrics.org/http://www.environmentalgeriatrics.org/http://www.riskdom.com/


30/30

Addii&nal Re$eren(es

• Jn'in) *!*) eran) A*F* The H&me-isi* American Family Physician;Vol. 60/No. 5 (October 1, 1999

• Me%er) K*S*) Kibb&ns) R*-*1 B Engl Med) De( 5@)51 77694 [email protected]>

• S'ager%) D*L* H&use Calls in #rimar%

Care1 !ansas Re%n&lds #r&gram inAging) Jni,* &$ !S S(h&&l &$ Medi(ine

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