Perception of Mortality and the Psychological Well-Being of Older Persons
By
Yakob Abdul Rahman Wilhelm Scholer
Home Nursing Providers
Malaysia
Reigning measures of psychological well-being have little theoretical ground, despite an extensive literature on the contours of positive functioning. Aspects of well-being derived from literature are: self-acceptance, positive relationship with others, autonomy, environmental mastery, purpose in life, and personal growth.
Unquestionable these are very universal goals of the elderly, yet more often a dream than reality.
Happiness, however, is not being the only indicator of positive psychological functioning. Much literature has also been generated on well-being defined as life satisfaction. Prominent measures in this domain (e.g. Life Satisfaction Index, or LSI; Neugarten, Havighurst, & Tobin, 1961) were also developed for purposes other than defining the basic structure of psychological well-being. We have to differentiate persons who were aging successfully from those who were not.
Early retirement is supposed to give you extra golden years to enjoy. But that may not happen, a new study suggests.
A study of Shell Oil employees shows that people who retire at age 55 and live to be at least 65 die sooner than people who retire at 65. After rhe age 65, the early retirees have a 37% higher risk of death than their counterparts who retired at 65.
That's not all. People who retire at 55 are 89% more likely to die in the 10 years after retirement than those who retire at 65.
"This difference could not be attributed to the effects of sex, socioeconomic status, or calendar year of the study, although the poorer health status of some early retirees may play some part, noted Shan P. Tsai and colleagues at Shell Health Services.
The researchers looked at all past employees of Shell Oil who retired at ages 55, 60, or 65.
"Mortality improved with increasing age at retirement for people from both high and low socioeconomic groups,” they found. "Retiring at 65 was not associated with a greater risk of mortality than retiring at 55 or 60.” British Medical Journal.
What then are the reasons for earlier death in early retirement? Surely not overwork! There are hardly any sicentific studies that will shed light on the reasons of this evident phenomena.
Let me make some psychological assumption as to the possible reason of early mortality of early retirees. When I say early retirees I realy mean those who after their formal retirement also live in this retirement. This is not meant for those who after retirement embark on a new challenge in life. It is abvious from the above observation what complacency in retirement can mean.
Perception of Mortality and the Psychological Well Being of Older Person: By Yakob Abdul Rahman Wilhelm Scholer
A BIASED VIEW OF RETIREMENT
Are the daily activities of the retired engaging or alienating? We might see the retirees portrayed as alienated, withdrawn from society, disconnected from productive work, socially isolated from others and living an unfullfilled, boring, useless and routine existance. In this view retirement presents as jobless. In retirement people who have had a meaningful role are now seperated from themselves and others, with little attachement to productive activity.
In comparison to full time employees, those of retirees are more alienated in some aspect but more engaged in others. Retirees’ activities are more routine, provide less chance to learn new things, provide less social interaction with others, and they are especially less likely involved in problem solving activities. However, retirees’ activities are also equally enjoyable and more autonomous compared to those with full time work. Autonomous fullfilling activities which are enjoyable and provide opportunities to learn new things and integrated activities are all positively associated with a sense of control and negatively associated with psychological distress.
Journal Health and Behavior Catherine E. Ross & Patricia Drentea
Possible reasons leading to early death of retirees could be:
1. Lack of meaning in life. The retiree is suddenly removed from the respected position he/she had in the working life into oblivion, no more Yes Sir, No Sir, Please Sir, Good morning Sir, etc. While in Position he was some one. In retirement he is reduced to no one. This leads to a sense of emptiness and depression.
2. Empty nest syndrome. This refers to the often expirienced reality that prior to retirement their children who were part of the family have made the journey towards their own destiny. Leaving suddenly the house empty, quiet, abandoned. This physical feeling is also perceived emotionally. Creating a sense of abandonment and emptiness, not expirienced to this extend while in a working life.
3. Complacency. The long expected retirement has come, suddenly the “freedom” of job obligations are to be enjoyed. Time routines are changed, personal neglect developes, laziness surface, boredom creeps in etc.
4. Personal life style change. Boredom, feeling of emptiness etc. create a new demand for satisfaction, often resulting in a pleasure seeking behavior, in particular of oral satisfaction = eating. Not merely to fill the daily nutritritional demand but rather as emotional pacification, leading to overweight with all the subsequent health complications.
5. Financial constrains. Suddenly the bank account shows a reduced monthly statement. Yet obligations may not have deminished. Suddenly the previous life style can hardly be maintained. On the other hand the personally perceived, social obligations may have increased, such as marriages of children, arrival of grand children etc.
6. Social/Sexual activities. Many people equate retirement also with sexual passivity. Reduced social contacts with friends, and former working colleges, due to the declining economic status, or just as symptom of depression. This too often leads to a negative attitute towards sexuality particularly when the female spouse is still in employment. Retirement here influences also the balanced sexual life, which may be reduced to a mere obligatory function as the mental attitute towards sexuality has “retired”. However the oposite has also been noted, that retirees need to prove their sexual “attractiveness and ability” by overt sexual activities.
Happiness/Wellbeing
“Contours of Well-Being: Alternative Perspectives
The extensive literature aimed at defining positive psychological functioning includes such perspectives as Maslow’s (1968) conception of self-actualization, Rogers’s (1961)
View of the fully functioning person, Jung’s (1933; Von Franz, 1964) formulation of individuation, and Allport’s (1961) conception of maturity. A further domain of theory for defining psychological well-being follows from the life span development perspective, which emphasizes the differing challenges confronted at various phases of the life cycle. Included here are Erikson’s (1959) psychological stage modes, Buhler’s basic life tendencies that work towards fulfillment of life. (Buhlers, 1935; Buhler & Massarik, 1968), and Neugarten’s 1968, 1973) description of personality change in adulthood and old age. Jahoda’s(1958) positive criteria of mental health, generated to replace definitions of well-being as the absence of illness, also offer extensive descriptions of what it means to be in good psychological health”
If we look at the aspect of well-being = well-feeling, we can not but must view it in perspective of happiness. This again can not be viewed in isolation but needs to be seen in the various aspects of psychology.
Self Acceptance The most importance criterion of well-being is in the individual’s sense of self- acceptance. This is defined as central feature of mental health as well a characteristic of self-actualization, optimal functioning and maturity. Lifespan Theory also emphasizes acceptance of self and one’s past life. Thus holding positive attitudes towards oneself emerges as a central characteristic of positive psychological functioning.
Positive relation with others The important emphasis here is on a warm trusting interpersonal relationship with a spouse or other family, or social community member
Self-actualization The realization of fulfillment of ones potentials, independency, autonomy, tendency to form few but deep friendships, a philosophical sense of humor, a tendency to resist outside pressures and a general transcendence of the environment rather than simply coping with it.
“The highest fulfillment of all good achievable by human action is happiness”
Aristotle (1069)
Discussion
Taking into consideration the afore said we do have to make an effort to seriously question the way we look at and treat senior citizen in this country. Are they in general, particularely those from lower income groups, in any way meeting the aforesaid criteria?
Can we speak of human dignity when we visit “Old People’s Homes”? Are senior citizens given even the basic opportunity to be accepted as respected members of society, when they are:
· excluded from Health Insurances coverage,
· not eligieble for a Credit Card,
· not even considered to get a Bank Loan, even if they can produce securities,
· not served in their home setting by medical doctors,
· treated as non persons in hospitals,
· lacking of urgent nursing help in their home setting, because Institutions do not do their home work etc.
We should consider retired persons as sources of knowledge, inspiration and resources of human capital. For most do have a wealth of knowledge and expirience accumulated in the years of their life and service.
The present practice of sending government servant into early retirement just to give “way for unemployed
youth” is unrealistic and counterproductive. How does anyone justify to sent an expirienced Medical Assistant into early retirement while the country is short of nursing personel?
Where are the seniors who can pass the knowledge and skills to the juniors in the employment sectors?
Is the poor performance in various fields in the country not a result of “ousting” expirienced work force, to make way for the young unemployed, albeit also inexpirienced persons. Would it not make more sense to all concerned if the seniors reduce their working hours, but stay on to pass the knowledge to the juniors? This would not only benefit the young but also give credit to the seniors that they are not being looked at as an obstacle of the younger generation’s aspiration, but catalyst to the improvement of service quality and sources of knowledge for the young. A rethink here is of urgent importance.
This approach would very well go a long way in preventing the retirees feel a sense of uselessness and depreciation of their self worth.
Where are the Senior citizen ‘Towns’, where they can enjoy life in a senior citizen compatible situation and surrounding?
When do we change our mentality of sending “burdening” old sick senior citizens into strange homes instead of providing them with the needed care in their own home setting?
When will the building authorities wake up and insist that new houses and flats have senior citizen compatible bathrooms where also a wheelchair or commode can be moved in and out?
When is society starting to realize that everyone, even the newborn is likely to become old one day and needs help.
When does the government start a compulsory saving scheme that would be available for nursing care once senior citizen need it?
When do professional organisations and individuals stand up and demand from all concerned to ensure that senior citizens can live a life in dignity and solace?
When do I AND YOU put aside personal convenience and initiate what needs to be done in one’s own area of service, related to the issue of improving senior citizen’s plight?
“A country and society will be judged by the way it looks at and treats those senior citizens who have served it and contributed to its deveopement”.
For further information and care for the elderly,
MOBILE NURSING/DOCTOR contact:
006 03-78777202
nursing@hnp-mobilenursing.com
www.hnp-mobilenursing.com
July 24, 2008
Organisational concept and structure of mobile nursing
Organisational concept and structure of mobile nursing
The population in Malaysia will increase annually. Correspondently so are more Senior Citizens in need of various degrees of care-taking and nursing supports.
The homogeneous family bonds are increasingly depleting, as migration of family members for job opportunities and carrier have become a reality. As a result, many Senior Citizens find themselves at the autumn of their lifespan alone, often as a result of not wanting to leave their place of stay since childhood. Children are, therefore, not able or willing to look into the physical, social, mental and health needs of these Senior Citizens. The ability of these “lost/misplaced/displaced” Senior Citizens to fend for themselves depletes as age advance.
For the same reasons as they often refuse to follow their children to a new place, they refuse to be placed in a residential home setting, resulting sometimes in development of deplorable conditions they slither in. Nonetheless these people have a right of a human worth living condition and care. Not to be under-estimated, is the special mental and psychological development these persons are experiencing, which needs a special handling of their situation. Gerontological care taking is a new field in this part of the world, and care givers have to possess a basic knowledge in this field, as well as the access to constant guidance and counselling.
Home Nursing Providers SDN BHD established in 2004 in Malaysia is aware of these special situations, and have gained some experience in the course of their service in dealing with the special conditions of such people, although the family thus far have been able and willing to bear the financial burden of the care-taking.
The system of care providing for senior, dependable and sick Citizens, is well known to the writer who has spend several years in this field in GERMANY. The basic human behaviours and needs do not differ from one country to another and transcends the cultural and religious affiliations. The basic human needs according to Maslow are applicable to every human being, and in the absence of the same we speak of “human unworthy” conditions or situations.
3 Categorisation of Clients’ Needs
As manifold as humans are their needs just as manifold also, objectively or subjectively. Care-giving should take this into account and should always be aimed at helping to restore self-help as far as this is applicable.
The support requirement of clients can roughly be put in three different categories:
Category I (substantial need of support)
Daily 90 Minutes, of which at least 45 minutes requirement of basic nursing, physical hygiene, and at least two times a week household up-keeping such as:
cleaning (maintenance)
washing and ironing/folding of clothing,
purchase of goods (shopping)
changing of bed sheets etc.
Category II (intensive nursing requirement)
Daily 3 hours’ need of which at least 2 hours in basic nursing, inclusive of 2 to 3 times a day:
general body hygiene,
preparing of nourishment,
assisting in the discharge of body waste,
2-3 times a week household up-keeping,
Category III (total nursing dependency)
Daily 5 hours’ need, of this at least 3.5 hours on basic nursing attendance requirement within 24 hours. This will include Category I and II with additional:
feeding inclusive of trans nasal feeding (Ryle’s tube)
dispensing of medication (which is prepared by a Nurse)
keeping in close liaison with health/welfare support services.
3 Special Requirements
At times it is necessary to attend to the Physical aspect of the living environment, providing intensive cleaning, assuring the environment is meeting with the basic requirement in hygiene and utilities.
Due to the fact that these Senior Citizens often have difficulties to control their body waste discharge, more laundry than generally expected is needed. For such purpose consideration should be given to make necessary provisions.
4 Establishing of Requirement (Assessment)
As mentioned above the requirements of support will vary from one client to another, not only in respect to their actual needs, but also how much the family members (if there are any) can contribute both financially and physically.
Family members should not be excluded but be integrated in the overall nursing process. External care-giving should be supplementary and financial compensation to a family member may be a first option. Leaving to the external support the activities that cannot be delivered by the family, such as:
wound management,
urethral catheters or Ryle’s tube insertion
nursing observation, Blood Sugar, Blood Pressure measurement etc.
Not to be underestimated is the need for psychological support and couching (technical know-how in nursing) to the primary care-giver and family members.
5 Assessment:
It is imperative in our experience that before any client is being given support an Assessment should be made to:
establish the IS situation
assess the family/community support
establish the objective and subjective needs
check on the physical/environmental requirements
assess the families ability and willingness to cooperate
make a nursing assessment, which includes nutritional requirements and body care condition besides an overall assessment.
At the end of such an assessment, at which besides the “reachable family members” also a competent Nurse (HNP) should be present, the respective Officer will analyse and recommend the steps to be taken, and decide on the optimal combination or arrangement to ensure the “best” for the care-seeker.
It is not unusual the situation can become more manageable by merely couching, professional stand-by and counselling of the family members, as far as such are available.
6 Services and Cost
The services Home Nursing Providers can deliver are as shown in the web site of the Company
WWW:HNP-HOME NURSING PROVIDERS.COM
CHARGES SCHEDULES
Medical Nursing charges
General Nursing charges
House Keeping charges
The charges are negotiable and “Special Rates” would form part of the contract between the Ministry and HNP Service Agency.
In each case a combination of services as required should be compiled to meet the client’s
needs and circumstances.
7 Patient call service
Consideration should also be given to the establishment of a 24-hour 365 day “PATIENT CALL SERVICE” which would enable clients in categories II and III to request for help and be attended to.
8 Conclusion
Home Nursing Providers would suggest a pilot Project in the Klang Valley, and the experience of a year’s ‘trial’ period should be a good basis for future development, covering also other areas in the country.
We would like to reiterate that the name (Sdn Bhd) should not be interpreted as primary money-making establishment, although the shareholders expect a return, we see ourselves as a catalyst in providing a much-needed and so far well solicited nursing and care giving service.
Our Team consists of a combination of highly qualified Nurses, Psychologist with Social Experience and trained and supervised Home Nursing Aids, working directly under our supervision and instruction and subjected to continuous training and counselling.
For further information on MOBILE NURSING/MOBILE DOCTOR contact:
006 03-78277202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
The population in Malaysia will increase annually. Correspondently so are more Senior Citizens in need of various degrees of care-taking and nursing supports.
The homogeneous family bonds are increasingly depleting, as migration of family members for job opportunities and carrier have become a reality. As a result, many Senior Citizens find themselves at the autumn of their lifespan alone, often as a result of not wanting to leave their place of stay since childhood. Children are, therefore, not able or willing to look into the physical, social, mental and health needs of these Senior Citizens. The ability of these “lost/misplaced/displaced” Senior Citizens to fend for themselves depletes as age advance.
For the same reasons as they often refuse to follow their children to a new place, they refuse to be placed in a residential home setting, resulting sometimes in development of deplorable conditions they slither in. Nonetheless these people have a right of a human worth living condition and care. Not to be under-estimated, is the special mental and psychological development these persons are experiencing, which needs a special handling of their situation. Gerontological care taking is a new field in this part of the world, and care givers have to possess a basic knowledge in this field, as well as the access to constant guidance and counselling.
Home Nursing Providers SDN BHD established in 2004 in Malaysia is aware of these special situations, and have gained some experience in the course of their service in dealing with the special conditions of such people, although the family thus far have been able and willing to bear the financial burden of the care-taking.
The system of care providing for senior, dependable and sick Citizens, is well known to the writer who has spend several years in this field in GERMANY. The basic human behaviours and needs do not differ from one country to another and transcends the cultural and religious affiliations. The basic human needs according to Maslow are applicable to every human being, and in the absence of the same we speak of “human unworthy” conditions or situations.
3 Categorisation of Clients’ Needs
As manifold as humans are their needs just as manifold also, objectively or subjectively. Care-giving should take this into account and should always be aimed at helping to restore self-help as far as this is applicable.
The support requirement of clients can roughly be put in three different categories:
Category I (substantial need of support)
Daily 90 Minutes, of which at least 45 minutes requirement of basic nursing, physical hygiene, and at least two times a week household up-keeping such as:
cleaning (maintenance)
washing and ironing/folding of clothing,
purchase of goods (shopping)
changing of bed sheets etc.
Category II (intensive nursing requirement)
Daily 3 hours’ need of which at least 2 hours in basic nursing, inclusive of 2 to 3 times a day:
general body hygiene,
preparing of nourishment,
assisting in the discharge of body waste,
2-3 times a week household up-keeping,
Category III (total nursing dependency)
Daily 5 hours’ need, of this at least 3.5 hours on basic nursing attendance requirement within 24 hours. This will include Category I and II with additional:
feeding inclusive of trans nasal feeding (Ryle’s tube)
dispensing of medication (which is prepared by a Nurse)
keeping in close liaison with health/welfare support services.
3 Special Requirements
At times it is necessary to attend to the Physical aspect of the living environment, providing intensive cleaning, assuring the environment is meeting with the basic requirement in hygiene and utilities.
Due to the fact that these Senior Citizens often have difficulties to control their body waste discharge, more laundry than generally expected is needed. For such purpose consideration should be given to make necessary provisions.
4 Establishing of Requirement (Assessment)
As mentioned above the requirements of support will vary from one client to another, not only in respect to their actual needs, but also how much the family members (if there are any) can contribute both financially and physically.
Family members should not be excluded but be integrated in the overall nursing process. External care-giving should be supplementary and financial compensation to a family member may be a first option. Leaving to the external support the activities that cannot be delivered by the family, such as:
wound management,
urethral catheters or Ryle’s tube insertion
nursing observation, Blood Sugar, Blood Pressure measurement etc.
Not to be underestimated is the need for psychological support and couching (technical know-how in nursing) to the primary care-giver and family members.
5 Assessment:
It is imperative in our experience that before any client is being given support an Assessment should be made to:
establish the IS situation
assess the family/community support
establish the objective and subjective needs
check on the physical/environmental requirements
assess the families ability and willingness to cooperate
make a nursing assessment, which includes nutritional requirements and body care condition besides an overall assessment.
At the end of such an assessment, at which besides the “reachable family members” also a competent Nurse (HNP) should be present, the respective Officer will analyse and recommend the steps to be taken, and decide on the optimal combination or arrangement to ensure the “best” for the care-seeker.
It is not unusual the situation can become more manageable by merely couching, professional stand-by and counselling of the family members, as far as such are available.
6 Services and Cost
The services Home Nursing Providers can deliver are as shown in the web site of the Company
WWW:HNP-HOME NURSING PROVIDERS.COM
CHARGES SCHEDULES
Medical Nursing charges
General Nursing charges
House Keeping charges
The charges are negotiable and “Special Rates” would form part of the contract between the Ministry and HNP Service Agency.
In each case a combination of services as required should be compiled to meet the client’s
needs and circumstances.
7 Patient call service
Consideration should also be given to the establishment of a 24-hour 365 day “PATIENT CALL SERVICE” which would enable clients in categories II and III to request for help and be attended to.
8 Conclusion
Home Nursing Providers would suggest a pilot Project in the Klang Valley, and the experience of a year’s ‘trial’ period should be a good basis for future development, covering also other areas in the country.
We would like to reiterate that the name (Sdn Bhd) should not be interpreted as primary money-making establishment, although the shareholders expect a return, we see ourselves as a catalyst in providing a much-needed and so far well solicited nursing and care giving service.
Our Team consists of a combination of highly qualified Nurses, Psychologist with Social Experience and trained and supervised Home Nursing Aids, working directly under our supervision and instruction and subjected to continuous training and counselling.
For further information on MOBILE NURSING/MOBILE DOCTOR contact:
006 03-78277202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
Why choose home nursing SERVICES?
We, the HOME NURSING PROVIDERS team are pleased to provide nursing services within the comfort of your home. Our emphasis is on nursing support – to retain or regain the ability of physical functions sufficiently to ensure a sustained and improved life quality of the sick and/or elderly to continue to be a ‘normal’ family member.
A local, highly qualified and specially trained team, comprising of nurses and other support staff will be at your disposal round-the clock (24 x 7 x 365) for this purpose to ensure the best possible professional mobile nursing service.
Home Nursing Providers is a solely Malaysia company that aims at assisting in the establishment of a qualified comprehensive mobile nursing program in Malaysia.
The Nursing Consultant is Mr. Yakob Abdul Rahman W. Scholer. He combines the best of experiences throughout more than 27 years he lived in Malaysia before returning to Germany to expand his knowledge in modern health care.
While in Germany he served in the Infectious Disease Ward of the University of Mainz for 9 years, expanded his knowledge in modern health care. The last 4 years in Germany before returning to Malaysia he was employed in the field of ‘Mobile Home Nursing’, visiting the sick and elderly in their family setting, providing them with optimal nursing care to assure their continuous stable health condition.
Mr. Yakob lectures at a local university on Health Psychology and also gives seminars on various nursing aspects such as prevention of bedsore, appropriate nutrition, mobilization, etc.
His vast knowledge is now available to this country where local nurses and nursing aides can be trained to provide the best possible family nursing care for those in need.
If you have specific questions, perhaps you can find the answers below. If we can help answer any other questions, please call us at (03) 7877-7202. Thank you for considering our home health care/mobile home nursing services.
Why choose home health care/mobile home nursing?
What is home health care?
Do I have a choice in which home health agency I use?
How quickly can services be provided?
Can I change my schedule if I have appointments?
How is my care giver chosen?
How do I pay for my home care?
General Questions
Why choose home health care/mobile home nursing?The need and interest in home health care/mobile home nursing has grown for many reasons. Medical science and technology have improved. Many treatments that could once be done only in a hospital can now be done at home. Also, home health care is usually less expensive and can often be just as effective as care in a hospital or skilled nursing facility. Finally, most patients and their families prefer to stay at home which is their natural environment rather than stay in a hospital or nursing home.
What is home health care?
"Home care" is a simple phrase that encompasses a wide range of health and social services and “mobile” denotes the mobility of our nursing service. Home health care is a cost effective alternative to hospital and nursing home stays. Generally, home care is appropriate whenever a person prefers to stay at home but needs ongoing care that cannot easily or effectively be provided solely by family and friends. It is a health care option that includes skilled nursing care, as well as other skilled and non-skilled care services, like physical and occupational therapy, personal care, homemaking and respite care. These services are given by a variety of health care professionals in your own home.
Home Nursing Providers' staff provides and helps coordinate the care and/or therapy that your doctor orders. The goal of short-term home health care is to provide treatment for an illness or injury. It helps you get better, regain your independence, and become as self-sufficient as possible. The goal of long-term home health care (for the chronically ill or physically or mentally challenged) is to maintain your highest level of ability or health, and help you learn to live with your condition.
Do I have a choice in which home health agency I use?
Yes. You have the right to choose a home health care agency to give you the care and services you need. Your choice will be honored by your doctor, hospital discharge planner, or other referring agency. Even though some hospitals and nursing homes have their own home health care agency, you are not required to choose the hospital or nursing home's home health care agency. You may choose any agency that you feel will meet your needs.
As an example of your right to choose, let's assume your mom is admitted to the hospital or nursing home because she fell and broke her hip. Upon her discharge, she will need home health care services in order to continue to heal properly and regain her independence at home. Your mom is free to choose any home care provider she prefers. She does not have to select the hospital or nursing home's
How quickly can services be provided?Generally, services provided by Home Nursing Provider can begin within 48 hours or less.
Can I change my schedule if I have appointments?
Yes. Changes are easily accomplished with as little as a phone call to one of our staffing coordinators. Our philosophy is to make the schedule work for the family and not just the agency. We attempt to meet your needs, your requests, and your schedule. We will do everything possible to make sure the schedule you want is the schedule you get. Of course, the earlier you notify us of a change in your schedule, the better we are able to accommodate your needs.
How is my care giver chosen?
Selecting the right person for you is our main concern. Your home health care needs are matched with the skills, qualities and expertise of our caregivers. All caregivers have been oriented to our standards and your needs before their first assignment. Home Nursing Providers Home Health Care recruits, screens, tests and trains our employees to provide you with the best care possible. Payment Questions.
How do I pay for my home care? You will be billed twice a month for our rendered services and/or medical/nursing supplies we help you obtain.
Payment can be made with crossed cheque, cash or internet banking.
For more information contact.
Home Nursing Providers
006 03-78777202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
A local, highly qualified and specially trained team, comprising of nurses and other support staff will be at your disposal round-the clock (24 x 7 x 365) for this purpose to ensure the best possible professional mobile nursing service.
Home Nursing Providers is a solely Malaysia company that aims at assisting in the establishment of a qualified comprehensive mobile nursing program in Malaysia.
The Nursing Consultant is Mr. Yakob Abdul Rahman W. Scholer. He combines the best of experiences throughout more than 27 years he lived in Malaysia before returning to Germany to expand his knowledge in modern health care.
While in Germany he served in the Infectious Disease Ward of the University of Mainz for 9 years, expanded his knowledge in modern health care. The last 4 years in Germany before returning to Malaysia he was employed in the field of ‘Mobile Home Nursing’, visiting the sick and elderly in their family setting, providing them with optimal nursing care to assure their continuous stable health condition.
Mr. Yakob lectures at a local university on Health Psychology and also gives seminars on various nursing aspects such as prevention of bedsore, appropriate nutrition, mobilization, etc.
His vast knowledge is now available to this country where local nurses and nursing aides can be trained to provide the best possible family nursing care for those in need.
If you have specific questions, perhaps you can find the answers below. If we can help answer any other questions, please call us at (03) 7877-7202. Thank you for considering our home health care/mobile home nursing services.
Why choose home health care/mobile home nursing?
What is home health care?
Do I have a choice in which home health agency I use?
How quickly can services be provided?
Can I change my schedule if I have appointments?
How is my care giver chosen?
How do I pay for my home care?
General Questions
Why choose home health care/mobile home nursing?The need and interest in home health care/mobile home nursing has grown for many reasons. Medical science and technology have improved. Many treatments that could once be done only in a hospital can now be done at home. Also, home health care is usually less expensive and can often be just as effective as care in a hospital or skilled nursing facility. Finally, most patients and their families prefer to stay at home which is their natural environment rather than stay in a hospital or nursing home.
What is home health care?
"Home care" is a simple phrase that encompasses a wide range of health and social services and “mobile” denotes the mobility of our nursing service. Home health care is a cost effective alternative to hospital and nursing home stays. Generally, home care is appropriate whenever a person prefers to stay at home but needs ongoing care that cannot easily or effectively be provided solely by family and friends. It is a health care option that includes skilled nursing care, as well as other skilled and non-skilled care services, like physical and occupational therapy, personal care, homemaking and respite care. These services are given by a variety of health care professionals in your own home.
Home Nursing Providers' staff provides and helps coordinate the care and/or therapy that your doctor orders. The goal of short-term home health care is to provide treatment for an illness or injury. It helps you get better, regain your independence, and become as self-sufficient as possible. The goal of long-term home health care (for the chronically ill or physically or mentally challenged) is to maintain your highest level of ability or health, and help you learn to live with your condition.
Do I have a choice in which home health agency I use?
Yes. You have the right to choose a home health care agency to give you the care and services you need. Your choice will be honored by your doctor, hospital discharge planner, or other referring agency. Even though some hospitals and nursing homes have their own home health care agency, you are not required to choose the hospital or nursing home's home health care agency. You may choose any agency that you feel will meet your needs.
As an example of your right to choose, let's assume your mom is admitted to the hospital or nursing home because she fell and broke her hip. Upon her discharge, she will need home health care services in order to continue to heal properly and regain her independence at home. Your mom is free to choose any home care provider she prefers. She does not have to select the hospital or nursing home's
How quickly can services be provided?Generally, services provided by Home Nursing Provider can begin within 48 hours or less.
Can I change my schedule if I have appointments?
Yes. Changes are easily accomplished with as little as a phone call to one of our staffing coordinators. Our philosophy is to make the schedule work for the family and not just the agency. We attempt to meet your needs, your requests, and your schedule. We will do everything possible to make sure the schedule you want is the schedule you get. Of course, the earlier you notify us of a change in your schedule, the better we are able to accommodate your needs.
How is my care giver chosen?
Selecting the right person for you is our main concern. Your home health care needs are matched with the skills, qualities and expertise of our caregivers. All caregivers have been oriented to our standards and your needs before their first assignment. Home Nursing Providers Home Health Care recruits, screens, tests and trains our employees to provide you with the best care possible. Payment Questions.
How do I pay for my home care? You will be billed twice a month for our rendered services and/or medical/nursing supplies we help you obtain.
Payment can be made with crossed cheque, cash or internet banking.
For more information contact.
Home Nursing Providers
006 03-78777202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
Mobile Nursing - the modern alternative for caring of the sick and infirm.
Mobile Nursing can be a viable alternative in the management of sick personsIn the Malaysian society the aged population is on the rise with the improved health standards. More and more people will live up to an old age, with the need for special care and attention.
The once BIG FAMILY concept is breaking down; more and more elderly are left to be taken care of by one of the offspring. Consequently the need for nursing and care support is evident.
In the past and perhaps still at present times the only alternative is a nursing or old folks’ home. This concept, once popular in Europe, is seeing a reverse, as many such homes are closed and the sick and infirm are taken care of in his/her own home setting.
To enable this concept two approaches may be used:
The once BIG FAMILY concept is breaking down; more and more elderly are left to be taken care of by one of the offspring. Consequently the need for nursing and care support is evident.
In the past and perhaps still at present times the only alternative is a nursing or old folks’ home. This concept, once popular in Europe, is seeing a reverse, as many such homes are closed and the sick and infirm are taken care of in his/her own home setting.
To enable this concept two approaches may be used:
1) The mobile nursing approach that ensures that the person in need, gets the optimal nursing care according to need and condition
2) The second approach is day care facility where the person can stay during the day, in case he or she can not be left alone.
The main purpose of this modern approach is that it is most inhumane to have a person, in the autumn of life, removed from their life-long dwelling. This conveys the message that they have become a “burden and being abandoned”.
Mobile Nursing in the concept practiced by HNP (Home Nursing Providers) in the Klang Valley, provides the optimal care, which enables the family to have good nursing care and the assurance of continued stay of the elderly within the family setting.
Mobile Nursing comprises mainly of two aspects:
2) The second approach is day care facility where the person can stay during the day, in case he or she can not be left alone.
The main purpose of this modern approach is that it is most inhumane to have a person, in the autumn of life, removed from their life-long dwelling. This conveys the message that they have become a “burden and being abandoned”.
Mobile Nursing in the concept practiced by HNP (Home Nursing Providers) in the Klang Valley, provides the optimal care, which enables the family to have good nursing care and the assurance of continued stay of the elderly within the family setting.
Mobile Nursing comprises mainly of two aspects:
1. Medical Nursing as shown in our documentation and performed by Registered Nurses
or Assistant Nurses.
2. General Nursing which covers the complete care-taking of non-medical aspects
inclusive of patient security and nutritional intake.
For further information about MOBILE NURSING/DOCTOR contact:
or Assistant Nurses.
2. General Nursing which covers the complete care-taking of non-medical aspects
inclusive of patient security and nutritional intake.
For further information about MOBILE NURSING/DOCTOR contact:
Home Nursing Providers,
006 03-78777202
www.hnp-mobilenursing.com
www.hnp-mobilenursing.com
What mobile nursing is all about needs to be understood to be appreciated
Mobile Nursing - the modern alternative for caring of the sick and infirm.
In the Malaysian society the aged population is on the rise with the improved health standards. More and more people will live up to an old age, with the need for special care and attention.
The once BIG FAMILY concept is breaking down; more and more elderly are left to be taken care of by one of the offspring. Consequently the need for nursing and care support is evident.
In the past and perhaps still at present times the only alternative is a nursing or old folks’ home. This concept, once popular in Europe, is seeing a reverse, as many such homes are closed and the sick and infirm are taken care of in his/her own home setting.
To enable this concept two approaches may be used:
1) The mobile nursing approach that ensures that the person in need, gets the optimal nursing care according to need and condition
2) The second approach is day care facility where the person can stay during the day, in case he or she can not be left alone.
The main purpose of this modern approach is that it is most inhumane to have a person, in the autumn of life, removed from their life-long dwelling. This conveys the message that they have become a “burden and being abandoned”.
Mobile Nursing in the concept practiced by HNP (Home Nursing Providers) in the Klang Valley, provides the optimal care, which enables the family to have good nursing care and the assurance of continued stay of the elderly within the family setting.
Mobile Nursing comprises mainly of two aspects:
1. Medical Nursing as shown in our documentation and performed by Registered Nurses
or Assistant Nurses.
2. General Nursing which covers the complete care-taking of non-medical aspects
inclusive of patient security and nutritional intake (see Attached
Documentation).
For more information about MOBILE NURSING/MOBILE DOCTOR contact:
In the Malaysian society the aged population is on the rise with the improved health standards. More and more people will live up to an old age, with the need for special care and attention.
The once BIG FAMILY concept is breaking down; more and more elderly are left to be taken care of by one of the offspring. Consequently the need for nursing and care support is evident.
In the past and perhaps still at present times the only alternative is a nursing or old folks’ home. This concept, once popular in Europe, is seeing a reverse, as many such homes are closed and the sick and infirm are taken care of in his/her own home setting.
To enable this concept two approaches may be used:
1) The mobile nursing approach that ensures that the person in need, gets the optimal nursing care according to need and condition
2) The second approach is day care facility where the person can stay during the day, in case he or she can not be left alone.
The main purpose of this modern approach is that it is most inhumane to have a person, in the autumn of life, removed from their life-long dwelling. This conveys the message that they have become a “burden and being abandoned”.
Mobile Nursing in the concept practiced by HNP (Home Nursing Providers) in the Klang Valley, provides the optimal care, which enables the family to have good nursing care and the assurance of continued stay of the elderly within the family setting.
Mobile Nursing comprises mainly of two aspects:
1. Medical Nursing as shown in our documentation and performed by Registered Nurses
or Assistant Nurses.
2. General Nursing which covers the complete care-taking of non-medical aspects
inclusive of patient security and nutritional intake (see Attached
Documentation).
For more information about MOBILE NURSING/MOBILE DOCTOR contact:
Access to mobile nursing is a right to one in need of it
Providing home nursing
By AUDREY EDWARDS STAR Paper
MOHD SALLEH Abdul Rashid, 80, was a sportsman in his younger days. He was also a chatterbox and lived for his family until his sixth stroke recently left him unable to move or speak.
He now spends his days on a hospital bed at home where his loved ones care for him and tend to his needs with the help of mobile home nursing agency Home Nursing Providers Sdn Bhd.
When the agency first began visiting Mohd Salleh, representatives arrived twice daily to dress his bedsores, provide counselling, exercise and massage and change catheter and drip tubes. The family has since learnt how to take care of some of these tasks and the agency only visits once a day.
Mohd Salleh's wife Noraini Abu Bakar, 71, tends to him at night.
Norizan (left)talking to her father as Yakob (right) and Noraini look on.
“It was a shock to him but I think he has accepted it. The personal touch is important and that is what made me decide to tend to him at home. I think he is more secure with his family,” added his daughter Norizan.
Norizan also admitted that at first, the family did not know what to do but the hospital had recommended the agency and it had been a good move.
“He is doing much better now. We took him out for Raya in a wheelchair and relatives have been visiting him. Although he cannot talk, he uses facial expressions. We read to him and tell him all the gossip. And he refuses to eat if my mother does not feed him,” she added.
Home Nursing Providers managing director and nursing officer Yakob Abdul Rahman W. Scholer stressed that it was not a nursing agency or a hospice service but one where family members were coached to care for the patient and advice was given.
It serves as a link between the clinic or hospital and the client in his home setting. There will be initial assessments and consultations to determine the kind of nursing care a client needs. Records are also kept to keep track of the client's progress.
“The idea is not to have people staying in the hospital unless medically necessary.
“Nursing care means looking after all aspects of a person from nutrients, body care and mobilisation to emotional and social needs,” he added.
If you need good MOBILE NURSING/MOBILE DOCTOR contact:
Home Nursing Providers
006 03-78777202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
By AUDREY EDWARDS STAR Paper
MOHD SALLEH Abdul Rashid, 80, was a sportsman in his younger days. He was also a chatterbox and lived for his family until his sixth stroke recently left him unable to move or speak.
He now spends his days on a hospital bed at home where his loved ones care for him and tend to his needs with the help of mobile home nursing agency Home Nursing Providers Sdn Bhd.
When the agency first began visiting Mohd Salleh, representatives arrived twice daily to dress his bedsores, provide counselling, exercise and massage and change catheter and drip tubes. The family has since learnt how to take care of some of these tasks and the agency only visits once a day.
Mohd Salleh's wife Noraini Abu Bakar, 71, tends to him at night.
Norizan (left)talking to her father as Yakob (right) and Noraini look on.
“It was a shock to him but I think he has accepted it. The personal touch is important and that is what made me decide to tend to him at home. I think he is more secure with his family,” added his daughter Norizan.
Norizan also admitted that at first, the family did not know what to do but the hospital had recommended the agency and it had been a good move.
“He is doing much better now. We took him out for Raya in a wheelchair and relatives have been visiting him. Although he cannot talk, he uses facial expressions. We read to him and tell him all the gossip. And he refuses to eat if my mother does not feed him,” she added.
Home Nursing Providers managing director and nursing officer Yakob Abdul Rahman W. Scholer stressed that it was not a nursing agency or a hospice service but one where family members were coached to care for the patient and advice was given.
It serves as a link between the clinic or hospital and the client in his home setting. There will be initial assessments and consultations to determine the kind of nursing care a client needs. Records are also kept to keep track of the client's progress.
“The idea is not to have people staying in the hospital unless medically necessary.
“Nursing care means looking after all aspects of a person from nutrients, body care and mobilisation to emotional and social needs,” he added.
If you need good MOBILE NURSING/MOBILE DOCTOR contact:
Home Nursing Providers
006 03-78777202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
Tender Care to the end
Tender Care Till the End
Thursday, April 28 2005
New Straits Times: Life & Times
For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers may be just what they need. SARAH SABARATNAM writes. WHEN my father's health began its inevitable decline in January this year after battling cancer for more than two years, the family immediately looked at options for nursing support at home. Caring for him had been manageable in the past but he was fast deteriorating and had become bedridden. We wanted to know how we could make him as comfortable as possible. We needed help with the physical aspects of caring for him when my sisters and I were at work and my mother was alone with him. We also wanted to be prepared for any medical eventuality. We found just what we needed in the form of the Home Nursing Providers. Not only were the staff willing to come to the family home in Rawang — which was out of the work zone of other palliative care providers such as Hospice, they were very professional and compassionate where nursing agencies were not. Private nursing agencies we called offered us limited options: we could take a nurse for a minimum of eight hours a day, or nothing. They were expensive and although we were willing to pay whatever it costs, we were not sure we needed someone for so many hours. There was no consultation or assessment involved; the nursing people seemed interested only in making a transaction. The people behind the Home Nursing Providers surprised us. Yakob Abdul Rahman W. Scholer, the outfit's managing director and nursing officer, turned up at our doorstep just a few hours after we called him. YAKOB: ‘While we may not be able to add days to a patient's life, we can add life to their days'. He told us he could only make an offer on the kind of service that would be provided, and its costs, after meeting the patient and making an assessment. He spent almost 20 minutes with us discussing my father's medical history, asking us what we felt we needed from his side, and what our concerns and fears were. Then he examined my father and gave us his assessment. After more discussions, he made suggestions as to how we could care for our father, what material we would need to make him comfortable, how to prevent bed sores, and how to care for his skin. He assigned us a nurse, at our request. She would come in for one to two hours a day, and help my mother wipe my father down and change him, check his blood pressure and pulse, change his dressings and do whatever else was necessary. He confirmed that it would be unnecessary to employ a nurse for eight hours. Although a nurse had been assigned to my father, busy Yakob continued to drop in regularly, to check on us, all the way from his office in Kelana Jaya. He never seemed in a rush and would spend time talking to family members, counselling, reassuring and preparing us for the inevitable. They charged only for what was necessary and based on what kind of nursing or care was provided. Everything was itemised and a daily log was kept. We found, later, they were less than four times as expensive as some of the nursing agencies we called. They promised round the clock availability. We could call them any time there was an emergency, or if we simply had a question. Yakob even gave us his handphone number. “In Malaysia, it is very difficult to get doctors to make house visits. We can fill in this gap,” he said. The Home Nursing Providers don't just provide nursing services for the terminally ill. The staff also work at rehabilitating patients that doctors have given up on. Wan Nor Gat Ismail, 77, is one such person. He had been bedridden for three months when Yakob was assigned to him in January this year. Pak Wan's wife, Kalsom Amir, 72, says that at that time, her husband was just tunggu mati (waiting to die). MAKING HOUSE CALLS: Yakob helping Abdullah with his exercises. Mobile nursing can help where the doctors leave off, relieving the stress of patients who would rather be at home. The doctors had found nothing wrong with him, despite keeping him hospitalised in Alor Star for a month. Yet he was fast deteriorating. He was constipated and had no appetite. Within a month he had lost almost 20kg. He could not go to the toilet himself. He hardly ate. He became incontinent. By New Year's Day, Pak Wan had been bedridden for three months. He was so skinny his dentures could not fit. And when they put him on the toilet bowl, he almost fell through the seat, for he had lost all the flesh on his rear end. But seven months since he first became bedridden, Pak Wan is on his feet, greeting us as we arrive in his daughter's house in Bukit Jelutong, smiling and proud of the fact that he shaved himself that morning. The transformation is attributed to Yakob's special touch. “My daughter discovered Yakob about four months ago,” says Kalsom. “Now my husband can walk and eat. He is going to the toilet himself. Yakob takes him to the park to exercise every day. His progress had been so good, we are thinking of going back home to Alor Star next month,” says Kalsom. The Home Nursing Providers provides mobile nursing services in the comfort of one's home. For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers are just what they need. “While we may not be able to add days to a patient's life, we can add life to their days,” says Yakob. He says that many people assume that as people get old or sick, they must become slow, lose their muscles and deteriorate physically. “This is not true. With some exercise, motivation and the right amount of nursing, they can improve so much.” A family member of another patient attests to this: “The doctors had given my father one week to live, but under their (Home Nursing Providers) care, he lived a month and even improved so much that for a while we thought he was going to survive.” The mobile nurses believe in early intervention and rehabilitation, unlike doctors who focus only on treating the illness and give very little attention to the physical, emotional and psychological needs of the patient. Besides, the longer a patient is kept in a hospital, the more sick he becomes. This is especially true of elderly people who find it hard to adjust to the hospital setting. Instead, mobile nursing can help where the doctors leave off. “It can save families a lot of money, and relieve the stress of patients who would rather be at home,” says Yakob. Mobile nursing is also a better alternative to nursing homes. “People who end up in nursing homes feel rejected, unwanted and a burden. They tend to go into depression and fall ill easily. Studies show their life span shortens dramatically because they have no purpose in life.” Yakob and his staff help nurse elderly people whose family finds it beyond their capability to look after. Or they can help make the days of a dying patient bearable, comfortable and free from unnecessary stresses. They provide necessary equipment such as oxygen compressors, ripple mattresses, hospital beds and cushions to prevent bed sores. They check on the person's blood pressure, sugar level, heart rate, eating habits and so on. They can install catheters and tend to dressings. Mostly, they are there for patients who are no longer in need of medical attention but in need of nursing. Yakob, who has had extensive experience in mobile nursing in Germany and had spent many years nursing in Malaysia, believes that mobile nursing has to meet two important criteria. Firstly, he says, there must be transparency. “The family of the patient must be consulted, involved and given decision- making power. Just like someone should be able to walk into a shop and choose what he or she wants to buy, the family must not be pressured. There are nursing agencies which impose on families very limited options.” Secondly, mobile nursing must be accessible and available to everyone in need of it. “A minimum service must be given irrespective of financial capabilities. The minimum would be to teach the patient's family how to do general nursing, and this can be done in a relatively short time to willing parties.” He says a lot of families want the best “but everybody should have a right to this best, according to their budget”. A complete one and half hour coaching and consultation, says Yakob, is only RM75 which is within the reach of an average income earner. “Mobile nursing is different from hospitals. You are not dealing with the patient alone but the whole complexity of a family setting. When there is more than one person, there is more than one idea, or opinion, or expectation, or emotional contact with the sick patient.” This is where he says mobile nursing, as provided by the outfit he runs, differs drastically from the hospital setting, or the standard of services provided by some nursing agencies. “Our nurses are taught to be sensitive. We give a clear picture of what can and cannot be done. We give the family options. Respect for the family has to be the highest criteria. They get the last say. I cannot impose my nursing experience or ideas onto the family. It is not acceptable. My duty is to show them options and consequences, and then they choose.” The patient too, if able, should be included in the decision-making process. Most families who have utilised the services provided by the Home Nursing Providers are struck by their compassion and commitment to their profession. The son of one of Yakob's patients says, “We are the lucky few that managed to get Yakob's full attention. He is such a knowledgeable person, caring and, of course, very dedicated. Sometimes I just wish there are more of him so that he can attend to my father's rehabilitation more often in a day. My father, Haji Abdullah Haji Shukur, is 90 and suffers from a paralysis due to a stroke some years ago. I wouldn't know what to do and how to care for my father without him and his nurses.” Note: The Home Nursing Providers Sdn Bhd is located in Kelana Jaya and can be contacted at 03-78777202 or through email: hnpys@streamyx.com. Visit its website at HNP-mobilenursing.com Nursing is Yakob's Passion YAKOB Abdul Rahman Wilhelm Scholer (right) first came to Malaysia in 1957 to join the Catholic Order of the Brothers' of Mercy who were running the Fatimah hospital in Ipoh. “I have been fascinated about Malaysia since my teenage years. I remember reading about the Sultanate of the Straits of Malacca which records the fights between the different States and their Sultans. “Later on, I came across several books about Asia. This part of the world fascinated me,” he said. When he had the option of going either to Brazil or Malaysia to work, he chose the latter. Since then, he has gone back to Germany several times to further his study and expand his experience. But he keeps coming back to Malaysia. He has previously worked with a mobile medical team during the emergency period in Ipoh, and was founding member and manager of the Yayasan Pusat Pertolongan in the 1970s which was Malaysia's first drug rehabilitation centre. He also founded Yayasan Alkoholisma Malaysia in the 1980s and was involved with the nation's first all-female drug dependents rehabilitation centre at around the same time. He also helped set up the first non-governmental organisation (NGO) for the awareness of HIV/AIDS in Malaysia and the AIDS Hotline, which later led to the development of the Malaysian AIDS Council. He has also spent many years doing street work. Nursing remains his biggest passion and he, together with the owner of the Home Nursing Providers (who wishes to remain anonymous), intends to provide affordable mobile nursing services for as long as they can. “I see mobile nursing as a major future in health service. The cost of medical fees will continue to escalate and anyway, hospitals are not places for recuperation. People, especially the elderly, are uncomfortable in hospitals.” Mobile nursing will also be important in Malaysia as very few doctors are willing to make house calls. Besides, many elderly patients need nursing care more than medical treatment. Mobile nursing provides follow-up supervision after a person is discharged from the hospital. It involves doing everything a nurse would do in a hospital setting but in the comfort of one's home. Says Yakob, “Mobile nursing is something beautiful if done nicely. To see a patient recover, ask you when you are coming again, and to see the family looking contented — that is something money can't buy. The feeling is irreplaceable, and that is our motivation.”
For further information about MOBILE NURSING/MOBILE DOCTOR please contact:
06 03 78777202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
Thursday, April 28 2005
New Straits Times: Life & Times
For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers may be just what they need. SARAH SABARATNAM writes. WHEN my father's health began its inevitable decline in January this year after battling cancer for more than two years, the family immediately looked at options for nursing support at home. Caring for him had been manageable in the past but he was fast deteriorating and had become bedridden. We wanted to know how we could make him as comfortable as possible. We needed help with the physical aspects of caring for him when my sisters and I were at work and my mother was alone with him. We also wanted to be prepared for any medical eventuality. We found just what we needed in the form of the Home Nursing Providers. Not only were the staff willing to come to the family home in Rawang — which was out of the work zone of other palliative care providers such as Hospice, they were very professional and compassionate where nursing agencies were not. Private nursing agencies we called offered us limited options: we could take a nurse for a minimum of eight hours a day, or nothing. They were expensive and although we were willing to pay whatever it costs, we were not sure we needed someone for so many hours. There was no consultation or assessment involved; the nursing people seemed interested only in making a transaction. The people behind the Home Nursing Providers surprised us. Yakob Abdul Rahman W. Scholer, the outfit's managing director and nursing officer, turned up at our doorstep just a few hours after we called him. YAKOB: ‘While we may not be able to add days to a patient's life, we can add life to their days'. He told us he could only make an offer on the kind of service that would be provided, and its costs, after meeting the patient and making an assessment. He spent almost 20 minutes with us discussing my father's medical history, asking us what we felt we needed from his side, and what our concerns and fears were. Then he examined my father and gave us his assessment. After more discussions, he made suggestions as to how we could care for our father, what material we would need to make him comfortable, how to prevent bed sores, and how to care for his skin. He assigned us a nurse, at our request. She would come in for one to two hours a day, and help my mother wipe my father down and change him, check his blood pressure and pulse, change his dressings and do whatever else was necessary. He confirmed that it would be unnecessary to employ a nurse for eight hours. Although a nurse had been assigned to my father, busy Yakob continued to drop in regularly, to check on us, all the way from his office in Kelana Jaya. He never seemed in a rush and would spend time talking to family members, counselling, reassuring and preparing us for the inevitable. They charged only for what was necessary and based on what kind of nursing or care was provided. Everything was itemised and a daily log was kept. We found, later, they were less than four times as expensive as some of the nursing agencies we called. They promised round the clock availability. We could call them any time there was an emergency, or if we simply had a question. Yakob even gave us his handphone number. “In Malaysia, it is very difficult to get doctors to make house visits. We can fill in this gap,” he said. The Home Nursing Providers don't just provide nursing services for the terminally ill. The staff also work at rehabilitating patients that doctors have given up on. Wan Nor Gat Ismail, 77, is one such person. He had been bedridden for three months when Yakob was assigned to him in January this year. Pak Wan's wife, Kalsom Amir, 72, says that at that time, her husband was just tunggu mati (waiting to die). MAKING HOUSE CALLS: Yakob helping Abdullah with his exercises. Mobile nursing can help where the doctors leave off, relieving the stress of patients who would rather be at home. The doctors had found nothing wrong with him, despite keeping him hospitalised in Alor Star for a month. Yet he was fast deteriorating. He was constipated and had no appetite. Within a month he had lost almost 20kg. He could not go to the toilet himself. He hardly ate. He became incontinent. By New Year's Day, Pak Wan had been bedridden for three months. He was so skinny his dentures could not fit. And when they put him on the toilet bowl, he almost fell through the seat, for he had lost all the flesh on his rear end. But seven months since he first became bedridden, Pak Wan is on his feet, greeting us as we arrive in his daughter's house in Bukit Jelutong, smiling and proud of the fact that he shaved himself that morning. The transformation is attributed to Yakob's special touch. “My daughter discovered Yakob about four months ago,” says Kalsom. “Now my husband can walk and eat. He is going to the toilet himself. Yakob takes him to the park to exercise every day. His progress had been so good, we are thinking of going back home to Alor Star next month,” says Kalsom. The Home Nursing Providers provides mobile nursing services in the comfort of one's home. For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers are just what they need. “While we may not be able to add days to a patient's life, we can add life to their days,” says Yakob. He says that many people assume that as people get old or sick, they must become slow, lose their muscles and deteriorate physically. “This is not true. With some exercise, motivation and the right amount of nursing, they can improve so much.” A family member of another patient attests to this: “The doctors had given my father one week to live, but under their (Home Nursing Providers) care, he lived a month and even improved so much that for a while we thought he was going to survive.” The mobile nurses believe in early intervention and rehabilitation, unlike doctors who focus only on treating the illness and give very little attention to the physical, emotional and psychological needs of the patient. Besides, the longer a patient is kept in a hospital, the more sick he becomes. This is especially true of elderly people who find it hard to adjust to the hospital setting. Instead, mobile nursing can help where the doctors leave off. “It can save families a lot of money, and relieve the stress of patients who would rather be at home,” says Yakob. Mobile nursing is also a better alternative to nursing homes. “People who end up in nursing homes feel rejected, unwanted and a burden. They tend to go into depression and fall ill easily. Studies show their life span shortens dramatically because they have no purpose in life.” Yakob and his staff help nurse elderly people whose family finds it beyond their capability to look after. Or they can help make the days of a dying patient bearable, comfortable and free from unnecessary stresses. They provide necessary equipment such as oxygen compressors, ripple mattresses, hospital beds and cushions to prevent bed sores. They check on the person's blood pressure, sugar level, heart rate, eating habits and so on. They can install catheters and tend to dressings. Mostly, they are there for patients who are no longer in need of medical attention but in need of nursing. Yakob, who has had extensive experience in mobile nursing in Germany and had spent many years nursing in Malaysia, believes that mobile nursing has to meet two important criteria. Firstly, he says, there must be transparency. “The family of the patient must be consulted, involved and given decision- making power. Just like someone should be able to walk into a shop and choose what he or she wants to buy, the family must not be pressured. There are nursing agencies which impose on families very limited options.” Secondly, mobile nursing must be accessible and available to everyone in need of it. “A minimum service must be given irrespective of financial capabilities. The minimum would be to teach the patient's family how to do general nursing, and this can be done in a relatively short time to willing parties.” He says a lot of families want the best “but everybody should have a right to this best, according to their budget”. A complete one and half hour coaching and consultation, says Yakob, is only RM75 which is within the reach of an average income earner. “Mobile nursing is different from hospitals. You are not dealing with the patient alone but the whole complexity of a family setting. When there is more than one person, there is more than one idea, or opinion, or expectation, or emotional contact with the sick patient.” This is where he says mobile nursing, as provided by the outfit he runs, differs drastically from the hospital setting, or the standard of services provided by some nursing agencies. “Our nurses are taught to be sensitive. We give a clear picture of what can and cannot be done. We give the family options. Respect for the family has to be the highest criteria. They get the last say. I cannot impose my nursing experience or ideas onto the family. It is not acceptable. My duty is to show them options and consequences, and then they choose.” The patient too, if able, should be included in the decision-making process. Most families who have utilised the services provided by the Home Nursing Providers are struck by their compassion and commitment to their profession. The son of one of Yakob's patients says, “We are the lucky few that managed to get Yakob's full attention. He is such a knowledgeable person, caring and, of course, very dedicated. Sometimes I just wish there are more of him so that he can attend to my father's rehabilitation more often in a day. My father, Haji Abdullah Haji Shukur, is 90 and suffers from a paralysis due to a stroke some years ago. I wouldn't know what to do and how to care for my father without him and his nurses.” Note: The Home Nursing Providers Sdn Bhd is located in Kelana Jaya and can be contacted at 03-78777202 or through email: hnpys@streamyx.com. Visit its website at HNP-mobilenursing.com Nursing is Yakob's Passion YAKOB Abdul Rahman Wilhelm Scholer (right) first came to Malaysia in 1957 to join the Catholic Order of the Brothers' of Mercy who were running the Fatimah hospital in Ipoh. “I have been fascinated about Malaysia since my teenage years. I remember reading about the Sultanate of the Straits of Malacca which records the fights between the different States and their Sultans. “Later on, I came across several books about Asia. This part of the world fascinated me,” he said. When he had the option of going either to Brazil or Malaysia to work, he chose the latter. Since then, he has gone back to Germany several times to further his study and expand his experience. But he keeps coming back to Malaysia. He has previously worked with a mobile medical team during the emergency period in Ipoh, and was founding member and manager of the Yayasan Pusat Pertolongan in the 1970s which was Malaysia's first drug rehabilitation centre. He also founded Yayasan Alkoholisma Malaysia in the 1980s and was involved with the nation's first all-female drug dependents rehabilitation centre at around the same time. He also helped set up the first non-governmental organisation (NGO) for the awareness of HIV/AIDS in Malaysia and the AIDS Hotline, which later led to the development of the Malaysian AIDS Council. He has also spent many years doing street work. Nursing remains his biggest passion and he, together with the owner of the Home Nursing Providers (who wishes to remain anonymous), intends to provide affordable mobile nursing services for as long as they can. “I see mobile nursing as a major future in health service. The cost of medical fees will continue to escalate and anyway, hospitals are not places for recuperation. People, especially the elderly, are uncomfortable in hospitals.” Mobile nursing will also be important in Malaysia as very few doctors are willing to make house calls. Besides, many elderly patients need nursing care more than medical treatment. Mobile nursing provides follow-up supervision after a person is discharged from the hospital. It involves doing everything a nurse would do in a hospital setting but in the comfort of one's home. Says Yakob, “Mobile nursing is something beautiful if done nicely. To see a patient recover, ask you when you are coming again, and to see the family looking contented — that is something money can't buy. The feeling is irreplaceable, and that is our motivation.”
For further information about MOBILE NURSING/MOBILE DOCTOR please contact:
06 03 78777202
www.hnp-mobilenursing.com
nursing@hnp-mobilenursing.com
July 3, 2008
Good mobile nursing is a challenge
Thursday, April 28 2005 New Straits Times: Life & Times
Tender Care Till the End
For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers may be just what they need. SARAH SABARATNAM writes.
WHEN my father's health began its inevitable decline in January this year after battling cancer for more than two years, the family immediately looked at options for nursing support at home. Caring for him had been manageable in the past but he was fast deteriorating and had become bedridden. We wanted to know how we could make him as comfortable as possible. We needed help with the physical aspects of caring for him when my sisters and I were at work and my mother was alone with him. We also wanted to be prepared for any medical eventuality. We found just what we needed in the form of the Home Nursing Providers. Not only were the staff willing to come to the family home in Rawang — which was out of the work zone of other palliative care providers such as Hospice, they were very professional and compassionate where nursing agencies were not. Private nursing agencies we called offered us limited options: we could take a nurse for a minimum of eight hours a day, or nothing. They were expensive and although we were willing to pay whatever it costs, we were not sure we needed someone for so many hours. There was no consultation or assessment involved; the nursing people seemed interested only in making a transaction. The people behind the Home Nursing Providers surprised us. Yakob Abdul Rahman W. Scholer, the outfit's managing director and nursing officer, turned up at our doorstep just a few hours after we called him. YAKOB: ‘While we may not be able to add days to a patient's life, we can add life to their days'. He told us he could only make an offer on the kind of service that would be provided, and its costs, after meeting the patient and making an assessment. He spent almost 20 minutes with us discussing my father's medical history, asking us what we felt we needed from his side, and what our concerns and fears were. Then he examined my father and gave us his assessment. After more discussions, he made suggestions as to how we could care for our father, what material we would need to make him comfortable, how to prevent bed sores, and how to care for his skin. He assigned us a nurse, at our request. She would come in for one to two hours a day, and help my mother wipe my father down and change him, check his blood pressure and pulse, change his dressings and do whatever else was necessary. He confirmed that it would be unnecessary to employ a nurse for eight hours. Although a nurse had been assigned to my father, busy Yakob continued to drop in regularly, to check on us, all the way from his office in Kelana Jaya. He never seemed in a rush and would spend time talking to family members, counselling, reassuring and preparing us for the inevitable. They charged only for what was necessary and based on what kind of nursing or care was provided. Everything was itemised and a daily log was kept. We found, later, they were less than four times as expensive as some of the nursing agencies we called. They promised round the clock availability. We could call them any time there was an emergency, or if we simply had a question. Yakob even gave us his handphone number. “In Malaysia, it is very difficult to get doctors to make house visits. We can fill in this gap,” he said. The Home Nursing Providers don't just provide nursing services for the terminally ill. The staff also work at rehabilitating patients that doctors have given up on. Wan Nor Gat Ismail, 77, is one such person. He had been bedridden for three months when Yakob was assigned to him in January this year. Pak Wan's wife, Kalsom Amir, 72, says that at that time, her husband was just tunggu mati (waiting to die). MAKING HOUSE CALLS: Yakob helping Abdullah with his exercises. Mobile nursing can help where the doctors leave off, relieving the stress of patients who would rather be at home. The doctors had found nothing wrong with him, despite keeping him hospitalised in Alor Star for a month. Yet he was fast deteriorating. He was constipated and had no appetite. Within a month he had lost almost 20kg. He could not go to the toilet himself. He hardly ate. He became incontinent. By New Year's Day, Pak Wan had been bedridden for three months. He was so skinny his dentures could not fit. And when they put him on the toilet bowl, he almost fell through the seat, for he had lost all the flesh on his rear end. But seven months since he first became bedridden, Pak Wan is on his feet, greeting us as we arrive in his daughter's house in Bukit Jelutong, smiling and proud of the fact that he shaved himself that morning. The transformation is attributed to Yakob's special touch. “My daughter discovered Yakob about four months ago,” says Kalsom. “Now my husband can walk and eat. He is going to the toilet himself. Yakob takes him to the park to exercise every day. His progress had been so good, we are thinking of going back home to Alor Star next month,” says Kalsom. The Home Nursing Providers provides mobile nursing services in the comfort of one's home. For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers are just what they need. “While we may not be able to add days to a patient's life, we can add life to their days,” says Yakob. He says that many people assume that as people get old or sick, they must become slow, lose their muscles and deteriorate physically. “This is not true. With some exercise, motivation and the right amount of nursing, they can improve so much.” A family member of another patient attests to this: “The doctors had given my father one week to live, but under their (Home Nursing Providers) care, he lived a month and even improved so much that for a while we thought he was going to survive.” The mobile nurses believe in early intervention and rehabilitation, unlike doctors who focus only on treating the illness and give very little attention to the physical, emotional and psychological needs of the patient. Besides, the longer a patient is kept in a hospital, the more sick he becomes. This is especially true of elderly people who find it hard to adjust to the hospital setting. Instead, mobile nursing can help where the doctors leave off. “It can save families a lot of money, and relieve the stress of patients who would rather be at home,” says Yakob. Mobile nursing is also a better alternative to nursing homes. “People who end up in nursing homes feel rejected, unwanted and a burden. They tend to go into depression and fall ill easily. Studies show their life span shortens dramatically because they have no purpose in life.” Yakob and his staff help nurse elderly people whose family finds it beyond their capability to look after. Or they can help make the days of a dying patient bearable, comfortable and free from unnecessary stresses. They provide necessary equipment such as oxygen compressors, ripple mattresses, hospital beds and cushions to prevent bed sores. They check on the person's blood pressure, sugar level, heart rate, eating habits and so on. They can install catheters and tend to dressings. Mostly, they are there for patients who are no longer in need of medical attention but in need of nursing. Yakob, who has had extensive experience in mobile nursing in Germany and had spent many years nursing in Malaysia, believes that mobile nursing has to meet two important criteria. Firstly, he says, there must be transparency. “The family of the patient must be consulted, involved and given decision- making power. Just like someone should be able to walk into a shop and choose what he or she wants to buy, the family must not be pressured. There are nursing agencies which impose on families very limited options.” Secondly, mobile nursing must be accessible and available to everyone in need of it. “A minimum service must be given irrespective of financial capabilities. The minimum would be to teach the patient's family how to do general nursing, and this can be done in a relatively short time to willing parties.” He says a lot of families want the best “but everybody should have a right to this best, according to their budget”. A complete one and half hour coaching and consultation, says Yakob, is only RM75 which is within the reach of an average income earner. “Mobile nursing is different from hospitals. You are not dealing with the patient alone but the whole complexity of a family setting. When there is more than one person, there is more than one idea, or opinion, or expectation, or emotional contact with the sick patient.” This is where he says mobile nursing, as provided by the outfit he runs, differs drastically from the hospital setting, or the standard of services provided by some nursing agencies. “Our nurses are taught to be sensitive. We give a clear picture of what can and cannot be done. We give the family options. Respect for the family has to be the highest criteria. They get the last say. I cannot impose my nursing experience or ideas onto the family. It is not acceptable. My duty is to show them options and consequences, and then they choose.” The patient too, if able, should be included in the decision-making process. Most families who have utilised the services provided by the Home Nursing Providers are struck by their compassion and commitment to their profession. The son of one of Yakob's patients says, “We are the lucky few that managed to get Yakob's full attention. He is such a knowledgeable person, caring and, of course, very dedicated. Sometimes I just wish there are more of him so that he can attend to my father's rehabilitation more often in a day. My father, Haji Abdullah Haji Shukur, is 90 and suffers from a paralysis due to a stroke some years ago. I wouldn't know what to do and how to care for my father without him and his nurses.” Note: The Home Nursing Providers Sdn Bhd is located in Kelana Jaya and can be contacted at 03-78777202 or through email: hnpys@streamyx.com. Visit its website at HNP-mobilenursing.com Nursing is Yakob's Passion YAKOB Abdul Rahman Wilhelm Scholer (right) first came to Malaysia in 1957 to join the Catholic Order of the Brothers' of Mercy who were running the Fatimah hospital in Ipoh. “I have been fascinated about Malaysia since my teenage years. I remember reading about the Sultanate of the Straits of Malacca which records the fights between the different States and their Sultans. “Later on, I came across several books about Asia. This part of the world fascinated me,” he said. When he had the option of going either to Brazil or Malaysia to work, he chose the latter. Since then, he has gone back to Germany several times to further his study and expand his experience. But he keeps coming back to Malaysia. He has previously worked with a mobile medical team during the emergency period in Ipoh, and was founding member and manager of the Yayasan Pusat Pertolongan in the 1970s which was Malaysia's first drug rehabilitation centre. He also founded Yayasan Alkoholisma Malaysia in the 1980s and was involved with the nation's first all-female drug dependents rehabilitation centre at around the same time. He also helped set up the first non-governmental organisation (NGO) for the awareness of HIV/AIDS in Malaysia and the AIDS Hotline, which later led to the development of the Malaysian AIDS Council. He has also spent many years doing street work. Nursing remains his biggest passion and he, together with the owner of the Home Nursing Providers (who wishes to remain anonymous), intends to provide affordable mobile nursing services for as long as they can. “I see mobile nursing as a major future in health service. The cost of medical fees will continue to escalate and anyway, hospitals are not places for recuperation. People, especially the elderly, are uncomfortable in hospitals.” Mobile nursing will also be important in Malaysia as very few doctors are willing to make house calls. Besides, many elderly patients need nursing care more than medical treatment. Mobile nursing provides follow-up supervision after a person is discharged from the hospital. It involves doing everything a nurse would do in a hospital setting but in the comfort of one's home. Says Yakob, “Mobile nursing is something beautiful if done nicely. To see a patient recover, ask you when you are coming again, and to see the family looking contented — that is something money can't buy. The feeling is irreplaceable, and that is our motivation.”
For further information contact:
Home Nursing Providers 0060378777202
www.hnp-mobilenursing.com
or nursing@hnp-mobilenursing.com
Tender Care Till the End
For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers may be just what they need. SARAH SABARATNAM writes.
WHEN my father's health began its inevitable decline in January this year after battling cancer for more than two years, the family immediately looked at options for nursing support at home. Caring for him had been manageable in the past but he was fast deteriorating and had become bedridden. We wanted to know how we could make him as comfortable as possible. We needed help with the physical aspects of caring for him when my sisters and I were at work and my mother was alone with him. We also wanted to be prepared for any medical eventuality. We found just what we needed in the form of the Home Nursing Providers. Not only were the staff willing to come to the family home in Rawang — which was out of the work zone of other palliative care providers such as Hospice, they were very professional and compassionate where nursing agencies were not. Private nursing agencies we called offered us limited options: we could take a nurse for a minimum of eight hours a day, or nothing. They were expensive and although we were willing to pay whatever it costs, we were not sure we needed someone for so many hours. There was no consultation or assessment involved; the nursing people seemed interested only in making a transaction. The people behind the Home Nursing Providers surprised us. Yakob Abdul Rahman W. Scholer, the outfit's managing director and nursing officer, turned up at our doorstep just a few hours after we called him. YAKOB: ‘While we may not be able to add days to a patient's life, we can add life to their days'. He told us he could only make an offer on the kind of service that would be provided, and its costs, after meeting the patient and making an assessment. He spent almost 20 minutes with us discussing my father's medical history, asking us what we felt we needed from his side, and what our concerns and fears were. Then he examined my father and gave us his assessment. After more discussions, he made suggestions as to how we could care for our father, what material we would need to make him comfortable, how to prevent bed sores, and how to care for his skin. He assigned us a nurse, at our request. She would come in for one to two hours a day, and help my mother wipe my father down and change him, check his blood pressure and pulse, change his dressings and do whatever else was necessary. He confirmed that it would be unnecessary to employ a nurse for eight hours. Although a nurse had been assigned to my father, busy Yakob continued to drop in regularly, to check on us, all the way from his office in Kelana Jaya. He never seemed in a rush and would spend time talking to family members, counselling, reassuring and preparing us for the inevitable. They charged only for what was necessary and based on what kind of nursing or care was provided. Everything was itemised and a daily log was kept. We found, later, they were less than four times as expensive as some of the nursing agencies we called. They promised round the clock availability. We could call them any time there was an emergency, or if we simply had a question. Yakob even gave us his handphone number. “In Malaysia, it is very difficult to get doctors to make house visits. We can fill in this gap,” he said. The Home Nursing Providers don't just provide nursing services for the terminally ill. The staff also work at rehabilitating patients that doctors have given up on. Wan Nor Gat Ismail, 77, is one such person. He had been bedridden for three months when Yakob was assigned to him in January this year. Pak Wan's wife, Kalsom Amir, 72, says that at that time, her husband was just tunggu mati (waiting to die). MAKING HOUSE CALLS: Yakob helping Abdullah with his exercises. Mobile nursing can help where the doctors leave off, relieving the stress of patients who would rather be at home. The doctors had found nothing wrong with him, despite keeping him hospitalised in Alor Star for a month. Yet he was fast deteriorating. He was constipated and had no appetite. Within a month he had lost almost 20kg. He could not go to the toilet himself. He hardly ate. He became incontinent. By New Year's Day, Pak Wan had been bedridden for three months. He was so skinny his dentures could not fit. And when they put him on the toilet bowl, he almost fell through the seat, for he had lost all the flesh on his rear end. But seven months since he first became bedridden, Pak Wan is on his feet, greeting us as we arrive in his daughter's house in Bukit Jelutong, smiling and proud of the fact that he shaved himself that morning. The transformation is attributed to Yakob's special touch. “My daughter discovered Yakob about four months ago,” says Kalsom. “Now my husband can walk and eat. He is going to the toilet himself. Yakob takes him to the park to exercise every day. His progress had been so good, we are thinking of going back home to Alor Star next month,” says Kalsom. The Home Nursing Providers provides mobile nursing services in the comfort of one's home. For families who want the best possible options of care for their loved ones — especially those who have been written off by doctors and hospitals, the services provided by the Home Nursing Providers are just what they need. “While we may not be able to add days to a patient's life, we can add life to their days,” says Yakob. He says that many people assume that as people get old or sick, they must become slow, lose their muscles and deteriorate physically. “This is not true. With some exercise, motivation and the right amount of nursing, they can improve so much.” A family member of another patient attests to this: “The doctors had given my father one week to live, but under their (Home Nursing Providers) care, he lived a month and even improved so much that for a while we thought he was going to survive.” The mobile nurses believe in early intervention and rehabilitation, unlike doctors who focus only on treating the illness and give very little attention to the physical, emotional and psychological needs of the patient. Besides, the longer a patient is kept in a hospital, the more sick he becomes. This is especially true of elderly people who find it hard to adjust to the hospital setting. Instead, mobile nursing can help where the doctors leave off. “It can save families a lot of money, and relieve the stress of patients who would rather be at home,” says Yakob. Mobile nursing is also a better alternative to nursing homes. “People who end up in nursing homes feel rejected, unwanted and a burden. They tend to go into depression and fall ill easily. Studies show their life span shortens dramatically because they have no purpose in life.” Yakob and his staff help nurse elderly people whose family finds it beyond their capability to look after. Or they can help make the days of a dying patient bearable, comfortable and free from unnecessary stresses. They provide necessary equipment such as oxygen compressors, ripple mattresses, hospital beds and cushions to prevent bed sores. They check on the person's blood pressure, sugar level, heart rate, eating habits and so on. They can install catheters and tend to dressings. Mostly, they are there for patients who are no longer in need of medical attention but in need of nursing. Yakob, who has had extensive experience in mobile nursing in Germany and had spent many years nursing in Malaysia, believes that mobile nursing has to meet two important criteria. Firstly, he says, there must be transparency. “The family of the patient must be consulted, involved and given decision- making power. Just like someone should be able to walk into a shop and choose what he or she wants to buy, the family must not be pressured. There are nursing agencies which impose on families very limited options.” Secondly, mobile nursing must be accessible and available to everyone in need of it. “A minimum service must be given irrespective of financial capabilities. The minimum would be to teach the patient's family how to do general nursing, and this can be done in a relatively short time to willing parties.” He says a lot of families want the best “but everybody should have a right to this best, according to their budget”. A complete one and half hour coaching and consultation, says Yakob, is only RM75 which is within the reach of an average income earner. “Mobile nursing is different from hospitals. You are not dealing with the patient alone but the whole complexity of a family setting. When there is more than one person, there is more than one idea, or opinion, or expectation, or emotional contact with the sick patient.” This is where he says mobile nursing, as provided by the outfit he runs, differs drastically from the hospital setting, or the standard of services provided by some nursing agencies. “Our nurses are taught to be sensitive. We give a clear picture of what can and cannot be done. We give the family options. Respect for the family has to be the highest criteria. They get the last say. I cannot impose my nursing experience or ideas onto the family. It is not acceptable. My duty is to show them options and consequences, and then they choose.” The patient too, if able, should be included in the decision-making process. Most families who have utilised the services provided by the Home Nursing Providers are struck by their compassion and commitment to their profession. The son of one of Yakob's patients says, “We are the lucky few that managed to get Yakob's full attention. He is such a knowledgeable person, caring and, of course, very dedicated. Sometimes I just wish there are more of him so that he can attend to my father's rehabilitation more often in a day. My father, Haji Abdullah Haji Shukur, is 90 and suffers from a paralysis due to a stroke some years ago. I wouldn't know what to do and how to care for my father without him and his nurses.” Note: The Home Nursing Providers Sdn Bhd is located in Kelana Jaya and can be contacted at 03-78777202 or through email: hnpys@streamyx.com. Visit its website at HNP-mobilenursing.com Nursing is Yakob's Passion YAKOB Abdul Rahman Wilhelm Scholer (right) first came to Malaysia in 1957 to join the Catholic Order of the Brothers' of Mercy who were running the Fatimah hospital in Ipoh. “I have been fascinated about Malaysia since my teenage years. I remember reading about the Sultanate of the Straits of Malacca which records the fights between the different States and their Sultans. “Later on, I came across several books about Asia. This part of the world fascinated me,” he said. When he had the option of going either to Brazil or Malaysia to work, he chose the latter. Since then, he has gone back to Germany several times to further his study and expand his experience. But he keeps coming back to Malaysia. He has previously worked with a mobile medical team during the emergency period in Ipoh, and was founding member and manager of the Yayasan Pusat Pertolongan in the 1970s which was Malaysia's first drug rehabilitation centre. He also founded Yayasan Alkoholisma Malaysia in the 1980s and was involved with the nation's first all-female drug dependents rehabilitation centre at around the same time. He also helped set up the first non-governmental organisation (NGO) for the awareness of HIV/AIDS in Malaysia and the AIDS Hotline, which later led to the development of the Malaysian AIDS Council. He has also spent many years doing street work. Nursing remains his biggest passion and he, together with the owner of the Home Nursing Providers (who wishes to remain anonymous), intends to provide affordable mobile nursing services for as long as they can. “I see mobile nursing as a major future in health service. The cost of medical fees will continue to escalate and anyway, hospitals are not places for recuperation. People, especially the elderly, are uncomfortable in hospitals.” Mobile nursing will also be important in Malaysia as very few doctors are willing to make house calls. Besides, many elderly patients need nursing care more than medical treatment. Mobile nursing provides follow-up supervision after a person is discharged from the hospital. It involves doing everything a nurse would do in a hospital setting but in the comfort of one's home. Says Yakob, “Mobile nursing is something beautiful if done nicely. To see a patient recover, ask you when you are coming again, and to see the family looking contented — that is something money can't buy. The feeling is irreplaceable, and that is our motivation.”
For further information contact:
Home Nursing Providers 0060378777202
www.hnp-mobilenursing.com
or nursing@hnp-mobilenursing.com
Quality of nursing in Hospitals
“Not what it used to be at hospitals”
I can only agree 100% with the statement made by N.O. of IPOH.
Sad to say this is not an issue pertaining to the G.H. of IPOH alone, but this “VIRUS” of ‘nursing negligence’ has spread all over the country and does not limit itself to the government hospitals only. The private hospitals are not less “infected by the Virus of nursing negligence” only that it is being done less obviously. I have been in Malaysia, with some interruption, since 1963. As head of a Mobile Nursing agency and currently still involved in the nursing field both in practice as well as in the teaching field,. I am regularly meeting the problem of nursing incompetence. The neglect of patients is so bad that some of the ‘nursing negligence’ are being regarded as “BIASA” particularly the development of bed sore. How are nurses to notice if a patient is endangered with the development of bed sore if the maid does all the cleaning and washing of the patient. Even when made aware of the existence of a bed sore development nurses would not inspect the area, but provide the MAID with Zinc oxide cream to apply onto the patient. If neither a nurse nor a doctor in a Hospital notices the development of necrosis on both heals of a patient, and claims that there is no antibiotic cream in the ward. Or a patient who has the mouth full of oral thrush and the nurse responding to the observation that she is awaiting the doctor instruction as to the intervention. I can only ask one question “On which planet is our nursing staff? What has happened? What sort of training do they get in the nursing schools? Are Nursing Schools just to provide nursing students with the academic know how to pass an examination or are they being motivated to become caring nursing professionals?
Of course it is unfair to generalize in giving the impression that ALL nurses are inadequate or incompetent. There are so many dedicated and conscientious nurses in both private and government hospitals. The concern is that there is a decline in nursing quality in general of which we all must be alarmed by. If only we acknowledge a deficit then we are also willing to make corrections.
The problem lies certainly also in the system itself. The higher the nurses climb in the nursing hierarchy, the less they are in contact with the patients. Resulting in the situation that very young and inexperienced nurses pass on whatever know how they have to the young trainees in a ward. So there is no surprise if “one blind leads the even more blind and the patients have to suffer the consequence.” Are we having to many highly qualified nurses in administrative positions where they have neither the time nor the opportunity to pass on and provide the practical bed-side training for the young nursing personnel?
Is it time to restructure the organizational system to provide highly qualified staff working on wards, may be rotating from wards to ward, and receive the same benefits as their counterparts in administrative positions (Nursing Directors etc.) There is a further problem: the field of nursing is still very much under the organizational and clinical domain of Medical Doctors. A paradox, as doctors are trained in medicine and not in nursing. Yet nurses will ask and wait for the doctors’ instruction as to a whole range of nursing procedures. Thisgives the impression that nurses are merely lackeys to the doctors, executing their instructions and follow their directives.
The Nurses, as well as the public are at a lost as to the role they are projecting.
Nursing is an independent profession. Nurses are working side by side with the doctors, and NOT under the doctors. The professional image is certainly part of the problems we are facing in the nursing profession. I am aware that a number of very concerned Nurses in our country realize the problem and work very hard, but without voicing on strategies and/or programs to address this issue. They will however only succeed as far as the relevant Organizational Systems are supportive and willing to review the structure of nurses Administration. The solution is in a concerted effort by ALL SECTORS related to the nursing profession.
In the meantime we can only appeal to the nurses with excellent skills to share their knowledge and the young one to take their profession serious and with pride and understand that improvement or decline of a patient’s condition lies very much in their hands.
“A hospital can survive some time without a doctor, but not an hour without a nurse”.
More information about MOBILENURSING/MOBILE DOCTOR contact:
Home Nursing Providers:
006 03-78777202
nursing@hnp-mobilenursing.com
www.hnp-mobilenursing.com
I can only agree 100% with the statement made by N.O. of IPOH.
Sad to say this is not an issue pertaining to the G.H. of IPOH alone, but this “VIRUS” of ‘nursing negligence’ has spread all over the country and does not limit itself to the government hospitals only. The private hospitals are not less “infected by the Virus of nursing negligence” only that it is being done less obviously. I have been in Malaysia, with some interruption, since 1963. As head of a Mobile Nursing agency and currently still involved in the nursing field both in practice as well as in the teaching field,. I am regularly meeting the problem of nursing incompetence. The neglect of patients is so bad that some of the ‘nursing negligence’ are being regarded as “BIASA” particularly the development of bed sore. How are nurses to notice if a patient is endangered with the development of bed sore if the maid does all the cleaning and washing of the patient. Even when made aware of the existence of a bed sore development nurses would not inspect the area, but provide the MAID with Zinc oxide cream to apply onto the patient. If neither a nurse nor a doctor in a Hospital notices the development of necrosis on both heals of a patient, and claims that there is no antibiotic cream in the ward. Or a patient who has the mouth full of oral thrush and the nurse responding to the observation that she is awaiting the doctor instruction as to the intervention. I can only ask one question “On which planet is our nursing staff? What has happened? What sort of training do they get in the nursing schools? Are Nursing Schools just to provide nursing students with the academic know how to pass an examination or are they being motivated to become caring nursing professionals?
Of course it is unfair to generalize in giving the impression that ALL nurses are inadequate or incompetent. There are so many dedicated and conscientious nurses in both private and government hospitals. The concern is that there is a decline in nursing quality in general of which we all must be alarmed by. If only we acknowledge a deficit then we are also willing to make corrections.
The problem lies certainly also in the system itself. The higher the nurses climb in the nursing hierarchy, the less they are in contact with the patients. Resulting in the situation that very young and inexperienced nurses pass on whatever know how they have to the young trainees in a ward. So there is no surprise if “one blind leads the even more blind and the patients have to suffer the consequence.” Are we having to many highly qualified nurses in administrative positions where they have neither the time nor the opportunity to pass on and provide the practical bed-side training for the young nursing personnel?
Is it time to restructure the organizational system to provide highly qualified staff working on wards, may be rotating from wards to ward, and receive the same benefits as their counterparts in administrative positions (Nursing Directors etc.) There is a further problem: the field of nursing is still very much under the organizational and clinical domain of Medical Doctors. A paradox, as doctors are trained in medicine and not in nursing. Yet nurses will ask and wait for the doctors’ instruction as to a whole range of nursing procedures. Thisgives the impression that nurses are merely lackeys to the doctors, executing their instructions and follow their directives.
The Nurses, as well as the public are at a lost as to the role they are projecting.
Nursing is an independent profession. Nurses are working side by side with the doctors, and NOT under the doctors. The professional image is certainly part of the problems we are facing in the nursing profession. I am aware that a number of very concerned Nurses in our country realize the problem and work very hard, but without voicing on strategies and/or programs to address this issue. They will however only succeed as far as the relevant Organizational Systems are supportive and willing to review the structure of nurses Administration. The solution is in a concerted effort by ALL SECTORS related to the nursing profession.
In the meantime we can only appeal to the nurses with excellent skills to share their knowledge and the young one to take their profession serious and with pride and understand that improvement or decline of a patient’s condition lies very much in their hands.
“A hospital can survive some time without a doctor, but not an hour without a nurse”.
More information about MOBILENURSING/MOBILE DOCTOR contact:
Home Nursing Providers:
006 03-78777202
nursing@hnp-mobilenursing.com
www.hnp-mobilenursing.com
Over caring or Under Nursing
“Over Caring or Under Nursing”
To anyone who reads this heading their first reaction will be “HOW”??, Contradictory? NO!
In the years of my professional work and especially since getting involved in mobile nursing, this apparent conflicting phenomenon disturbs me. Confirmed through a visit of a relative in a nursing home, where most of the people were fitted with a nasal tube and received liquefied nourishment.
Obviously this home was not specially for elderly persons who had a problem with swallowing, but rather an issue of convenience to the caretakers, (assisting a person by spoon feeding may be very time consuming).
This experience and that of other observations, brings me to the issue of drawing awareness of the public to the issue of what is correct and professional nursing.
Certainly not:
Over caring, a phenomenon that arises when a person is attended 24 hours by a “care taker“ which is being paid to take “good care” of the sick person.. From the point of view of the family, “we want to provide the best care”. However from a professional nursing concept it is wrong, because the patient will solicit the service of the “paid “ care taker and for all concerned unnoticed the sick person will not be motivated to start doing things for themselves but rely on the care taker do almost everything for him/her.
Thereby loosing very fast the competences and skills to help themselves. Experience has shown that, where the sick person gets only the complementary level of assistance the motivation to regain the former abilities is much greater than for those who have a special care taker. In the long run the developing of a mutual dependency, between that care taker and the sick, will reach a stage where the sick person has lost most of the abilities to do even basic functions and the family is in a stress situation, because sooner or later the financial burden becomes to great, yet the situation has become worse instead of improved. This is also observed in institutional settings, where the patient expects that everything is being doe for him. It is a well observed fact that recovery and regaining of abilities towards self help is greatly enhanced if the person is in his own home environment and fostered to increase his owns kills and abilities to cope with daily task to care for themselves, and is stimulated to pay attention to what is happening within his/her environment, grandchildren, pets, friends, family members etc.
Under nursing, is the other side due to lack of professional nursing. Obvious there is hardly anyone who does not want to provide the best “care” for the sick family member. However the motivation and good intention by it selves, does not compensate for the professional nursing.
A professional nurse needs 3 years of training before getting a certificate of competence, and many years of experience are needed to become skilled in dealing with sick people. And additional skills are required to work in a mobile nursing system providing service in a family setting. The most common problem arise out of lack of knowledge and experience in assuring improvements of the condition, and preventing worsening of the condition. To avoid the sick a lot of suffering and anxiety, the family distress, costly medical treatment and perhaps major hospitalization fees, professional nursing is needed, at least on an advisory level.
The most common problem arising out off:
a) Dehydration; Most elderly persons do not feel thirsty and will generally not ask for liquid, giving the impression that there is also no need for intake of liquid. In many cases of hospitalization of elderly there is always the symptom of dehydration in the forefront. This may result in renal failure, and a chain reaction of complicating problems. Many people have developed temporary “mental impairment” solely due to lack of liquid intake.
b) Improper intake of Medication: No one is fond of swallowing pills. Elderly persons have an aversion to pill taking, in particular when they are insufficiently informed of the working mechanism of the same and the consequences if they are not taken regularly. People like to see medications as a symptom reliever. “I don't need to take them today I am feeling very fine”! Elderly persons are forgetful, (particularly the short term memory) they may not remember if they have taken the medication or not, resulting in double intake or missing out of a doses. Either one may have, depending on the type of medication, severe consequences. Taking medication with liquid other than water, may result in impairment of the effect of the medication or cause avoidable intestinal complications
c) Bed sore: With sick persons who are temporarily or permanently bedridden or wheel chair bound, this is perhaps one of the most frequent problems encountered, yet in most cases avoidable. Simple aids and knowledge can prevent the same development and subsequent suffering and costly treatment to the sick person.
These are just a few of the problems that a family may encounter. In my training experience (of family nurses family members) I come across that care takers are often at loss as to what to do. Having outside nursing care may be too expensive and also infringing in the family setting.
The alternative is:
a) Professional nursing counseling with case assessment;
b) On the spot nursing coaching by experienced and examined nursing staff;
c) Attending of available training in coping with sick and or handicapped family members;
d) Soliciting professional nursing help, where and when needed, on a sporadic or regular basis as may be necessary or desired.
Conclusion:
We are steering to a situation where people become elder and live longer and this includes also more impaired (naturally due to aging) persons in our society.
"Modern medicine is as good as the surrounding supportive nursing care is available".
Fore professional MOBILE NURSING/MOBILE DOCTOR contact:
Home Nursing Providers
006 03-78777202
nursing@hnp-mobilenursing.com
www.hnp-mobilenursing.com
To anyone who reads this heading their first reaction will be “HOW”??, Contradictory? NO!
In the years of my professional work and especially since getting involved in mobile nursing, this apparent conflicting phenomenon disturbs me. Confirmed through a visit of a relative in a nursing home, where most of the people were fitted with a nasal tube and received liquefied nourishment.
Obviously this home was not specially for elderly persons who had a problem with swallowing, but rather an issue of convenience to the caretakers, (assisting a person by spoon feeding may be very time consuming).
This experience and that of other observations, brings me to the issue of drawing awareness of the public to the issue of what is correct and professional nursing.
Certainly not:
Over caring, a phenomenon that arises when a person is attended 24 hours by a “care taker“ which is being paid to take “good care” of the sick person.. From the point of view of the family, “we want to provide the best care”. However from a professional nursing concept it is wrong, because the patient will solicit the service of the “paid “ care taker and for all concerned unnoticed the sick person will not be motivated to start doing things for themselves but rely on the care taker do almost everything for him/her.
Thereby loosing very fast the competences and skills to help themselves. Experience has shown that, where the sick person gets only the complementary level of assistance the motivation to regain the former abilities is much greater than for those who have a special care taker. In the long run the developing of a mutual dependency, between that care taker and the sick, will reach a stage where the sick person has lost most of the abilities to do even basic functions and the family is in a stress situation, because sooner or later the financial burden becomes to great, yet the situation has become worse instead of improved. This is also observed in institutional settings, where the patient expects that everything is being doe for him. It is a well observed fact that recovery and regaining of abilities towards self help is greatly enhanced if the person is in his own home environment and fostered to increase his owns kills and abilities to cope with daily task to care for themselves, and is stimulated to pay attention to what is happening within his/her environment, grandchildren, pets, friends, family members etc.
Under nursing, is the other side due to lack of professional nursing. Obvious there is hardly anyone who does not want to provide the best “care” for the sick family member. However the motivation and good intention by it selves, does not compensate for the professional nursing.
A professional nurse needs 3 years of training before getting a certificate of competence, and many years of experience are needed to become skilled in dealing with sick people. And additional skills are required to work in a mobile nursing system providing service in a family setting. The most common problem arise out of lack of knowledge and experience in assuring improvements of the condition, and preventing worsening of the condition. To avoid the sick a lot of suffering and anxiety, the family distress, costly medical treatment and perhaps major hospitalization fees, professional nursing is needed, at least on an advisory level.
The most common problem arising out off:
a) Dehydration; Most elderly persons do not feel thirsty and will generally not ask for liquid, giving the impression that there is also no need for intake of liquid. In many cases of hospitalization of elderly there is always the symptom of dehydration in the forefront. This may result in renal failure, and a chain reaction of complicating problems. Many people have developed temporary “mental impairment” solely due to lack of liquid intake.
b) Improper intake of Medication: No one is fond of swallowing pills. Elderly persons have an aversion to pill taking, in particular when they are insufficiently informed of the working mechanism of the same and the consequences if they are not taken regularly. People like to see medications as a symptom reliever. “I don't need to take them today I am feeling very fine”! Elderly persons are forgetful, (particularly the short term memory) they may not remember if they have taken the medication or not, resulting in double intake or missing out of a doses. Either one may have, depending on the type of medication, severe consequences. Taking medication with liquid other than water, may result in impairment of the effect of the medication or cause avoidable intestinal complications
c) Bed sore: With sick persons who are temporarily or permanently bedridden or wheel chair bound, this is perhaps one of the most frequent problems encountered, yet in most cases avoidable. Simple aids and knowledge can prevent the same development and subsequent suffering and costly treatment to the sick person.
These are just a few of the problems that a family may encounter. In my training experience (of family nurses family members) I come across that care takers are often at loss as to what to do. Having outside nursing care may be too expensive and also infringing in the family setting.
The alternative is:
a) Professional nursing counseling with case assessment;
b) On the spot nursing coaching by experienced and examined nursing staff;
c) Attending of available training in coping with sick and or handicapped family members;
d) Soliciting professional nursing help, where and when needed, on a sporadic or regular basis as may be necessary or desired.
Conclusion:
We are steering to a situation where people become elder and live longer and this includes also more impaired (naturally due to aging) persons in our society.
"Modern medicine is as good as the surrounding supportive nursing care is available".
Fore professional MOBILE NURSING/MOBILE DOCTOR contact:
Home Nursing Providers
006 03-78777202
nursing@hnp-mobilenursing.com
www.hnp-mobilenursing.com
Bed sore and diabetic foot
bed sore of a diabetes patient
BED SORE:
World wide, is the population of older citizen rapidly increasing. This creates a whole rage of health problems directly related to aging. While the Health Science has developed into a more sophisticated, apparatuses oriented level of patient care, some of the basic knowledge’s of nursing has seemingly drifted in the background in the daily care of bed ridden patients.
As a result, do many patients not receive the required attention and care to prevent one of the most crininal nursing neglects = BED SORE.
As a result, do many patients not receive the required attention and care to prevent one of the most crininal nursing neglects = BED SORE.
Unfortunately, do many teaching institutes not pay enough attention to the aspect of development and prevention of bed sore, to the extend that many nurses believe that development of bed sores is “normal and unavoidable”. Few do understand that the development of bed sore is a neglect of patient care, and can be a criminal case.
In many countries this is becoming a source of worry and concern as criminal proceedings are not just causing a serious damage to the good image of competence of an Institute, but are also costing hugh sums of money in compensation and legal fees. Nurses can also be held personally responsible and eventually loose their licenses.
Bed sore’s is at least in 85% of all cases preventable.
Bed sore’s is at least in 85% of all cases preventable.
However to be able to prevent the development of bed sore one needs to have a comprehensive knowledge of the actual causes and circumstances that lead to the development of bed sores.
For treatment and management of bedsore/presure sore or
For treatment and management of bedsore/presure sore or
MOBILE NURSING/MOBILE DOCTOR please contact:
Home Nursing Provider
Home Nursing Provider
006 03-78777202
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