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
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