Nursing Home versus Home Nursing

Nursing Homes versus Home Nursing!

The controversy of sending the sick and or aged to a nursing home is perhaps as old as nursing homes exist.

While there may be many reasons for people to send a family member into a nursing home/old folks home there are equal number of reasons not to fall for a quick and "comfortable solution".
Let us look from a client’s point of view what it means to be sent to a nursing home.
First and foremost such a person, if still mentally alert, must feel to be deposited, discarded by the family and those she/he has been sharing their lives in the past. It must be assumed that in most cases it is the children who will make such a decision. These are the very same persons who have for all their lives benefited from the care and concern of the now elderly and needy family member.
I wonder whether the persons who make such a decision have ever considered how they would feel, if in the future their children or grandchildren would ‘discard’ them.
Have they ever taken time and contemplate what the person would feel once deposited in a nursing home?
I guess that most people do suppress any thinking in this direction. They just feel that the needy person becomes a burden and since she/he is no more "productive" is ready to be discarded or disregarded.
In the many visits I have made in nursing homes I have observed only one prevailing condition. That was "APATHY and DEPRESSION". It is not surprising, therefore, that about 50% of nursing cases sent into nursing homes pass away within the first 6 months

Apathy and loneliness are the main triggers for depression. Depression in return reduces the immune system. A low immune system makes subjects the person to get infected easily and even a simple cold will be enough to cause the final journey (death). What reason has a burden, discarded, useless, problem-creating and money consuming old and sickly person to fight for?
Where has the filial concern at one time the trade mark of Asian families gone? It has been sacrificed for the money and convenience of those concerned.
I am not intending to go into the conditions that exist in most nursing and old folks homes particularly those run on a commercial basis.
But anyone who has visited some of these homes would have noted that they do not meet with the minimal standard of humanity, respect and dignity.

For sure there are such medically complicated cases where it might be very difficult to keep a person in the family home setting. However these cases should be placed in medical and nursing homes where they can be attended to in a professional and
competent manner. I guess that the percentage of such severe medical conditions is below 5% of all nursing cases.

However in my experience in more that 10 years of home nursing/mobile nursing has shown that with proper professional and caring teams anyone can be attended to in their own home setting.
Even comatose patients with tracheotomy can be managed in the family setting provided the family is willing to cooperate and give the necessary support.
What happened to a person who is "comatose"? Does he still register the surrounding? No serious scientist dares to make a conclusive statement on this matter. However my professional experience has shown many a time that people were making clear signs on stimulations by the sound of a family member, a close friend, and/or certain melody of which the person was familiar with.
It is not unusual that even doctors in the hospital advise the family to look for a nursing home instead of looking at the option of caring for the patient in their own home setting with the available mobile home nursing.
More people grow older and are more likely to become nursing dependent at their final stage of life. Home nursing/mobile nursing should be the first option for anyone to be considered. Nursing homes should be the last option and be left for the absolutely difficult cases.
Mobile nursing which is able to provide any amount of support from simply giving a bath to a 24 hours general or medical nursing care is the correct and appropriate way of managing those who have spent their whole life being concerned about our welfare.
"Let us treat our beloved the same way we want to be treated when we grow old and dependent".

For further information about MOBILE NURSING or MOBILE DOCTOR contact:

Home Nursing Providers Tel +6 03 78777202

nursin@hnp-mobilenursing.com

www.hnp-mobilenursing.com

MOBILIZATION OF STROKE PATIENTS

WHAT IT NEEDS TO DO SUCCESSFUL MOBILIZATION OF STROKE PATIENTS
A lot of times the need of people in the category of Golden Age is beyond the understanding or comprehension of other people. We often tend to forget that reaching the golden age has one‘s own afflictions and problems. These are inherent due to the age span with which goes for some more for some less complication directly related to ageing.
However a considerable number of people also tend to suffer secondary health problems and these are particularly related to strokes. I guess getting a cerebral stroke is to some even more scaring than to get a cardiac infarct. When a cardiac infarct ends up in survival well and good, if not it does not leave behind much to be worried. Unlike a brain stroke, where the chances of survival are much better yet the short and long term consequences are difficult to predict. One of the most common side effects would be paralysis of one or more limbs. Depending on the location of the stroke in the brain speech might also be affected. The scariest form of stroke is perhaps a stroke affecting the brain stem resulting almost always in severe or total paralysis.

The damage to the brain depends on the area affected and the most crucial factor is how soon the patient can receive correct treatment in a hospital. Those would be the main determining factors of the damage to the brain and subsequently to the handicap experienced.
To a great extent paralysis can be reverted. This however depends very much on the time frame of mobilization therapy after the patient has been stabilized. The sooner appropriate therapy is initiated the greater are the chances for recovery.
To understand how the recovery works we have to understand what is really appending to a patient with a stroke.
Stroke / Brain Attack

What is stroke?

Stroke, also called brain attack, occurs when blood flow to the brain is disrupted. Disruption in blood flow is caused when either a blood clot blocks one of the vital blood vessels in the brain (ischaemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (haemorrhagic stroke).
The brain needs a constant supply of oxygen and nutrients in order to function. Even a brief interruption in blood supply can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen supply. The area of dead cells in tissues is called an infarct. Due to both the physical and chemical changes that occur in the brain with stroke, damage can continue to occur for several days. This is called a stroke-in-evolution.
A loss of brain function occurs with brain cell death. This may include impaired ability with movement, speech, thinking and memory, bowel and bladder, eating, emotional control, and other vital body functions. Recovery from stroke and the specific ability affected depends on the size and location of the stroke. A small stroke may result in only minor problems such as weakness in an arm or leg. Larger strokes may cause paralysis (inability to move part of the body), loss of speech, or even death.
According to the National Stroke Association (NSA), it is important to learn the three R's of stroke:
Reduce the risk.
Recognize the symptoms.
Respond by calling (your local ambulance service).
Stroke is an emergency and should be treated as such. The greatest chance for recovery from stroke occurs when emergency treatment is started immediately.
Stroke is the third largest cause of death, ranking behind diseases of the heart and all forms of cancer. Strokes kill more than 158,000 Americans each year. About 5.5 million US adults live today with the effects of a stroke.

IF BRAIN DAMAGE TAKES PLACE, HOW CAN A PERSON RECOVER?
That's a good question! The brain is a remarkable organ. When the blood flow is cut off, new pathways can take over and supply the blood to that damaged area. Also, the brain can make compensations. One area will take over the functions that were previously handled by a different area. Remember, people can and do recover from a stroke!

WHAT ARE THE STEPS OF RECOVERY FROM A STROKE?
Usually, recovery happens in phases. It takes place over a period of time that can vary from a few weeks to a few years. Every stroke is different and the extent of damage varies. Below are the general phases that a stroke patient can expect to go through.

TREATMENT FOR THE ACTUAL STROKE- This begins when a person first enters the hospital. Doctors will determine the type of stroke and will provide the appropriate treatment. This may consist of drugs to break up clots and thin the blood or surgery to repair a broken blood vessel. Treatment is aimed at preventing another stroke from taking place and limiting the amount of brain damage that occurs.
RECOVERY- After a stroke, some spontaneous recovery takes place for most people. Abilities that may have been lost will begin to return. This process can take place very quickly over the first few weeks, and then, it may begin to taper off.
REHABILITATION- This phase usually takes place while the patient is still in the hospital. Various therapists and specialists will work with the stroke victim to bring back lost skills. This can be a very frustrating time for the patient as they become aware of their limitations from the stroke. Oftentimes, this is the period where anger or depression can set in. It's good to remember that with proper therapy, many or most skills can be relearned.

RETURNING TO THE HOME ENVIRONMENT-
This can be a very exciting time, but adjustments may have to be made. Some of the adjustments might be temporary or some may last for a lifetime.
For the stroke victim, simple tasks such as tying shoes or fastening pants can be difficult. These are easy to remedy. Velcro shoes and drawstring pants can be worn. Other issues may not be as easy. But take courage. There will be many experts to ease this transition.

In my experience the most crucial aspect is to develop a trust relationship between the therapist and the patient. The greater the trust relationship between the therapist and the patient the greater the chances of progress. While the techniques play a vital role in the recovery process, the cooperation between patient and therapist is the most crucial factor. The therapist is not merely an executer of certain limb movements and contractions of muscles; he is the stimulator, motivator and source of confidence.
It needs also to be understood that the approach to each client has to be adapted to his/her personality. Very important is the knowledge of biography of the patient. Basing on the patient’s interests, hobbies etc. motivation can be initiated.

Motivating the client might be initially the most difficult part of the patient management. Without a personal goal that is to be achieved little success can be expected. What does that mean in practice? As much as the stimulation of the limbs is important so is the continual stimulation in motivation which is a crucial necessity. That is why by merely attaching the patients to machines and instruments which move the limbs without intensive mental contact with the patients is of little benefit. The therapist primary objectives must be the constant motivation and giving feedback to his client. This includes the knowledge of how a stroke affects a patient in his/her day to day physical and mental state.
Only when all of these aspects are being taken in consideration the therapist will be able to provide a basis for successful mobilization.

WHAT ARE SOME OF THE EFFECTS FROM A STROKE?
Again, this will depend on which area of the brain is affected. Some common after-effects of a stroke are:
· Paralysis or simple weakness on one side of the body. Remember, this will be the opposite side of the body from which the stroke occurred.
· Difficulty with speech.
· Trouble with swallowing.
· Difficulty with urination.
· Balance and coordination problems.
· Problems with cognitive functions - the stroke victim may have memory problems or may have difficulty following directions.
· Fatigue
· Emotional upsets - these can vary from depression to bouts of spontaneous laughter.

WHAT ABOUT LONG-TERM DISABILITIES?
This can happen. It depends on each individual. Some strokes are mild and will result in complete recovery. Others are severe and will produce lingering problems.

CAN I PREVENT A STROKE FROM OCCURRING?
There are things that you can do to minimize your risk of having a stroke. Many strokes are caused by fatty deposits that reduce the blood flow to the brain. A proper diet, coupled with regular exercise, can keep your body strong and healthy.
Also, there is research that strongly suggests that consuming aspirin and vitamin E on a regular basis may help to prevent ISCHEMIC strokes. The vitamin E keeps the blood thin while the aspirin lowers the clotting ability of the blood. The drawback to this type of preventative course is that it can cause a small number of HAEMORRAGIC strokes. For many people, this type of prevention out weighs the risk. Remember, most strokes are ISCHEMIC in nature.
Do talk with your doctor before you undertake any type of self-treatment. This type of therapy is not appropriate for everyone.

FINAL THOUGHTS
A stroke can be scary, but recovery can and does take place. A positive outlook is one of the most useful tools during the rehabilitation process.
This does include also the environment of the patient. It is not uncommon that relatives and close friends, out of ignorance and pity, consolidate the negative mental state of the affected person. Here too the therapist has a role to play and influence the environment and to be couscous of their comments and impressions on the patient.

"A person will recover as much as SHE/HE sets the goal and believe in it".

For more information about "mobilization/rehabilitation" or MOBILE NURSING/MOBILE DOCTOR please contact:

Home Nursing Providers, Tel: 006 0378777202 or

nursing@hnp-mobilenursing.com

http://www.hnp-mobilenursing.com