1.) medication – family does not seem to understand the need of Mr. Trosack taking the medication, think that diet alone will solve the problem. Needs to understand the reasoning behind both BP and diabetic medication. 2.) Diet – BP and diabetic diet. Expired food needs to be assessed 3.) ADL’s – pt just had surgery, stairs in house, how will pt get food, utilize restroom with small room, need bathroom assistance/safety features such as raised toilet seat, handrails in shower, handrails in hallway, etc
A.) medication – if do not take meds, will return to hospital. Elderly people often forget, may overdose, someone should administer medications or put them in a M-S pill container for him. Be sure to teach about postural hypotension due to BP med. (check this)
Diet – must learn to adapt to low sodium diet to manage BP and diabetic ADA diet to manage diabetes
ADL’s – need to ensure basic needs are met, will be following surgery so will be more difficult to pt to get around that he is used to. If someone can help shop for him and get basic needs (bathroom, kitchen supplies, etc) that will ensure pt has adequate supplies necessary for living.
1. Social worker/case manager – set up home care help, set physical therapy to be started, get medical supplies ready for the household (walker, wheelchair, shower seat) 2. physical therapist – help with rehab of hip, assist with ADL’s as well 2A. RN with nurse aid – oversees care of pt and teaches disease processes, dispenses meds, nurse aid – assist with ADL’s/cooking, getting supplies
3. Stairs at home – difficult for post-op patient, and if pt does not want any assistance, if refuses – unable to move around, complete ADL’s, will not be able to eat – will need to consider placement if continues to refuse assistance, no elevator
Possibility of non-compliance with meds – unhappy with having to take the “darn” medications, so pt may refuse to take meds...