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Care of the Long-Stay Elderly Patient by Michael J. Denham (auth.), Michael J. Denham (eds.)

By Michael J. Denham (auth.), Michael J. Denham (eds.)

Since the 1st variation of this booklet was once released there were massive alterations in carrying on with care. NHS nursing houses were created, fanatics have constructed new projects, and makes an attempt were made to enhance attitudes. the hot White Paper on group Care is probably going to speed up the move of huge numbers of aged sufferers from long-stay health center beds to private-sector lodging: a movement usually followed through a lot anxiousness approximately criteria of care. even though healthiness experts stopover at inner most nursing houses and observe the nationwide organization of overall healthiness experts' criteria to them, anxieties proceed. regrettably for the sufferers who stay in sanatorium, many healthiness gurus look reluctant to use those comparable criteria to their very own long-stay departments, because many might fail abysmally. The 1987 annual document of the health and wellbeing Advisory carrier (see bankruptcy three) provides a damning indictment of the care given to previous humans: a contemporary assessment of twelve consecutive HAS studies on companies for older humans in hospitals indicates that long-stay wards continually provided environments which have been not able to provide privateness, homely atmosphere, own area and possessions or sufficient furnishings. within the twelve districts there has been now not one entire customized garments carrier. 1/2 the reviews commented at the loss of effec­ tive administration of continence. Catering used to be frequently supplied in response to the wishes of the establishment instead of these of the resident patients.

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The consultant who visits the traditional unit regularly will be able to assess the clinical care of the patients and the ward environment as well as the Differing models of continuing care and their medical input 39 morale and attitudes of the staff. He will thus have the knowledge to work with the nurse-manager for the elderly to ensure that good standards of care are maintained or improved. This may be achieved by using staff/patient questionnaires to assess job satisfaction (Raphael and Mandeville, 1979; Green, 1988), assessing and using achievable standards (Davies, 1986; King's Fund Project Paper No.

The patient's age Many patients in continuing care are elderly. However, their age plays little part in the decision to give treatment or to withhold it. Age per se is not a bar, for example, to the insertion of pacemakers. Elderly people in the state of some dependency must not be denied the benefits of modern medicine because of their age (Fox, 1987). 34 The physician and the continuing-care patient Conclusion The decision to treat or withhold treatment must be based on an unhurried, thoughtful, responsible, sensitive judgement made after considering all the relevant information obtained by members of the multidisciplinary team.

Junior nursing staff may be afraid to take any risks with patients in case of falls resulting in injury and accusations of negligence (Health Advisory Service, 1987). For example, physical restraints or tilt-chairs may be used to prevent falls, but these limit a patient's quality of life and should not be allowed except in very special circumstances. If they have to be used, the restraints should be removed at least every two hours when range of movement, skin care and change of position are provided (Wells and Adolphus, 1987).

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