For your Commitment and Care to their Service Users within the Community.
Falls & Pressure Area Care
Please be aware of the importance of reporting the above to your local office Nurse Manager. A phone call or email will suffice as we will need to keep a record. If you are unable to contact your nurse manager, please contact the office and speak to another member of the team.
Pressure ulcers, also sometimes known as bedsores or pressure sores, are a type of injury that affects areas of the skin and underlying tissue. They are caused when the affected area of skin is placed under too much pressure.
Pressure ulcers can range in severity from patches of discoloured skin to open wounds that expose the underlying bone or muscle. Pressure ulcers develop when a large amount of pressure is applied to an area of skin over a short period of time. Or, they can occur when less force is applied but over a longer period of time.
The extra pressure disrupts the flow of blood through the skin. Without a blood supply, the affected area of skin becomes starved of oxygen and nutrients. It begins to break down, leading to the formation of an ulcer.
Healthy people do not get pressure ulcers because they are continuously and subconsciously adjusting their posture and position so that no part of their body is subjected to excessive pressure.
However, people with health conditions that make it difficult for them to move their body often develop pressure ulcers. In addition, conditions that can affect the flow of blood through the body, such as type 2 diabetes, can make a person more vulnerable to pressure ulcers
Pressure ulcers can be unpleasant, upsetting and challenging to treat. Therefore, healthcare professionals use a range of techniques that are designed to prevent pressure ulcers developing in the first place. These include:
· regularly changing a person's position
· using equipment, such as specially designed mattresses and cushions, to protect vulnerable parts of the body
Falls in an ageing population
Falls have a multifactorial aetiology and numerous risk factors can be identified. These are diverse and can include such risks factors as
· Living Alone
· Limitations in mobility and undertaking activities of daily living without support
· Polypharmacy. Those who are taking more than 4 different types of medication have been shown to be at an increased a risk of falling
· Environmental hazards such as loose-fitting rugs, uneven floors and inadequate lighting
· Stairs without supporting handrails
There are ways in which you can support the client you are caring for and help reduce the risk of them having a fall Key Tips:
· Encourage the person to keep active and do some exercises daily
· Encourage a healthy diet which will improve overall health
· Remind the person to have their hearing and eye health checked regularly
· Remind the person & their family to have the persons medications checked and reviewed every year
· Encourage goof foot care, and recommend wear well fitted shoes and slippers when at home
· Ensure your clients home is safe by removing tripping hazards and encourage same when you are not on your work shift
· Encourage your client to have social contacts where possible and take time for friends
Parkinson's Disease Care
Parkinson’s disease (PD) is a progressive, neurological disease that mainly affects movement but can also affect cognition. Parkinson’s disease results from the destruction of nerve cells in a part of the brain called the basal ganglia.
Different parts of the brain work together by sending signals to each other to coordinate all of our thoughts, movements, emotions, and senses. When we want to move, a signal is sent from the basal ganglia to the thalamus and then to the cerebral cortex, all different parts of the brain. Nerve cells in the brain communicate by using chemicals. A chemical (neurotransmitter) called dopamine is produced in a group of cells called the substantia nigra and is essential for normal movement. When the cells die, they can no longer produce and send dopamine, so the signal to move doesn’t get communicated. By the time a person starts to experience motor symptoms of Parkinson’s, they’ve already lost approximately 50% of their dopamine producing cells. People may experience non-motor symptoms from loss of other neurotransmitters up to ten years before motor symptoms are noticed.
All persons with Parkinson’s do not develop the same symptoms, and any symptoms that do develop may change over time as the disease progresses. People will experience both motor and non-motor symptoms. Typically, PD motor symptoms start on one side of the body, and over time may progress to both sides. Often, one side is more affected than the other. The primary symptoms most commonly associated with Parkinson’s disease are:
· Tremor: Not all persons with PD develop tremor, but this is a common symptom. The tremor is described as a “pill rolling” action of the hand/fingers, usually most pronounced at rest, and may lessen with action, or movement. Tremor often starts on one side of the body—usually with the hand—but may also involve the arms, feet, legs, and chin.
· Rigidity or stiffness: In addition to making movement difficult, stiffness can also cause muscle aches. This symptom often is initially attributed to arthritis or pain syndromes, and persons often seek medical attention for “frozen shoulder” symptoms or “tennis elbow” and other orthopaedic complaints.
· Slow movement (bradykinesia), loss of movement (akinesia): Symptoms present with a decreased arm swing on one side, or decreased ability to perform usual motor tasks at usual speeds. Those affected can lose the ability to make normal facial expressions, appearing “mask-like” to the person they are talking with. Family and friends may comment that the person smiles less or appears disinterested when in fact they are unable to make the facial muscles move in ways to help express what they are feeling.
· Balance and walking problems: Initially persons have difficulty walking at normal speeds or may find it difficult to fully lift a leg, causing the foot to “drag” behind the other foot. Or, they may take unusually small steps to move forward or use several tiny steps to turn around. Eventually postural problems result in a stooped torso with a noticeable shuffling gait. The resulting body imbalance can cause the person to stumble or experience near falls. The person may no longer instinctually reach their arm out to “break” their fall, putting them at greater risk for injury. Most people do not develop postural problems until many years after they have been diagnosed.
Some individuals also experience episodes of “freezing” when they cannot move for several seconds or minutes. This is most common when they are approaching a doorway or other contained or small space.
When you're a caregiver for someone with Parkinson's disease, some days you'll need to help them with daily tasks. Other days you just need to give them enough time to do them on their own. This checklist can make life easier for both of you.
Grooming · Make it easy for them. Try an electric toothbrush if their hands or fingers are stiff from Parkinson's. If you help with flossing or brushing, try not to touch the back of their tongue, to prevent their gagging. Keep a small towel handy if drooling is an issue.
· An electric shaver may make shaving easier. After shaving, have them use lotion instead of aftershave, which may be too harsh.
· For safety and comfort, use the shower, if possible. Tub baths can be a falling hazard.
· While they are bathing, have them sit on a shower stool, use a hand-held showerhead, and hold a grab bar.
· Wrap them up in an absorbent terry cloth robe after bathing. Then they don't have to dry themselves off with a towel.
· Make sure clothes are easy to put on, such as pants with elastic waistbands, bras that hook in front, and tube socks instead of dress socks. Skip pantyhose and clothes that pull on over the head. If favourite clothes have buttons, replace them with Velcro.
· Avoid shoes with rubber soles. They can cause tripping.
· Make dressing simple. Lay out clothes ahead of time, in the order they like to put them on. Offer dressing aids like buttonhooks or long-handled shoehorns.
· Let them dress themself as much as possible. Suggest that they sit down and dress on the side most affected first.
· Serve fibre -- like whole grains, bran cereals, fruits, and vegetables -- to prevent constipation, a common Parkinson's issue. If they are used to a low-fibre diet, add fibre slowly.
· Serve a calcium-rich food at least three times a day to prevent osteoporosis. This is a special concern with a person with Parkinson's, because falls that can lead to fractures are more likely. Dairy foods like cheese and vitamin D-fortified milk and yogurt are good choices.
· The Parkinson's drug levodopa is absorbed best on an empty stomach. Protein can decrease its absorption. So, space out proteins so they are served after they take their medicine, which may be every 3-4 hours.
· If they have trouble swallowing, fix moist, soft foods. Avoid foods that crumble easily, like crackers. Thick drinks, like protein shakes, are also easy to swallow. If eating is tiring, fix smaller meals more often.
· Don't let their symptoms discourage participating in activities. Specially adapted tools are available to help with things like holding a paintbrush. Their occupational therapist can also suggest strategies. If some hobbies become too hard, like playing a musical instrument, go to a concert or listen to music instead.
· Try relaxing activities to reduce stress, which can make symptoms worse. Listening to music and relaxation guided imagery may help ease tremors. You can learn guided imagery from books, CDs, or DVDs.
· Besides the daily exercise that their doctor probably suggests, urge them to exercise their face muscles, jaw, and mouth. Sing or read out loud (using big lip movements) or make faces.
The hands-on daily tasks of caregiving can be hard for both of you. But they also bring you together. As much as possible, focus on your client can do. Taking part in their own care and enjoying hobbies will help them enjoy life more.
Below are some useful websites if you would like to learn more about Parkinson’s
Myhomecare are excited to announce that we will shortly be changing our database system from Nursebuddy to One Touch Health. expected date will be November 9th 2020 This is great news for Stakeholders, Staff (Internal and External) and Clients. Some of the benefits included are :
· eDocument Management & File Sharing
· Data Protection & Compliance
· Financial Reporting – comprehensive reporting available
· HR Management- manage Holidays & Qualification
· E-health management - Assessment Forms – build our own company electronic forms
· A client should never be discussed in the presence of another person (client, family member or staff member) that is not directly involved with that client’s care
· If you need to talk to a colleague about a client (and your colleague is directly involved in client’s care), please use initials and not client’s name eg Mary Kelly would be referred to as MK. Ensure your tone and words are professional and respectful.
· If you are no longer working with a client, you have no access to that client’s information or current care status. Your colleagues cannot tell you how the client is doing.
· All documentation in the client’s home have their name, date of birth and client ID attached to the document. These can never leave the house or be brought to another client’s house. This would be breach of confidentiality and can cause mix up between clients’ information and result in serious harm and or disciplinary action.
· WhatsApp groups set up by staff can be useful tools when helping each other out with days off or other issues related to rosters and shifts, however clients can never be mentioned in these chats as their information is highly confidential.
· Remember to put your client in focus at all times. Always involve your client in all conversations and in all care that is being provided
Should you have any concerns or need to ask any questions around your role in confidentiality please contact your local nurse manager.
Your cooperation in utilising the new system will assist us in a seamless transition from nursebuddy. Thank you.
Refer A Friend 💶
We have a referral scheme in operation – if you refer a Nurse to us and they are activated - a fee of €150 will be awarded to the referrer (when the nurse has worked 120 hours with us)