Physical Nursing Assessment

Physical nursing assessment is a systematic and organized approach in the techniques which requires a trusted relationship between the patient and nurse. A trusted relationship between both nurse and the patient is required because it can reduce the stress experienced by the patient while examining him/her physically exposed. If the nurse explains the things that is to be done physically and the reason for the physical examination, then the patient naturally get relaxed and cooperate with the nurse for the examination. Even though physical assessment enables the nurse to identify the condition more accurately, the focus is more on the responses of the patient to actual problems.

Physical nursing assessment is the initial step of the process as it provides basic foundation for the care plan in which the observations of a nurse is important in the estimation, intervention as well as evaluation phases. Both subjective as well as objective findings are included in this assessment. Objective findings are taken from physical examination and subjective findings are taken from health history as well as reviews of body systems. Subjective findings are relevant only when the patient is affected and some of the examples for subjective data are worrying, itching and pain. Objective findings are the findings of the observer or tested according to the accepted standards. Some of the examples of objective data are discoloration of the skin, reading of blood pressure and emotional outburst of the patient like crying.

Physical nursing assessment is used to get both mental and physical data of the patient. This kind of assessment helps the nurse to diagnose the problem accurately and thereby possible to plan the patient care. It helps the health care professionals to solve the problems identified. In order to obtain a more accurate evaluation of the patient, the nurse has to establish a good rapport with the patient. It is essential to explain the procedure of physical examination to the patient well before performing the examination. The nurse should obtain the verbal consent of the patient for the physical assessment.

The physical data of the patient should be confidential and the nurse should choose a place where other people cannot see or overhear the patient. The nurse should inform the patient that who all will see the recorded data. Avoid circumstances of unnecessary exposure of the patient by ensuring privacy of the patient by closing the doors and by draping the body using clothes. Special instructions should be communicated with the patient. Physical nursing assessment is performed by using certain basic techniques such as inspection, palpation, auscultation and percussion. Inspection is performed by visual examination and palpation means examining the patient by touching the body of the patient. Listening to the sounds produced by the body is known as auscultation. Percussion means tapping the body of the patient with fingers.

I Hate It Here, I Feel Like I'm in Prison!

That is always a wonderful thing to hear out of a resident's mouth, especially in the middle of a tour. I am, of course, being sarcastic. However it is pretty common. And rightfully so. We all think we've done our mom a wonderful justice by helping her move into an assisted living where she is getting the care she needs and is safe 24/7. That is always the intention, doing what is best for our loved one. So why would they feel this way? Well there could be many reasons but mostly it's the amount of change and how rapidly it happens.

The truth is they probably do hate it. Nobody ever imagines themselves to "end up" in an assisted living requiring help with caring for themselves. Let alone being cared for by strangers! They are grieving the loss of a home, their independence, their identity and dignity. That's not even mentioning their dream of how their "golden years" would be. I always tell families give them 90 days to adjust, especially if they are resistant at all to moving into assisted living.

The first 30 days you will get phone calls about everything from how awful dinner was to the crazy old man she saw in the hallway. And OH THE NOISE! "I hate it here, get me out of here." There will be complaints about the staff and how they do things or don't do things. It's an adjustment she is going from living alone or with you to living with 70 strangers. If your loved one needs any assistance with care, these first 30 days are so tough. Imagine having a stranger help you toilet, or shower. Of course they hate it. Change is difficult for everyone, but even more so for the elderly.

Usually by day 45 the phone calls to you are less and she is relying on us more for care. By this time mom has gotten to know the care staff and has finally settled in with her table mates. She has made some friends but she still wants to go home. She is "feeling much better now"and believes she can handle things at home again. You see she is doing so much better indeed. So you begin to think maybe going back home isn't such a bad idea. STOP RIGHT THERE. Why do you think she's doing better? Could it be because she is getting three meals a day, her medications are given in a timely consistent manner, and her apartment is being cleaned weekly? That would be a giant YES! Now is a good time to gently remind mom of that and if you need help ask a trusted staff member to help you with that conversation.

By day 90 there is usually no longer discussion about going "home" because she feels she is there. She knows the staff and their routines, she has friends and is involved in activities. Sometimes I even here "why didn't we do this sooner?"

The only time this isn't the case is with loved one's who have some sort of cognitive impairment. Change is particularly hard for people with dementia or the like. I encourage families to try their hardest to recreate the most familiar space to their loved one. Sometimes it's that simple. Sometimes it's a fight tooth and nail and when that happens we have to talk about possible relocation to a secure memory unit, especially if their loved one is going to leave the building to "go home". We never really know the degree of people's dementia or inability to care for themselves until they move into an assisted living. People are really good about hiding their inability to care for themselves or how much they don't remember, especially in their own environments.

In closing, the worst thing you can do for everyone involved is panic and second guess yourself. Remember there are two sides to every story and because she is telling you she hates it here there is a good possibility that she's exaggerating. Also remember she is your mother and she knows how to play the guilt card. She is telling you how she hates is meanwhile she is telling everyone else she loves it. That happens so many times. The best thing you can do is re direct her to call the care staff to take care of her needs. She has to be able to form a relationship of trust with the staff. I am not by any means saying to ignore your mother's complaints. I am just asking you to please don't expect the worst. You too have to trust us or else this relationship is not going to work.

Planning Ahead for Long Term Care Insurance Costs

The expense of insurance can be overwhelming for those who have not planned properly; starting early can help minimize the long term care insurance costs. As there are five types of long term insurance, choosing the type of care you want early can protect you from not having much of a choice down the road. By planning and selecting the type of insurance you receive, as well as when and where you receive it can help minimize your costs and maximize your benefits.

Consider: Partner Discounts

You may not be able to state with complete certainty whether or not your spouse or life partner will be around when you need long term care, especially if you are planning ahead significantly. But if you're married or in a long term relationship, it's worth considering partner discounts when you try to minimize long term care insurance costs. Many companies will offer a discount for partners and if one person needs more than their own benefit period, they can use some of their partner's benefit period.

Consider: Money Pool

With long term care insurance, you pay for a specific amount of money that you can draw from; your benefit term and your daily benefit amount will determine your money pool. Ideally, plan for an estimated amount you would need per day and the length of time you'd like to have access to the money. For example, a person could have a $250 daily benefit and a 6 year benefit period - this would mean they have access to $547,500. If when drawing on the insurance you use less than the daily benefit, the benefit period can be extended. Be aware, when you price long term care insurance costs, that where you live can greatly affect the rates available.

Consider: Inflation Protection

As long term care insurance costs continue to increase, inflation can be a real problem. Depending on the policy, you may have the options of no inflation protection, simple inflation protection, and compound inflation protection. Unless an individual is already a senior citizen, compound inflation protection is usually best since you may not use your benefits for 15, 20, or 30 years down the road. The compounded interest will help offset the increasing costs for your care.

Consider: Type of Coverage

Another decision you'll face is whether you want facility only or comprehensive coverage. Predictably, a facility only policy will cover those services performed while you live in a nursing or assisted living facility or hospice center. Comprehensive coverage will provide for services you receive in a facility as well as those in adult day care and home health care services. For many individuals, comprehensive coverage is a better choice as it allows more freedom. It is usually less expensive to get facility only coverage if you know you'll be in a facility. Some people determine their likelihood of facility living based on factors such as family support, other illness or disabilities, and so on.

Planning for long term care early in life does mean that you are making decisions and estimates with limited information that may change before you have to use your benefits. That said, starting early and having to reevaluate later is a much better plan than simply waiting too long. Earlier planning will help you minimize your long term care insurance costs.

Degrees of a Burn Injury

A burn injury can be a painful experience to go through. Not all burn injuries are the same and they can vary greatly in the amount of damage they cause. Some of them can be simple and easy to treat at home, while others will require immediate medical care. In the past there were not as many facilities that were specific to burn victims. Today there are more options for those that are burned and they stand a greater chance of surviving and healing. Each year there are thousands of burn cases with over 3,000 of them resulting in a fatality; a large decline when compared to earlier years. There are a number of types of burn injuries that can be caused from heat, chemicals, friction, cold temperatures, radiation and more.

One of the more common types of burn injuries it was is a first degree burn. This one is superficial for the most part and often includes a burning feeling and reddening of the skin. This type of burn can usually be easily treated without the need for medical service unless it is present on more sensitive areas such as the face. A second degree burn goes deeper into the skin, burning down through the epidermis to the dermis. This can leave blisters on the skin as well as a deep red color. A second degree burn on a more serious level is known as a partial thickness burn. A third degree burn damages all of the skin as well as the subcutaneous tissue below. Not only does it harm these areas, it can also reach the muscle underneath. This type of burn will without doubt need to be treated by a medical professional and failure to do so can cause further damage including infection. A fourth degree burn makes it through all layers of skin, damaging anything below including muscle, nerves, blood vessels, tendons and even bones. Medical care will be needed as fast as possible and this type of injury can cause serious injury including the need for amputation.

Along with the depth of a burn, the amount of the body affected is also considered when assessing how serious an injury is. While the human body is able to recover from many types of trauma, some burn injuries may require additional help such as a skin graft. A burn can harm the nerves, leaving the injured part to lose sensation and the ability to feel in certain areas. The ability to heal will be depending on the health of the current victim along with how serious their injury was. A burn can cause irreversible damage along with unsightly scarring. Those that are burned seriously will be in need of medical service to not only heal them immediately but continue to carry on the mending process. Those that are injured depending on the type of burn can be left with lifelong effects. If a burn went all the way through the skin, nerves in the area may never be able to fully repair and the skin in the area may be unable to naturally heal on its own either. Injuries do not only occur to the outside of a person. Hot gases can be breather in that singe the lining of the nasal cavity, throat and lungs. When a burn injury does occur, emergency medical treatment should be sought first and then an attorney later to help seek compensation for any expenses and damages.

Using Social Networking to Find a Senior Care Job

These days, the job market is more fiercely competitive than ever - and decent jobs aren't all that easy to find. Things are quite a lot easier for those who are looking for senior care jobs, but tracking down the right assisted living jobs still requires a bit of creativity and finesse. Putting as many different resources to work for you as possible is one of the best ways to track down the nursing home job that's right for you; social networking websites are something that every serious job hunter should use. Learn more about using social networking sites to find nursing home administrator jobs by reading on below.

Connect Through Facebook - It seems like everyone has a profile on Facebook nowadays. The site has become a valuable tool for connecting with others. As you search for a nursing home job, browse around on Facebook to make some important connections. Let your existing network know that you're seeking an RN job or another job in the field and ask them to pass your name along to others. You never know - you might just hit pay dirt!

Use Twitter to Spread the Word - Although you are limited to 140 characters or less, Twitter can be a savvy way to spread the word about your job search. Post your resume online, then use Twitter to send a link to it out to the world at large. Use hashtags and targeted keywords that relate to assisted living jobs; you might pique the interest of a human resources manager somewhere. Remember, if you post your resume on a non-secure site, make sure your email address is in a format where it won't get a lot of spam like changing the @ symbol to text - i.e. name -at- email.com.

Get Active on LinkedIn - Anyone who's searching for senior care jobs without an active LinkedIn profile is missing out on a lot of valuable opportunities. Create and maintain a current LinkedIn profile; try to connect with as many people within the industry as you can. The larger your network is, the easier it will be to find the RN job of your dreams.

Interact on Senior Care Blogs - There is a plethora of blogs out there that relate to the senior care industry in some way. Look for the most active ones and get in on the conversations that are happening there. Include a link to your LinkedIn, Twitter and Facebook profiles in your signature and you might just attract some interest.

Get Involved with Online Industry Networks and Associations - Track down reputable online networks or associations, like the National Senior Living Providers Network, and use them as social networking resources. It's just one more way to get your name out there, and it's another savvy way to make additional connections on other social networking websites. The more connected you are, the easier it will be to find topnotch nursing home administrator jobs and other senior care opportunities!

The Tragic Effects of Nursing Home Abuse and Neglect

It isn't always easy to recognize when a patient at a nursing home is being abused or neglected. Many of the perpetrators of this type of behavior know full well the risks and will take active measures to abuse their victims in such a way that no noticeable damage is apparent, or, when it is, being sure to keep it hidden from concerned parties that might find them out. Even in the case of neglect, active precautions may be taken to ensure no red flags go up.

Not only that, but elderly people are often already insecure about the fact that they are so much more vulnerable later in life and may be so embarrassed by their inability to take care of or defend themselves that they just keep the abuse to themselves. But the effects of nursing home abuse on an elderly individual are extremely serious and for that reason it pays to always be curious and aware of what is going on.

Here are some of the effects that can manifest as a result.

1. Physical Injury and Suffering

Of course, any abuse, whether it be physical mistreatment, sexual abuse, or even rough handling, can lead to physical injuries or suffering. These can be bruises. They can be bedsores. They can even be broken bones or internal injuries.

These physical manifestations of abuse are obviously the easiest to notice, but most abusers will be sure to do their best to hide them, and since they are the ones in charge of the patient's care, they often have the power to do just that.

2. Emotional Wounds

Just as damaging can be the emotional scars created by a victim who is unable to defend themselves, and this is equally true when the abuse is more emotional than physical. Elderly people are often experiencing a lot of difficult emotions later in their lives, and anyone who is a victim of abuse will obviously suffer emotionally. In some cases, they will become extremely depressed if someone does not intervene.

3. Financial Losses and Theft

If the abuser is taking the elderly person's money and pocketing it or diverting it into their own bank account-possibly even just using it to purchase themselves expensive things-the end result can be severe financial damage to the elderly person's accounts or estate. In some cases, if enough money is taken, the victim can end up in a bad enough financial position that they can no longer take care of themselves in these later years of their life.

4. Sickness and Disease

Whether due to unsanitary conditions in the nursing home, neglect, or a lowered immune system stemming from emotional suffering, abuse can even lead to sickness and disease. As patients are often already physically weak in their old age, this can be a dangerous problem.

5. Premature Death

In a severe enough case, physical abuse can result in death. And even in other cases where the emotional effects of the abuse get bad enough, an elderly person may suffer declining health and premature death as a result of depression and an inability to cope with what is happening to them. It's tragic that we even have to think of such things in this day and age, but unfortunately, we cannot always trust the people who we depend on to keep our families safe and sound later in life. It's of utmost importance to always be aware of what's going on-most importantly, communicate with your aging loved ones as much as possible and inquire about their care.

And if anything is suspect, do not hesitate to contact legal help to get to the bottom of things.

A Portable Alternative to Adult Day Care and Assisted Living

The quality of someone's life is very important. If your quality of life is not worth living whether from illness or life situations, every day is difficult. The concept of Adult Day Care Centers and Assisted Living Facilities and CCRC's are to create a healthy and happy quality of life as your body ages. I recently came upon an article in a healthcare Magazine for the elderly where a reverend has come up with a portable home for an elderly person to live in, placed in the backyard of the caregiver. The home has all the necessities for life plus a system to transmit an occupants vital health information to offsite caregivers.

I believe that this concept will become very popular. But I worry if caregivers will be the benefit. They will have piece of mind that they are "caring" for their elderly parent by housing them and keeping them out of a nursing home. But I wonder about the quality of life the person will have. The caregiver still needs to provide activities, transportation, and care as the person ages. The MED Cottage has a kitchenette, living room/bedroom and bathroom. I just hope this concept isn't misused and people are left alone 24 hrs a day there.

On a better note. I believe it will be popular for people who are still independent. They could still have a garden, share in family activities, have neighbors, and if they drive still remain independent. However, it is being marketed as an alternative to a nursing home. The average person doesn't understand that people in adult day care and assisted living are paying mostly for health care and the potential need for skilled nursing at some point in their stay. It will be interesting to watch this trend.