8/8/2019 Merawat Lansia Di Rumah
1/30
HOME CARE OF THE ELDERLY
8/8/2019 Merawat Lansia Di Rumah
2/30
Tujuan pembelajaran
• Tipe kunjungan rumah
• Indikasi kunjungan rumah
•
Saisik kunjungan rumah• !eunungan"kerugian
• #erlengkapan
•
#engkajian lansia• Isu keselamaan
8/8/2019 Merawat Lansia Di Rumah
3/30
Tipe kunjungan rumah
• Saki
keika pasien mengalamikesakian"kegagalan$ungsi akiba pen%aki
kr&nis aau aku• #r&ses
kemaian"meninggal
pera'aan H&spi(e)dukungan kehilangan)pengumuman kemaian)kunjungan dukunganangg&a keluarga %angdiinggal
8/8/2019 Merawat Lansia Di Rumah
4/30
Tipe kunjungan rumah
• #engkajian
Dilakukan unukpasien %ang mungkinaau idak mungkin
menerima pela%anankesehaan di rumah*
#emeriksaan +sik)e,aluasi keamanan
rumah) e,aluasikeselamaan pasiendapa dilakukan padaberbagai jeniskunjungan*
8/8/2019 Merawat Lansia Di Rumah
5/30
T%pes &$ H&me -isis
• H&spial $&ll&'.up
Ma% help & pre,en/b&un(e ba(k0 &
h&spial premaurel%*Helps & assure hahe paien isre(ei,ing all &$ he&rdered supplies)ser,i(es) andadhering &medi(ai&ns(hedules*
8/8/2019 Merawat Lansia Di Rumah
6/30
Indi(ai&ns $&r H&me -isis
• An% (&ndii&n (reaing ph%si(alimpairmen &r limiai&n &$ m&bili%1La(k &$ ransp&rai&n
• Caregi,er burden (&n(ern•
Suspe(ed elder abuse &r negle(• #&l%pharma(% &r medi(ai&n
(&mplian(e issues• Failure & hri,e"gagal ugas
perkembangan• Re$usal & keep &2(e ,isi
app&inmens• Re(en his&r% &$ $alls a h&me• #s%(hiari( illness &r beha,i&rall%
di2(ul
8/8/2019 Merawat Lansia Di Rumah
7/30
Saisi(s
• L&' $re3uen(% &$ h&me,isis is due &4
5*De+(is in nurse
(&mpensai&n $&r ,isis6*Time (&nsrains
7*#er(ei,ed limiai&ns &$e(hn&l&gi( supp&r
8*C&n(erns ab&u risk &$liigai&n
9*La(k &$ nurses raining ande:p&sure
;*C&rp&rae and indi,idualaiudinal biases
8/8/2019 Merawat Lansia Di Rumah
8/30
Saisi(s &n H&me HealhCare
•
8/8/2019 Merawat Lansia Di Rumah
9/30
Saisi(s &n H&me HealhCare• 9.5>= &$ paiens in a primar% (are
pra(i(e re(ei,e h&me healh (are*
•
7>=? &$ paiens age @9 &r &lderre3uire a leas &ne h&me healh (are,isi per %ear*
• 6= &$ h&me (are paiens re(ei,edph%si(ian h&me ,isis*
8/8/2019 Merawat Lansia Di Rumah
10/30
Ad,anages
• Impr&,ed healh (are hr&ugh he re,ealing&$ unkn&'n healh (are needs
• Abili% & assess he en,ir&nmen 'hi(h (an
lead & design and implemenai&n &$ h&me.based iner,eni&ns ha pre,en $alls and&her sel$.injur%
• Insigh in& ps%(h&s&(ial issues
• Enhan(emen &$ nurse.paien relai&nship
8/8/2019 Merawat Lansia Di Rumah
11/30
Ad,anages
• H&me.based assessmens in(rease he pr&spe(&$ elderl% paiens remaining a h&me*
• Assessmens are d&ne in $amiliar surr&undings
• OT) #T (an ail&r rehab &a paiens h&me
• Burses rep&r a higherle,el &$ pra(i(e sais$a(i&n
han h&se 'h& d& n&&er his ser,i(e
8/8/2019 Merawat Lansia Di Rumah
12/30
Disad,anages
• Time inensi,e
• Less e(hn&l&gi(al
supp&r• Finan(ial issues
• #r&,ider sa$e%
8/8/2019 Merawat Lansia Di Rumah
13/30
E3uipmen
• Essential
5* Seh&s(&pe
6* O&s(&pe"Ophhalm&s(&pe
7* Sph%gm&man&meer
8* T&ngue depress&rs
9* B&n.serile &r serile gl&,es;* Lubri(an
* S&&l guaia( (ardsGde,el&per
@* Serile spe(imen (ups
* Disp&sable herm&meers
5>* Ree: hammer"uning $&rk
55* Jrine dipsi(ks
56* #res(ripi&n pad
• Optional
5* Klu(&meer
6* Di(aph&ne
7* Lap&p (&mpuer
8* #aien edu(ai&n maerials9* Tape measure
;* andage s(iss&rs
* 8:8 gaue and ape
@* Disp&sable suure rem&,al ki
* Sublingual nir&gl%(erin5>*Klu(&meer
55*#&rable &:imer% uni
56*#&rable ECK
8/8/2019 Merawat Lansia Di Rumah
14/30
E3uipmen
• Ani(ipae he need $&r pr&(edures
5* Debridemen
6* Dressing (hange7* #hleb&&m%
8* Suure rem&,al
8/8/2019 Merawat Lansia Di Rumah
15/30
Assessing he #aien
• Jse he /IBHOMES0 mnem&ni( & help re(allhe areas &$ $&(us $&r he h&me ,isi
I Imm&bili%
B Burii&nH H&me En,ir&nmen
O Oher #e&ple
M Medi(ai&ns
E E:aminai&nS Sa$e%) Spiriual healh) Ser,i(es
8/8/2019 Merawat Lansia Di Rumah
16/30
Assessing he #aien
• I.IMMOILITY5* Assess ADLs and iADLs6* Ask $&r a &ur &$ he h&me7* Obser,e gai and ambulai&n hr&ugh hall'a%s)
bedr&&m) and neg&iaing sairs8* Ask he paien & a( &u heir r&uines geing in
and &u &$ bed) &pening medi(ai&n b&les)per$&rming pers&nal h%giene
9* Talk 'ih &her members &$ he h&useh&ld ab&u
$un(i&nal (&n(erns
8/8/2019 Merawat Lansia Di Rumah
17/30
Assessing he #aien
• B.BJTRITIOB5* Ask ab&u $&&d pre$eren(es*
6* Ask $&r permissi&n & l&&k in here$rigera&r) (upb&ards) and"&rpanr%
7* Ask ab&u $&&d preparai&n4 'h&
prepares iN H&' &$en d&es hepaien ea during he da%N H&' issh&pping $&r $&&d a((&mplishedNH&' is i deli,eredN
8/8/2019 Merawat Lansia Di Rumah
18/30
Assessing he #aien
• H.HOME EB-IROBMEBT
5* Sa$e neighb&rh&&d
6* #r&:imi% & ser,i(es7* Ambien emperaure are he
heaing and air (&ndii&ning
(&nr&ls a((essible and eas% &readN
8* Jiliies4 running 'aer andemperaure
8/8/2019 Merawat Lansia Di Rumah
19/30
Assessing he #aien
• O.OTHER #EO#LE5* S&(ial supp&r s%sem4 $amil%
members) neighb&rs) $riends
6* Emergen(% help
7* Ideni+(ai&n &$ pers&n 'h& 'illser,e as surr&gae $&r he paien
D#OA) li,ing 'ill8* Assessmen &$ (aregi,er
sress"burn&u
8/8/2019 Merawat Lansia Di Rumah
20/30
Assessing he #aien
• M.MEDICATIOB5* Kaher ALL &$ he paiens medi(ai&ns in he h&me
medi(ine (abine) re$rigera&r) dra'ers) (&uners)e(*
6* E,aluae he %pe) am&un) and $re3uen(% &$medi(ai&n use) n&ing he &rganiai&n and meh&d&$ deli,er% sel$.adminisered &r help $r&m$amil%"$riends
7* Re,ie' indi(ai&ns $&r medi(ai&ns
8* C&nsider p&enial $&r drug.drug &r drug.$&&dinera(i&ns
9* Assess paien (&mplian(e
;* Re(&gnie he p&enial &r presen(e &$ abuse &$ OTCpreparai&ns and herbal remedies i*e*
diphenh%dramine
8/8/2019 Merawat Lansia Di Rumah
21/30
Assessing he #aien
• E.E:aminai&n5* F&(used e:aminai&n based &n paiens needs
6* -ial signs
7* Cardi&pulm&nar% G neur&l&gi( e:am8* Skin"'&und assessmen
9* M&bili%"Imm&bili% assessmen
;* C&gnii,e assessmen MMSE) KDS) S#MS
* l&&d glu(&se m&ni&ring p sh&ulddem&nsrae pr&per e(hni3ue
8/8/2019 Merawat Lansia Di Rumah
22/30
Assessing he #aien
• S.S#IRITJAL HEALTH " SER-ICES " SAFETY5* #eruse"elii he h&me $&r religi&us
&bje(s"reading maerials* This (&uld
iniiae a dis(ussi&n &$ spiriuali% as ahealing and (&ping sraeg%
6* C&&rdinaing he h&me ,isi 'ih h&mehealh agen(ies and ha,ing heir nurses
presen (an $a(iliae (&mmuni(ai&n and(&&perai&n be'een paien) ph%si(ian)and &her agen(ies* uesi&ns (an beans'ered) &rders (lari+ed) pri&riies andperspe(i,es dis(ussed) e(*
8/8/2019 Merawat Lansia Di Rumah
23/30
Sa$e% issues
5* Jiliies4 running 'aerand emperaure1 h&'aer emperaure
P8&
C 56>&
F6* Rumah eranakan)
meja) dan(&uner&ps
hambaan unukpenggunaan &ngka)pejalan kaki) aaukursi r&daN
7* Lighing sairs)hall'a%s) e(*
8/8/2019 Merawat Lansia Di Rumah
24/30
Sa$e% issues
5* Sea ele,a&r in bahr&&m
6* Tables) (hairs) and &her $urniuresurd% and 'ell.balan(edN
7* L&(ks &n d&&rs and 'ind&'s1 ease &$ es(ape in (ase &$ +re &r &heremergen(%
8* Ask 4 /Qha number d& %&u dial in(ase &$ emergen(%N0
8/8/2019 Merawat Lansia Di Rumah
25/30
Sa$e% issues
5* Ele(ri(al (&rds and applian(es
6* Fl&&ring) hr&' rugs) n&n.slipsur$a(es in ub"sh&'er) and
bahr&&m &&r7* Sm&ke dee(&rs) +re e:inguishers
baeriesN
8* urners &n s&,e easil% le$ &nN9* #es
;* Handrails in bahr&&m and &n sairs
8/8/2019 Merawat Lansia Di Rumah
26/30
#ers&nal Sa$e%
• Take a map and %&ur (ell ph&ne
• C&na( he paien &r (aregi,er 'hen %&uare en r&ue $&r a ,isi
• I$ %&ure g&ing & a kn&'n high (rime area)s(hedule ,isis in he A*M*) a,&id 'earing a'hie (&a) use alernai,e (arr%ing ,ehi(leinsead &$ he /bla(k bag0 i*e +shing a(kle
b&:• I$ %&u 3uesi&n %&ur sa$e%) !EE# DRI-IBK
8/8/2019 Merawat Lansia Di Rumah
27/30
Impr&,ing E2(ien(%
• Limi ge&graphi(al area & be (&,ered
• #lan a hal$.da% &$ r&uine h&me ,isisappr&:* 8 paiens in &ne general
neighb&rh&&d• Sar 'ih he address $urhes a'a% and
'&rk &'ards &2(e &r h&me
• D&(umen he reas&n $&r he h&me ,isi and
his&r% and e:aminai&n as medi(all%appr&priae
8/8/2019 Merawat Lansia Di Rumah
28/30
Summar%
• Is assisan(e a,ailable & (&mpensae $&rhe paiens $un(i&nal limiai&nsN
• Deermine g&als &$ reamen and heirrisks
• Implemen iner,eni&ns 'here indi(aed• Address ps%(h&s&(ial issues• e prepared $&r min&r pr&(edures• Jilie sraegies & impr&,e e2(ien(%• Jse he h&me ,isi (he(klis
8/8/2019 Merawat Lansia Di Rumah
29/30
-isi he $&ll&'ing 'ebsies & (he(k%&ur skills
• '''*riskd&m*(&m
• '''*en,ir&nmenalgeriari(s*&rg
http://www.riskdom.com/http://www.environmentalgeriatrics.org/http://www.environmentalgeriatrics.org/http://www.riskdom.com/
8/8/2019 Merawat Lansia Di Rumah
30/30
Addii&nal Re$eren(es
• Jn'in) *!*) eran) A*F* The H&me-isi* American Family Physician;Vol. 60/No. 5 (October 1, 1999
• Me%er) K*S*) Kibb&ns) R*-*1 B Engl Med) De( 5@)51 77694 [email protected]>
• S'ager%) D*L* H&use Calls in #rimar%
Care1 !ansas Re%n&lds #r&gram inAging) Jni,* &$ !S S(h&&l &$ Medi(ine
Top Related