Question

Allied health- What role does a person with a long-term condition have in guiding their own care? Can you outline your understanding of the concept of `patient choice' with regard to the management of a high-risk patient? What do you consider to be the key issues affecting the profession today?

Answer 1

High risk patient defined as those with high risk of mortality,including such as cancer,ESRD, heart failure and dementia; "functional impairement "define as dependency in one or more activities of daily living and; "utilization".

Long - Term care.

Long term care is only one part of the long term care system,and other forms of long -term care are available,such as those in the following list.

1 . subacute or transitional care.

For people who require ongoing care or recovery for an acute condition but do not need to receive the services on an acute hospital or nursing home,or it can be an entire facility dedicated to this purpose.

2 . Assisted living facility.

A form of housing that provides 24- hr staffing,meals, supervision of medications,and personal care assistance.

3.Adult day care.

A daytime program for people who typically have the same level of impairements as nursing home residents but who receive care in the community, usually by family members.

4.Home care.

For community based people who are homebound and who need caregiving assistance or special treatments.

5. Hospice.

For people who are terminally ill and need of care.This care can be provided in the home or in a day hospital setting.Care of the dying is a common experience in long term care .Caring behaviours of the staff at the time of death,allowing the family to be involved with the resident,and providing spiritual support are important and valued nursing functions

Each of these types of care has unique regulations and conditions for reimbursement.

Conclusions.

Residents possess a wide range of physical and mental conditions that require expert assessment,interventions,and monitoring.The inability of many residents to accurately express their needs and age- related alterations in the presentation of clinical manifestations presents special challenge in detecting changes in status.The absence of physicians in the facility on a daily basis places a greater burden on nurses to identify and seek treatment of residents' problems.The high proportion of unlicensed staff demands that nurses that nurses be effective managers.An abundance of regulatory and reimbursement requirements demand that nurses be knowledgeable of these topics.

The reality that most residents will not only recieve care,but will live in the facility for the remainder of their lives causes nurses often to serve as surrogate family.very few practice settings offer nurses the opportunity to fill such a wide and varied range of roles.Rather than a simple,nonchallenging, practice settings,LTCFs challenge nurses to use a wide range of knowledge and skills as they establish meaningful long-term relationships with residents and their families.To fill the roles and responsibilities competently, LTCF nurses must be among their profession's best.

Key issues in long term care .

Recurring concerns including staffing levels,abuse and neglect,unmet resident needs, quality problems,worker training and competency,and lack of integration with medical care.