Sunday, March 29, 2009

Drawing the line

How to determine when a patient is going to be safe to go home when they have short term memory loss.
I have a patient at the moment who is the primary carer of his son who has an ID. He is 86 with an HDS of 160/200 primary impairments in attention and memory. The family is very supportive and they wish for him to return home..however the team in particular the nursing staff dont think he should go home. The patient has alot of support for personal care and domestic tasks but the primary issue is his memory - to remember to take his meds, pay bills, and remember to heat and eat meals.

I am yet to talk to the family (particularly his daughter) but i plan to ask what types of things they supported him with pre-admission and discuss the support he will need to compensate for his short term memory impairment.

I have liaised with the SW and the only problem the family has from a SW perspective is the amount of support they have at home. I am concerned about the patients ability to "be a career" for his son - and what this entails - as his primary role at home it is important from an OT perspective that he is able to do this. This is something i plan to investigate

Im still unsure "completely" if this patient is safe for discharge - obviously they will need supports with taking medications (whether this is a daily phone call to check or physical assistance or an alarm). And similar for ensuring the patient is eating appropriately.

Once the situation is decided i will also need to check out the home environment to ensure that it is physically safe for discharge as he has SOBOE ++++

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