MS 8F PART 1- DISCHARGE CARE AND REHABILITATION

Primary

LEVELS OF CARE

Health promotion and

Specific protection

to decrease the vulnerability of the

individual or population to disease or dysfunction

Secondary

LEVELS OF CARE

Early detection

to limit disability by averting or delaying the consequences of advanced disease

Tertiary

LEVELS OF CARE

Long-term treatment

and Rehabilitation

to reduce complication

Primary

HOSPITAL CATEGORIES (DOH- Philippines)

• Equipped with the service capabilities needed to support the licensed physician rendering services

in Medicine, Pediatrics, Obstetrics and Minor Surgery.

Secondary

HOSPITAL CATEGORIES (DOH- Philippines)

Equipped with the service capabilities needed to support the licensed physician rendering services

in Medicine, Pediatrics, Obstetrics and Gynecology, General Surgery and other Ancillary Services.

Tertiary

HOSPITAL CATEGORIES (DOH- Philippines)

Fully departmentalized and equipped with the service capabilities needed to support the Medical

specialists

in Medicine, Pediatrics, Obstetrics and

Gynecology, Surgery, their subspecialties and Ancillary Services

prepare the client to move from one level to another

What is the purpose of discharge?

Discharge care

• A comprehensive

longitudinal plan

for the care of an

individual/family

returning to the community

from admission up until before discharge

When does discharge planning occur?

-evaluation of the client

-discussion with client and caregiver

-determine if caregiver needs more training

-planning transfer and homecoming

-referral to support

-arranging follow up activities

a discharge plan should involve the following:

Discharge summary

• Highlight client's illness and course of

care

• clinical report prepared by a

physician or other health professional

at the conclusion of a hospital stay

or series of treatments.

- activity level

- general care

- medication and treatment

- diet

- danger sign/ when to report

- emergency contact info

- follow up

Elements of a discharge

As ordered by the doctor

MODES OF DISCHARGE

This mode of discharge happens when the doctor officially states that the patient is ready to go home.

client has recovered/improved

HOME AGAINST MEDICAL ADVICE (HAMA)

MODES OF DISCHARGE

client leaves the hospital with or without permission

Death

MODES OF DISCHARGE

declared by the medical examiner, nurse, coroner

liaison

The discharge nurse is the —- between the patient and other health care providers in the community

loss

• Any situation in which the valued object or person has changed or is no longer accessible to the

individual.

actual

TYPES OF LOSS

recognized by others

anticipatory

TYPES OF LOSS

experienced before the loss occurs

can be actual or perceived

perceived

TYPES OF LOSS

experienced by one one person but cant be verified by others

situational

TYPES OF LOSS

like loss of job, death

developmental

TYPES OF LOSS

like departure of children from home

false- each person perceives loss differently

t/f

responses to loss are highly individualized as each person perceives the meaning of loss the same

LOSS OF AN EXTERNAL

OBJECT

CATEGORIES OF LOSS

Possession that is worn-out,

misplaced, stolen or ruined by

disaster or calamity

LOSS OF LIFE

CATEGORIES OF LOSS

•How one person views death

(relief vs. loneliness)

LOSS OF A KNOWN

ENVIRONMENT

CATEGORIES OF LOSS

•Temporary/permanent

relocation

•hospitalization

LOSS OF ASPECT OF SELF

CATEGORIES OF LOSS

•Psychological (self-confidence,

love, power, etc.)

•Physiological (body part)

LOSS OF SIGNIFICANT

OTHERS

CATEGORIES OF LOSS

•Loss of a loved one or

entertainment figures

grief

It is the SUBJECTIVE experience of the loss

Grief

is the internal subjective side of mourning,

• Series of intense physical and

psychological responses that occur

following a loss

grief

is the natural reaction to loss, both a universal and a personal experience

mourning

The period of time during which the grief is expressed and resolution and integration of the loss occur

the way we show grief in public

bereavement

means "to be robbed"

It is the losing of someone to

whom one has been closely

attached

bereavement

an OBJECTIVE state or condition of loss

bereavement

Grief and mourning occur during

the period of ——

normal grief

consists of normal behaviors, reactions to loss, and symptoms

anticipatory grief

process of letting go before an actual death has occured

complicated grief

an individual has trouble progressing through normal phases of grieving

disenfranchised grief

when loss is experienced and cannot be openly acknowledged, socially sanctioned, or publicly shared

recognize

react

recollect

re-experience

relinquish

readjust

reinvest

what are rando's 6 R's process model for complicated grief

Denial

-disbelief and sometimes not

acknowledging the real scenario

anger

feeling that most of the patients feel when things are not under their control anymore

bargaining

patients may think they can change the real situation when they change their attitude in return for a healthier outcome

depression

patients feel that they have gone into the downward spiral feeling of loss

acceptance

patients would usually manifest the feelings of acknowledging that there would always be an end at everything

shock and disbelief

GEORGE ENGEL'S STAGES OF GRIEVING

Refuses to accept loss

• Accepts the situations

intellectually but denies it

emotionally

Developing Awareness

GEORGE ENGEL'S STAGES OF GRIEVING

• Reality of loss begins to

penetrate consciousness

• Presence of physical and

emotional responses

Restitution

GEORGE ENGEL'S STAGES OF GRIEVING

• Involves rituals surrounding

loss or death

Resolving the loss

GEORGE ENGEL'S STAGES OF GRIEVING

Dealing with the

void/emptiness left by the

loss

• Dependent relationship to

the support system

Idealization

GEORGE ENGEL'S STAGES OF GRIEVING

• Exaggeration of the good

qualities of the person or

object lost

outcome

GEORGE ENGEL'S STAGES OF GRIEVING

Dealing with the loss a

common life occurrence

Shock

CATHERINE SANDERS' PHASES OF BEREAVEMENT

Few minutes to many days • a sudden and violent disturbance of the mind or emotions

Awareness of loss

CATHERINE SANDERS' PHASES OF BEREAVEMENT

Friends & family resume normal activities

Conservation/ withdrawal

CATHERINE SANDERS' PHASES OF BEREAVEMENT

Survivors feel a need to be alone to conserve and replenish both physical and emotional energy

Healing

CATHERINE SANDERS' PHASES OF BEREAVEMENT

• The turning point

Bereaved person move from distress about living without their loved one to learning and living more independently

Renewal

CATHERINE SANDERS' PHASES OF BEREAVEMENT

Move on to a new self-awareness, an acceptance of responsibility