Personal Care Services by the Home Health Aide - Essay Example

?Essay Inserts His/Her Inserts Grade Inserts (05 01, Outline Introduction 2. Steps and guidelines for common personal care 3. Importance of improvising equipment and adapting care activities in the home 4. Personal care delivery at home 5. Examples of equipments that can be used to provide care 6. Benefits of self care in promoting wellness 7. Key principles of body mechanics 8. How to adapt body mechanics in the home 9. Adaptations that can be made in the home for ambulation and positioning 10. The purpose of passive and active range motion exercise 11. High risk factors for skin breakdown and methods of prevention 12. Stages of pressure ulcers/decubitus ulcers and report observation 13. Types of ostomies and how to empty and change the pouch 14. Emergencies in the home and critical steps to follow 15. The chain of infection to the home care setting 16. Infection control measures to use in the home care setting 17. Role and responsibilities of the HHA in assisting the client to self-administer medications 18. Conclusion Personal Care Services by the Home Health Aide 1. Introduction. Personal care is important in the management of home care. Personal care enables the client to feel comfortable and prevent other illnesses. This paper will discuss personal care, equipments and taking care of the skin. It will also talk about infection and the role of home health aide in self administered medication. 2. Steps and guidelines for common personal care. The client in need of home healthcare may require assistance in personal care. The home health aide should have skills such as bed bath, tab bathing and shower bathing. They should be conversant with the guidelines for transferring the client or lifting the client when they want to change position. Personal care skills will also include lifting the patient from the floor. The personal care skills are necessary because the client may not be able to move independently. Their mobility can be limited because they suffered from a stroke that may have caused brain damage, body weakness or caused them to have unusual posture. Correct steps in personal care eases positioning and transfer as well as, maintains comfort for the client. The steps and guidelines in personal care assist in fostering safety when moving the client. The client and the home health aide reduce the chances of injury when conducting personal care as Birchenall (2012, p. 33) mentions. A bed bath is refreshing, allows skin inspection and allows change of beddings. A bed bath begins with ensuring privacy, informing the client of the intention of bath and maintaining a good conversation. The home health aide should prepare for bath by ensuring the room temperature is warm, close door, window and curtains for confidentiality. Collect all the equipment and materials to include: big pan or bowl, two firm chairs, soap and soap dish, bathing cloth, towels, newspaper for protection of chair from becoming wet and preferred cloths. The two chairs can be placed next to the bed, and then one chair is covered with the newspapers. The soap, dish and big pan are placed on the covered chair. The other chair is for placing the beddings. Light covers can be left to make the bed have warmth. The client can be requested to cooperate or assist in removing cloths, from top to bottom. The top can be cleaned, dried out and covered with cloths before moving to the bottom. The body parts that are paralyzed should be the last when removing cloths. The bottom cloths should be slipped slowly from waist to knee to the feet, one side first and then the other side if the person is unable to lift weight. Only the areas being cleaned should not be covered. The water in the bowl should be half full and tested with elbow for appropriate temperature. The soap should be kept in the dish and wash cloth used as required (Birchenall and Streight, 2003, p. 66). To wash the client’s face, the neck and bellow should be covered. Dampen cloth and squeeze all water and hold all the edges before cleaning the face without soap unless requested. Then wash the neck and ears with soap and dry. Wash the arms and hands with wet soapy cloth using long strokes. Then clean the abdomen and chest while paying attention to folds especially under the breast. Wash the front and lower part of body with circular movements and then wash the legs. The legs can be elevated for access and used with warm wet and soapy cloth using long strokes. Start with hips to knees and then knees to the feet. The feet can be cleaned while paying attention to in between the toes. If the client is unable they can be assisted to clean perennial area. The client can be helped to sit on a towel, by rolling them. The cloth can be givens sparing soap, dampened and squeezed. The client can be given the cloth and allowed to clean self. The home health aide should face away as they clean. If they are unable, one should clean using strokes that start from front to back. Pay attention to skin folds and dry well. Clean the clients back and remaining sides, from top to bottom and apply skin oil or lotion. At this point one can place the linen on the bed when the client is still on the side. The cloths should be worn beginning with the paralyzed body parts from the top to the bottom. The client should be allowed to choose pajamas or clothing. Guidelines for lifting and transferring propose that the load should be closest to the body as possible. This allows the centre of gravity to be close to the support’s base. A wide base for support is considered safe. This means that when lifting a load, one can use the surface close to floor with large base for support. Placing the legs apart creates a wide base for support. The back can be kept straight by bending the knee and hips, while lifting load to lower the centre of gravity and use the feet instead of the back. Always move the leg when making a turn and avoid twisting, which can be painful or cause injury. Small steps are useful in maintaining a stronger base when moving. When lifting load to a position above the head use a stool to step on. Load above the head lowers the centre of gravity (Wernig and Sorrentine, 1989, p. 81). 3. Importance of improvising equipment and adapting care activities in the home. Depending on the needs of the client Cain (1940, p. 294) suggests that, different equipments may be improvised because of cost and safety in their use. An example is the use of plastic chairs in bathing. The plastic chairs are affordable and easy to maintain clean. The improvised equipment will cut down on cost for extra costs that could have been used to purchase expensive equipment. The comfort of the client is maintained with less costly equipment. The improvised equipment are easy to use and can be applied across all social classes. Improvised equipments are helpful when required equipments are broken or not available. They facilitate the comfort of the client as they receive personalized care. The improvised equipment endorses self care in the home. Improvised equipment that can assist in the homecare activities can make a difference in creating good quality of life for the client. The client can gain independence and adapt to changes in their life. Adaptation can make the client feel comfortable and obtain fulfilling personalized care. The patient can sleep well, eat and move in and outside their home when they want. The availability of improvised equipment and adaptive care activities cause those in need of home health aide come to terms with the progress of their health condition. The activities include rearranging the house for easy mobility and use of when chairs because of weak legs. The client uses the improvised equipment or adaptive activity because it is necessary. Adaptive care activities necessitate the home health aide to adjust equipment and activities according to the need of the client. Improvised equipment may become convenient and suitable for client when designed for the need of the patient. 4. Personal care delivery at home. Personal care delivery at home entails giving personalized care according to individual needs of a client. It encourages comfort and safety to the client as they receive care. Personal care delivery entails giving healthcare services using skills while paying attention to safety and comfort of the client. Using the available information, the home health aide uses appropriate skills to deliver care to the client. They skillfully employ communication skills to facilitate their work. They interact with the patient, family and other healthcare professional to give best care as the client obtains healthcare in their home (Shi and  Singh 2011, p. 5). 5. Examples of equipments that can be used to provide care. Equipments used to provide personalized care include: wheel chair for transportation, mobility aids for clients with weal feet, transferring aids, lifting aids, breathing aids, audio and visual aids, continence equipments, beds, scales and feeding aids. 6. Benefits of self care in promoting wellness. Self care is the involvement of an individual in decisions concerning their health. A person practicing self care is aware of healthcare needs and makes informed decision. Self care is characterized by healthy eating habits, appropriate lifestyle preferences and being informed on when to ask for medical assistance. Self care entails making the appropriate decisions to exercise, take a balanced diet, get enough sleep and being kept to prevent any infections that can harm health. Self care can cause one to get immunized, treat infections and sickness before it advances, get screening for any conditions for early detection, follow recommended prescription and getting the correct appointment with a physician. Consequently, a client is able to make correct decisions about concerning their health. For instance, a healthy diet will make the body strong and prevent some illnesses caused by deficiency such as anemia. A healthy or balanced diet will keep sickness away. Balanced diet will enable the body to form a strong immune system. Self care can cause one to choose whether to treat a minor illness at home or at the hospital. It is easy to treat illness when one gives priority to a healthy diet and is able to take their medication as prescribed. Self care practices facilitate a good relationship between the client and the healthcare professionals. Communicating with the health care practitioners and the client becomes easier than when the patient is not aware of self care. Self care eventually causes one to have good quality of life by preventing and managing illness. Moreover, there is confidence in decision making and hope for improved health (Canadian Pharmacists Association, 2002, p. 5). 7. Key principles of body mechanics. Body mechanics uses different parts of the body to make safe movement, conserve energy and increase efficiency when conducting different activities with the body. Body mechanics discourage incorrect posture when using the body and reveals physical capabilities. Body mechanics emphasize balance when performing an action. Unity of action is considered as an important factor in attaining support. All the necessary muscles can be used to give support when a person is moving. The abdomen is considered a powerful source of power. The physical power can also be coordinated with the aid of the abdomen together with the back. The back should be kept upright to give control. Body mechanics that can be adapted in homecare is to use the correct posture to stand or sit. The chin should be lowed, shoulder rest towards the back and squared. The hips should be above knees when standing up. Twisting should be avoided. When lifting the heavy objects, the muscles in the leg can be used when legs are apart. The knees together with hips should be used for bending while the back is kept straight. The object being should be close to the body. When pulling and pushing, use both hands as well as the legs to acquire force. Use the palm instead of fingers and let the feet be firmly held to the ground when pushing. Pulling and pushing should be preferred to lifting. When reaching out or bending, the feet should be firmly placed on ground and the shoulders apart. The knees can be bending while the hips should be bending slightly. Avoid balancing or step on a higher ground (or stool). Exercising is another principle that can enable the body performs many functions. The abdomen and leg support lifting, pulling and pushing. When the body is flexible bending is easy. The shoulders give the back a support for posture. Exercising makes the body flexible and strengthens the muscles as Dixon (2000, p. 56) notes. 8. How to adapt body mechanics in the home. The home health aide can adapt motions that are safe for the client and themselves. This will involve supporting the client when they perform exercise and advice on the safe motions. They may use skills to transfer and lift them. When transferring a client one should ensure that they plan before they act. They should ensure their back is not bending and only lift the person if they are able. They should ask for assistance if the client has a lot of weight. When lowering the client on should spread the legs and avoid twisting. 9. Adaptations that can be made in the home for ambulation and positioning. The home health aide can ensure that the client gets physical support to sit, stand and move. The client can be supported with pillows when sited. One can hold their hand under the arm and closely to give them support as they stand and walk. Ensure the client changes position after a while to avoid exerting too much pressure on one side. 10. The purpose of passive and active range motion exercise. Passive range of motions is practiced in clients who cannot do exercise without support. The motions are done with the assistance of a professional to help strengthen muscle and joint with stretching. The purpose of passive range motions is to facilitate gentle movement to muscles and joints for daily movement. The body remains healthy and chances of being completely incapacitated by an illness are lowered. On the other hand, Action range motion exercises are conducted by a health professional to a client who can do exercises without support and therefore only receives instructions for exercising. Passive and active range motions secure the muscles from atrophy and enhance circulation. After the motions, the client pain alleviates and they become strong. the client benefits from body flexibility after the exercises. 11. High risk factors for skin breakdown and methods of prevention. The skin forms the largest organ outside the body. A third of the blood circulation occurs in the skin. The skin protects the body from heat, physical acts, chemicals and light. Furthermore, the skin shields the body from infection, maintains good environment and is an important sensory organ. Additionally, the skin retains water, vitamin D and fats that are important. The skin is resilient and can heal after an injury. Besides being resilient, the skin can undergo a breakdown if the following factors are experienced. When the skin is abused for a long time by friction and moisture can breakdown. A lot of pressure and force will damage the skin. Clients with myelitis, paralysis or illness that cause loss o sensation are susceptible to a skin breakdown. Paralysis affects skin tissue; where the collagen is reduced making the skin loses elasticity. Additionally, the muscles do not function and the lack of padding could lead to skin breakdown. Clients who have difficulty shifting weight lack sensation to be able to adjust their position. Their skin can be exposed to extreme heat, cold, discomfort, trauma or sun for long. The client’s skin with impaired sensation can be injured from heat near a fire place or a lap top. Ice packs and extreme cold can cause frost bite. Toe nails can in grow and get infected without the client feeling pain. Skin can get sun burns without the client noticing. Clients who have impaired sensation and reduced mobility may have pressure ulcers, which is a type of skin breakdown. Other types of skin breakdown reveal as a blister, cut, scrape or burn. Pressure ulcers may affect the bone and sometimes require surgery. Skin break down still occur even when care is taken and is preventable. Prescribed equipment and care does not guarantee that skin breakdown cannot occur. When the skin breakdown occurs care must be given in the initial stages before it advances. Skin breakdown advances from the initial stages to the advanced stages very quickly (Habif et al 2011, p. 9). Another factor that can cause skin breakdown is poor nutrition and failure to have liquid food or water. In addition, people who are overweight because of pressure on a particular side if unable to move. Clients with depression or those who abuse substances may be unable to attend to their body. Clients with depression may disregard self-care and neglect their skin. The skin can be kept clean and dry. Mild soaps can be used for bath, with warm water; since hot water can cause skin dryness. When drying the skin, avoid rubbing and use patting technique. The undergarments should be changed frequently. Pads should be changed immediately after bowel. Adapting to a therapy where the client exercises to strengthen muscles, increase circulation and facilitate flexibility is necessary. Skin breakdown can be prevented by feeding on a balanced diet and taking adequate water. Cutting down on weight will reduce body mass that compress blood vessels. Clients can eat foods rich in Omega three, Zinc, Protein, and Vitamins A and C. The foods nourish the sin and prevent skin breakdown. Prolonged pressure on one side can be eliminated by changing positions often. Change positions in bed after around three hours and place pillows at the back. Avoid sleeping on the back if the client had been using a wheel chair. Ensure the client is able to breathe comfortably at all times. Muscle spasms can be managed to allow control by exercising. Straps or braces should be comfortable to avoid pressure if worn correctly. 12. Stages of pressure ulcers/decubitus ulcers and report observation. Pressure ulcers are characterized by injury of skin or tissue bellow skin from combined friction and pressure. The home health aide should look at the skin to check to check the condition. There are four stages of skin breakdown. In the first stage the skin changes color to red, blue or grey after close to fifteen minutes without pressure, although the skin is still intact. In the next stage the epidermis together with the dermis layers loses skin thickness. In the following stage, all skin thickness is lost to a depression since the dermis and epidermis layer are absent. In the final and advanced stage the entire skin layers, muscles, bones and tendons are lost. The home health aide can report rashes, turgor, bruises, wrinkles, veins, and bumps. The temperature can be noted whether, cold, warm, cool or hot. Changes that must be reported include: redness or change in skin color, irritation, odor, swelling, drainage, sores and perspiration. It should be reported if the client experiences burning, pain and tingling in the affected skin (Habif 2011, p. 93). 13. Types of ostomies and how to empty and change the pouch. An ostomy is a surgical opening on a body after a surgery. Types of ostomies include: Colostomy, ileostomy and Urostomy. Ostomies pouch need to be kept clean. The first step to cleaning and changing the pouch is to collect all the materials required to include: another pouch, pouch clip, towel, scissors, wipes, tissue, card and pen, and stoma powder. Changing can be done when bathing. The pouch can be emptied in a toilet. Then the hands are cleaned, and then the pouch is removed. The clip is retained and the used pouch is thrown to a dustbin wrapped in a plastic bag. Clean the area with clean water using a towel and dry it. Inspect the skin to see if it is healthy. Use the wipes to clean around the opening and powder the wipes then gently pat the powder to the skin. The skin should be left to dry for two minutes. Measure the stoma then attach the new pouch using the clip. Finally, clean the hands using soap and water (Hampton and Bryant, 1992, p. 4). 14. Emergencies in the home and critical steps to follow. Emergencies in the home care include clients who are in danger like fire or drowning in water, and sustained injury from a collapse. It can be faint or absence of breathing from client or unconsciousness. Upon recognizing an emergency, the home health aide should move the client from the danger. If they have fallen and have serious injuries, they should avoid moving them. The ambulance can be called right away. The manager in charge of supervising the home health aide should be notified. 15. The chain of infection to the home care setting. In the home care setting an agent of infection may be found in the hands, equipment, masks or surfaces. The agent of infection will have a reservoir like a surface, equipment, water, air human where they live. They look for an exit through blood and body secretions. The agent of infection is transmitted to another who has contact with the infected (water, food, air or human). The agent gets entry to the body through the nose, digestive organs, reproductive system, respiratory system, skin and circulatory system. 16. Infection control measures to use in the home care setting. Infections can be controlled in the home setting if hands are cleaned thoroughly very often. The home health aide can take a balanced diet, wash cloths and the body daily. They can get immunized for common infections. Door knobs and other surfaces can be wiped with antiseptic. The mouth can be covered when coughing or sneezing. Waste can be disposed in the trash correctly. The toothbrush can be changed after a few months. Artificial nails can be avoided. It can help for a sick client to stay at home when sick to avoid re-infection and spreading the infection. Moreover, hygiene should be emphasized at all times (Rhinehart and McGoldrick, 2005, 11). 17. Role and responsibilities of the HHA in assisting the client to self-administer medications. The home health aide role and responsibility in assisting client to self administer medication includes getting the medicine from the storage and returning after use. Check the labels to confirm the medication is prescribed to the specific client. Observe time and remind the client time for the next dose. Be present as client takes medication and offer help. The client may need juice, spoon and one to open the container. Give support to the hand as the client takes medication, and offer help to return tablets to the container. 18. Conclusion. Personal care is a significant task in home. Personal care enables the client in home care to be comfortable and prevent infection. Improvised equipment cut down on cost and facilitates homecare delivery. Home care delivery is intended to give the client quality healthcare services. Understanding on body mechanics gives insight on the best way to transfer and move a client. The client needs to exercise for health circulation and muscle strengthening. The skin needs care to prevent it from injuries such as pressure ulcers. The skin can be protected by eating healthy and taking care of it. Infections can be controlled if hygiene is observed. References Birchenall, J. M. (2012). Mosby’s Textbook for the Home Aide. New Jersey: Mosby. Birchenall, J. M., and Streight, E. (2003) Mosby’s Textbook for the Homecare aide, 2nd edition, New Jersey: Mosby. Canadian Pharmacists Association (2002) Patient Self Care, Canada: Canadian Pharmacists. Cain, B. (1940) Improvised Equipment in the Home Care of the Sick, American Journal of Public Health and the Nations Health 30, 3, 294-294. Dixon, M. W. (2000) Body Mechanics and Self-Care Manual. New Jersey: Prentice Hall. Habif, T. P., Campbell, J. L., Chapman, M. S., Dinulos, J. G. H., and Zug, K. A. (2011)Skin Disease: Diagnosis and Treatment, Philadelphia: Saunders. Hampton, B. and Bryant, R. (1992). Ostomies and Continent Diversions: Nursing Management, Missouri: Mosby. Rhinehart, E., and McGoldrick, M. (2005) Infection Control In Home Care And Hospice, Massachusetts: Jones & Bartlett Learning.Shi, L. and  Singh, D. A. (2011) Delivering Health Care in America: A Systems Approach  Burlington: Jones & Bartlett Learning. Wernig, J. K., and Sorrentine, S. A. (1989). Homemaker- Home Health Aide. Journal of Health Occupation and Education, 5, 1, 81-82. Read More