Reviewer for Live-in Caregiver Canada - ADULT CARE



ADULT

WHAT ARE THE PHYSICAL CHANGES ASSOCIATED WITH AGING?
  • Dry  skin
  • Wrinkles
  • Gray Hair
  • Sagging skin
  • Decrease pain  sensation
  • Decrease oil production
  • Clouding of lens / decrease vision
  • Decrease taste bud
  • Decline  smell
  • Changing sleeping  pattern /  decrease  sleep
  • Stiffness of  muscles
  • Brittle  Bone
  • Alternation in bowel  habit
  • Less of  teeth
  • Incontinence
  • Less  balance mechanism
  • Difficulty  in swallowing
  • Decrease action and response to time

WHAT ARE THE  MENTAL  CHANGES  RELATED  TO  AGING?
  • Dementia
  • Loss of  memory
  • Disorientation
  • Fear of illness
  • Anxious
  • Depressed
  • Low interest in things she enjoy before.

WHAT  ARE   THE  THINGS  THAT  65  YEARS  OLD  CLIENT  HAVE  ON  HIS / HER  SIDE.
  • Give  emergency  numbers
  • Give  schedule  of  medicine
  • Give  medicine
  • Give  cane  or  reading  glass  if  needed.
  • Give  table  lamps  that  can  easily  be  turned  on  beside the  bed.
  • Give  them commode

WHAT  ARE THE THINGS  TO  CONSIDER  IF  YOU HAVE SENIOR  LIVING  IN YOUR  HOME?
·         Face  the  person  and  speak  clearly  and  slowly.
·         Explain  what  are  your  going  to  do  and  why
·         Give  short,  clear  and  simple  answer  to  question
·         Do  not  rearrange  furniture  or  the  persons  belongings.
·         Maintain  a  calm,  released  and  peaceful  atmosphere.
·         Pay  attention  and  make  him  feel  important.
·         Talk  directly  to  the  client  I  a  respectful  manner.
·         Keep  the room  well  lighted  and  maintain  safe  environment.

WHAT  ARE  THE  SAFETY  PRECAUTION  IF  YOU  HAVE  CLIENT  LIVING  IN  YOUR  HOME?
  • Be sure  to  lock  the  brakes and  any  wheels  on  bed,  stretcher  and  table.
  • Keep  bed  rails  up  and  in  locked  position.
  • Always  use  disposable  gloves  when  in  contact  with  body  fluid.
  • Clean  up  spill  immediately
  • Be safety  conscious  at  all  time.
  • Have  adequate  light  rail  on  stain  and  washroom.  Remove  obstacle.

HOW TO PROMOTE THE WELL BEING OF AN ELDERLY LIVING ALONE?
·         Maintain  a  safe  environment
·         Pay  attention to the patient and make him  feel  important.
·         Hove the patient  personal belonging where he wants them.
·         Encourage the patient to interact with others
·         Assist the patient to see himself as a valuable, needed and successful person.

WHAT  ARE  THE  PRECAUTION  IF  YOU  HAVE  A  52  YEAR  OLD  CLIENT  TAKING  AN  OXYGEN  THERAPHY.
·         No  smoking  tag
·         Verbally  instruct  the  client  and  relative  about  the  hazard  of  smoking  with  oxygen  in  used.
·         Inspect  all electrical  equipment  with  in  the  vicinity
·         Don’t  allow  the  patient  to  used  any  electrical  equipment  during  oxygen  theraphy.
·         Make  known  the  location  of  fire extinguisher
·         Keeping  tubing  free  of  kinks  and  blockage
·         Checking  flow  rate  and  oxygen  humidifier  frequently
·         Provide  oral  hygiene  by  moistening the  lips and  mouth  frequently  encourage  fluid  intake  if  allowed.
·         Checking  the  elastic  strap  for  chafing  and  a  firm  fit.
·         Cleaning  the  cannula,  catheter  or  mask  and  checking  the  skin  for  irritation.

WHAT  IS  THE  PROPER  MANAGEMENT  IF  YOUR  CLIENT  HAS  MOUTHSORE?
  • Gargle  with  cool  water  or  eat  popsicle.
  • Avoid  hot  beverages  and  foods,  spicy  and  salty  food  and  citrus.
  • Take  pain  reliever  like  acetaminophen.
  • Rinse  with  salt  water
  • Apply  thin  paste  f  baking  soda  and  water
  • Visiting  your  dentist  right  ways
  • Chewing  slowly

PREVENTION
·         Reducing  stress and practicing  relaxation  technique
·         Do  not  smoke
·         Limit  alcohol  to  2  drinks  per  day.

WHAT WILL YOU DO TO PREVENT BEDSORE IN A BEDRIDDEN PATIENT?
  • Turn the patient  position  every  2  hours  to  improve  mobility  and  to  reduce  friction  and  shear  forces.
  • Be  careful  when using  the  bedpan.  Never  leave  client  on  the  bed  pan  longer  than  necessary.
  • Keep  client s  body  as  clean  and  dry  as  possible.
  • If  clients  body  show  sign  of  developing  pressure  ulcer,  notify  the  skin  care  nurse.
  • Use  powder  or  cornstarch sparingly  where  skin  surfaces  come  together  and form  creases.
  • Improve  nutritional  status  by  giving  food  high  in  protein,  increase  vitamin  C  intake.
  • Use  bland  lotion  to  serve  as  protection  barrier  and  to  minimize  the  moisture.

REASONS  WHY  CLIENT  HAVE  BEDSORE
  • Pressure
  • Friction
  • Breaks  in  the  skin
  • Poor  circulation  to  an  area
  • Moisture
  • Dry  skin
  • Pro longed  immobilization

HOW TO  DRESS UP  BEDRIDDEN  PATIENT?
·         Dress  the  patient  from  the  weakest  and  affected  side  to  the  strongest  side  of  the  patient.

HOW  TO  CHANGE  DIAPER  OF  AN ADULT?
  • Wash  your  hand,  assemble  the  equipment,  identify  the  client,  explain  what  you  are  going to  do,  provide  privacy ,  wear  gloves.
  • Place  a  towel  or  rubber  sheet  under  the  person  to  protect  the  area  where you are  changing.   Keep  baby  powder  and  diaper  rash  ointment handy.  Place  a  trash can  near  you  so  that  you  can  dispose  of  your  wipes  and  soiled  diaper  as  quickly  and cleanly  as  possible.
  • Take  the pants  all the  way  not  just  to  the  ankle.  Pull the  client  knee  up.  Put  your  forearm  behind  his  knees  and  push  the  knees  as  close  to  his  chest.
  • Unfasten  the  wet  diaper  on  both  side.  Do  not  pull the  diaper  away  use  the wipes  and  wipe  from  front  to  back.  Put  your  wipes  in  the  sorted  diapers.  When  you  change  a  diaper  containing  bowel  movement.  Continue  using  wipes  until  one  comes  out  soiled  so  that  your  sure  the  anus  is  thoroughly  cleaned.
  • Folded the  sorted  diaper  with the  wipes  and  put  in the  trash can.
  • Put  your  forearm under the adult  knee and  lift  her  up.  Put  the  clean  diaper  under  her.  Pull  the  diaper  up  until  its at  her  waistline in the back.  Sprinkle  baby  powder  over the entire  diaper  area.  Full the  diaper  up  until  its  at  her  waist  line  in  the  back.  Sprinkle  baby  powder  over  the  entire  diaper  area.  Full  the  diaper  up  between  her  leg.  Fasten  the  diaper  tape and make  sure the  diaper  comfortable.

HOW TO  AVOID  ACCIDENT  IN  THE  BATHROOM?
  • Always  keep  the bathroom floor  dry.
  • Always put a rubber mat on the floor.

WHAT  WILL YOU  DO  IF  YOUR  CLIENT  WHILE  SWIMMING  IN  CONTACT  WITH  TENTACLES OF  JELLY  FISH?
  • Go  back  to  the  sea,  let  the  wave  flush  it  off in  the  affected  part.
  • If  the  jelly  fish  is  still  present,  flush  it  with  vinegar  and  alcohol
  • Presence of  allergy  rush  the  victim  to  the  nearest hospital.

PURPOSE  OF  CATHERIZATION
  • to  irrigate  the  bladder
  • to  instill  medication into the  bladder
  • to collect  urine specimen and residual  urine
  • for  post-surgical purposes and for dirt  with  spiral  injuries.

WHAT WILL YOU DO IF  YOUR  CLIENT  HAS  A  SPLINTER  IN HIS  FINGER?
  • Remove  it by using  tweezer  or  forcep
  • Wash  it with soap and water
  • Apply  antiseptic
  • Cover  with  dressing and bandage.

HOW TO  OFFER  BEDPAN  ON  A  BEDRIDDEN  PATIENT.
 Always  ask  patient  with  courtesy  if  he /  she   needs  a  bedpan.
  • prepare the necessary materials,
  • make sure bedpan is warm and dry before taking it to the bedside
  • cover with a paper towel or a piece of kitchen roll.
  • Also take a roll of toilet paper.
  • Make sure the bedroom door is closed to ensure privacy
  • Help the patient to lift up her nightgown or slide down his pajama/trousers.

HOW TO DRESS A BEDRIDDEN PATIENT?
Start  from  the  strong side  to  the  weaken  side  or  with  intravenous  line  or  affected  side.
·         Wash  your  hand
·         Assemble  the  equipment  in  dressing  a  bed  ridden  patient.
·         Identify  the  client  and  explain  him  what  are  you  going  to  do
·         Provide  privacy  to  the  patient
·         Place  a  bath  blanket  over  the  patient  body  and  remove  the  soiled  gown
·         Observe  for  any  redness,  swelling  and  allergies
·         Put  on  the  clean  gown  and  remove  bath  towel.
·         Put  up  the  top  linen  and  blanket
·         Record  any  observation.

HOW  WILL  YOU  FEED  A  BEDRIDDEN  CLIENT?
·         If  the  patient  is  eating  in  bed,  position  the patient  in  the  supine  position  with  the  head  of  the  bed,  elevated  as  high  as  is  comfortable.
·         If  the  patient  is  to  eat  at  a  table,  make  sure  the  patient  is  properly  positioned  and  aligned  in  the  chair  with  feet  supported.
·         Focus your  attention  to  the  patient  you  are  feeding.  Be  alert  for sign  of  choking.
·         Set  up  the  tray  on  table  so  that  it  is  convenient  and  attractive  to  the  patient.
·         Use  cups  with  handle  to help  the  patient  hold  the  cup[  or  take  a  drink 
·         Food  should  be  easy  to  chew  and  easy  to  swallow.
·         Allow  the  client  to  food  themselves  as  much  as  possible.
·         Do  not  rush  feeding.  Sit  if  possible
·         Be  gentle  with  forks  and  spoon.  You  can  use  straw  to  feed  liquids.
·         When  offering  glass  or  cups ,  put  towel  to  lips.



 BATHING A BED RIDDEN  PATIENT
·         Wash your hand, assemble the equipment
·         Identify the client / explain  what your going to do
·         Provide the privacy to the patient
·         Check vital signs and if it is normal proceed with the procedure.
·         Fold top linen down to foot area and replace it w/ bath blanket
·         Remove client gown, place a towel across the chest and make a bath mitt
·         Wash face and neck, start from the eyes from inner to outer cantus, wash, rinse and dry.
·         Fold a bath towel lengthwise and place under patient arm and hand.  Wash arm in the long firm stroke, pay attention to the axilla, rinse and dry.
·         Soak hand in smaller basin and wash pay attention to inter-digital of each fingers, rinse and dry.  Do  the same on the other hand.
·         Place a towel along chest and abdomen and pull down the bath blanket covering the perineum.
·         Wash the chest, pay attention to the skin fold under the breast and wash abdomen. Rinse and dry. Put back the bath  blanket and remove the towel.
·         Fold the bath blanket to expose the lover limb and fold a towel lengthwise and place it under the leg and foot
·         Wash the legs from dirtal to proximal in long firm stroke to facilitate blood circulation.
·         Soak foot on a smaller basin and  wash.  Rub callus using wash cloth. Rinse and dry.  Do the same on the other leg and foot.
·         Turn patient on side lying position and place towel near the back.  Wash, rinse and dry.  Apply back  rub on back massage to facilitate blood circulation and put powder or lotion and deodorant if client desires
·         Put client in supine position,  put  clean gown.  Remove bath blanket and put back top linen.
·         Document any unusual observation to the patient.

HOW  TO  SHAMPOO  A  BEDRIDDEN  CLIENT
·         Wash  your  hands
·         Assemble  the  equipment,  explain  what your  going  to  do.
·         Prepare the client.  Assist  the  client  to the  side  of  the  bed
·         Remove  pins and ribbons  of  client  and comb  hair to  remove  tangles.
·         Put  the  rubber  sheet  on  bed  under  the  head  to  keep  beddings  dry.
·         Remove  pillow  under the head and place under the shoulder  to  hyperextend the neck.
·         Tuck  a  bath towel around clients  shoulder to keep  dry.  Put  a  shampoo  basin or receptacle under the head.
·         Fanfold the  top  linen down to waist and cover  the  upper  part  of  the  client  w/  bath  blanket to keep the  clients warm.
·         Place  other  cloth or  pad  over  clients  eye  to  protect  from  soapy  water and it  will not  slip.
·         Place  cotton ball on  clients,  ear  to  keep  water  from  collecting  in  the  ear  canals.
·         Wet  hair  thoroughly.  Put  shampoo on  your  palm and apply  it  on  scalp and form a later.
·         Massage  from  front  to  back  using pads  of  your  fingers  avoid  scratching the scalp.
·         Rinse  briefly  and  apply  conditioner  or  shampoo  again.  Massage  scalp.
·         Rinse  thoroughly  and  remove  all shampoo from the hair  and  scalp.
·         Squeeze  water  out  of  the  hair  with  your  hands.
·         Dry  hair  thoroughly  with  towel  or  you may  use  hair dryer  and  warm  temperature.
·         Remove  equipment  used 
·         Document  any  observation.

HOW  TO  ASSIST  PATIENT  IN  TAKING   A BATH?
·         Prepare  all  necessary  materials  before  start  the  bath.
·         Check  the  body  temperature  of  the  client.  Make  sure  the  water  is  not  to  hot  nor  too  cold.
·         Assist  the  client  to  undress  and  start  the  bath.
·         After  bath  help  a  client  to  pat  dry  herself  and  dress  the  client.
·         Comb  the  hair  the  way  she  want.

HOW  WILL  YOU  BRUSH  YOUR  CLIENTS  TEETH?
  • Assist  the  person  in  a  sitting  position
  • Place  a  towel  over  the  chest.  Adjust  the  overhead  table
  • Apply  toothpaste  to  the  toothbrush.  Hold  the  toothbrush  and  brush  the  clients  teeth  gently.  Brush  in  circular  motion.
  • Advise  the  patient  to gargle  with  water.  Hold  the  kidney  basin  under the person chin.
  • Offer  mouth wash and dental floss.  Put lubrication on the lips
  • Remove  towel.  Record  any  unusual observation.
HOW WILL YOU  TAKE  GOOD  CARE  OF  YOUR  CLIENTS  DENTURE?
·         Pieces  of  food  must  be  removed  from  gums  and  the  tongue.
·         Dentures  can  be  soaked  in  a  cleansing  solution.
·         They  should  be  brushed  at  least  one  every  12 hours.
·         Be  careful  while  handling  dentures
·         Clean  the  dentures  daily
·         Place  a  paper  towel  or  wash  cloth  in  the  bottom  of  the  sink to  guard  against  breaking dentures  if  you  drop  the  accidentally.
·         Place  denture in  a cup and  close  the  lid.

HOW  WILL YOU  GIVE  OR  PERFORM ORAL CARE FOR CLIENT WHO WEAR DENTURES.
  • Spread  the towel  across the clients  chest
  • Wear gloves and ask the client to remove his dentures
  • Place them in a clean cup
  • Take the dentures to the sink and line the sink with wash cloth to protect the dentures from slipping  out  of  your hand
  • Fill the sink with water
  • Apply  tooth paste to the dentures then brush.  Rinse  with  cool  water.
  • Fill the labeled denture cup with cool  water  then place the denture in the cup and cover  it.
  • Help  rinse his mouth  with  water.

HOW  WILL YOU  GIVE  PERFORM  ORAL  CARE FOR UNCONSCOUS  CLIENT.
  • Tell the  client  what  your  going  to do  because  he  may  still  be  able  to  hear  you.
  • Stand  at  the  side  of  the  bed and  turn  clients  face  toward  you.
  • Support  the  face  on the  pillow  covered by  a  towel.  Put  a small basin  under  the  chin.
  • Place  mouth  care  equipment  near  you.  Wipe  entire  mouth  with  a  swab  dipped  in  solution.
  • Pat  the  face  dry  with  a towel.
  • Apply  lubricant  on  the  lips.  Do  after  care.

WHAT WOULD YOU DO IF CLIENT USING WHEELCHAIR AND WANTS TO TRANSFER TO BED?
  • Wash hand  ,  identify  the client.
  • Explain what your going to do.
  • Take note of strongest limb of the patient and it should be near to the bedside.
  • Place the wheelchair near the bedside in 45” angle and lock also  lock the bed wheel.
  • Raise the footrest and advice the patient to hold in you hips and place your hand around his waist.
  • Advise patient that at the count of three he will  be standing up and pivot towards the bedside and hold his strongest arm into the bedside.
  • While the patient is in sitting position  place your arms on his shoulder and the other in his hips and advise the patient that at the count of 3  his upper body  will lie on the side of the bed.
  • Raise his legs over the top of the bed and assist patient to move at the middle of the bed.
  • Cover the patient with top sheet.

TRANSFER  THE  PATIENT  FROM  BED  TO  WHEEL  CHAIR
  • Wash  hand
  • Identify  the  client
  • Explain  what  are  you  going  to  do
  • Take  note  the  strongest part of the patient  body.
  • Place  the  wheelchair  near  the  side  of  the  bed  45 degree angle  where  the  strongest  part  of  the  patient  body  was  located.
  • Lock  the  wheelchair  and  raise  the  foot rest  also  lock  the  bed
  • Assist  the  patient  to  move  toward  the  side  of  the  bed  and place  the  patient  in  side  lying  position  facing  you.
  • Put  down  both  legs  of  the  patient  fro  the  bed  and  place  your  arms   under  the  shoulder  of  the  patient  and  the other  hand  on  the  hips  of  the  patient.
  • Advice  the  patient  that  at  the  count  of  three,  he  will  be  put  in  sitting  position.
  • Advice  the  patient to  hold  into  your  waist  and  place  your  arms around  his  waist  and support  the  knees  of  the  patient  with  your  knees  to  prevent  buckling  of  knees.
  • Advice  the  patient  that  at the  count  of  three  he  will  be  standing  up  and  pivot to  the  wheelchair and  hold  to  the  arm  rest of  the  wheel  chair with  his  strong  hand  and  sit.
  • After  doing  so,  assist  the  patient  to  scoot in  to  sit  comfortably  and  place  the  foot of  the  patient  to  the  footrest  at  a time.
WHAT  ARE THE FACTORS  TO  CONSIDER  WHEN YOU TAKE  YOUR  CLIENT  IN WHEELCHAIR  TO THE PARK.
  • Make  sure to use safety  belt.  Check  the  locks of the wheelchair and  bed  the  sure  that  they  are  safe and in good  condition.
  • Check  the  vital  sign of the patient.
  • Consider  the  weather,  time  and  clothes  use  by  your  client.

HOW TO FEED A  COMATOSE  PERSON  BY  VASO  GASTRIC TUBE?
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