Non-Healing Wound

I think that it is safe to say that all of us will experience some sort of wound at some point in our lives.  However, most wounds will heal with the proper treatment.  A non-healing, or chronic wound, is one that does not heal within six to eight weeks with traditional wound care.  It is stated that more than 5 million Americans experience a non-healing wound at some point during their life, so this could possibly include you or your loved ones.  Chronic wounds can cause serious infections, illness, and even loss of a limb.  To ensure your health and safety, it is a good idea to learn and be able to recognize the causes and symptoms of these types of wounds.

There are certain health conditions that may cause chronic, non-healing wounds that you should be familiar with, including inflammatory diseases that include lupus and scleroderma.  Other conditions may also be the cause of your non-healing wound, such as:

·      Anemia

·      Bowel disorders

·      Circulation disorders

·      Diabetes

·      Heart Disease

·      Increased cholesterol

·      Hypertension

·      Kidney failure

·      Obesity

·      Malnutrition

·      Sickle Cell Anemia

·      Venous insufficiency

Individuals with non-healing wounds should also take their health history and current habits into consideration.  A past or current history of smoking, use of steroids, radiation therapy, cancer or infection, being in one position for an extended time period, or having a family history of non-healing wounds could all be causes for your current wound situation. 

You may wonder, “Well, when does a wound become a chronic, non-healing wound?”  Following are some distinctive signs to look for to help further determine if your wound can be considered non-healing.  Just look for these signs:

·      Persistent and increased pain in the wound area

·      A dark or bluish discoloration near the wound edges

·      Increased wound drainage

·      Redness or swelling that continues to extend from the wound

·      A foul odor that comes from the wound

There are a variety of wounds that are considered to be non-healing.  Some types of wounds that you may be familiar with in this category include pressure ulcers from being in one position for too long, diabetic ulcers, wounds that continue to reopen and are difficult to heal after surgery, and ischemic ulcers from a decrease in efficient blood circulation.  The type of wound depends upon what your current situation is and of course the wound experience will be unique to the individual that is involved. 

Treatment options will vary depending upon the type of wound, its location, and the condition of the client who is involved.  Once your wound is evaluated by your provider and a skilled team of wound care professionals, your treatment plan will be developed.  Generally, wound treatment regimens change according to how the wound is progressing with treatment.  Wound treatment plans will be adjusted in order to provide you with the most optimal healing results, or treatment will be continued to maintain your wound in its current state so that it does not worsen.

Total Home Health has a program that is right for you and all of your wound care needs.  Our highly skilled, professional staff will be alongside you in your journey.  Our staff will be there for you to carry out your unique wound treatment plan.  We will report any changes to your provider if ever the need arises, in order to ensure that your treatment is always the best it can be for your non-healing wound.  At all times while you are in our care we will do our best to see that you function as independently as possible.  Plus we will always educate you on ways to maintain your self-esteem even if you are compromised with a wound that just will not heal.  With Total Home Health anything is possible, let’s get started today!

Poor Cognition

Cognition is another word for “thinking.”  Cognition is the process that is used to understand and interact with the world around us.  Cognition is also used to describe how our brain functions in order to perceive and interpret our experiences.  Impaired cognition means that the skills and abilities that a person once had, either before an accident or a medical condition, may now be absent or have some important defect that is noticeable by others.

With age you may notice that memories may start to fade and that you or your loved ones begin to become forgetful causing difficulty in doing tasks that used to be second nature.  Cognitive impairment begins to happen when there are problems with the way you process your thoughts and actions.  Cognitive impairment can include loss of higher reasoning skills, simple forgetfulness, learning disabilities, difficulties in concentration, decreased intelligence, and other declines in mental functions.  Cognitive impairment can occur at any point in lifespan and development and puts an individual at increased risk for developing dementia.

The causes of poor cognition are not fully understood.  With age conditions such as stroke, dementia, delirium, brain tumors, chronic alcohol use, substance abuse, vitamin deficiencies, and other chronic diseases may be the cause of your poor cognition.  On the other hand, poor cognition could just be from a lack of sleep or from an increase in pain.  Also, any sort of head injury or infection of the brain or spinal cord can cause poor cognition at any age.  There are some risk factors that are strongly linked to developing poor cognition which include advancing age, family history of Alzheimer’s or another type of dementia, and other conditions that raise the risk for cardiovascular disease. 

An individual with poor cognition may have a noticeable decline in their self-confidence and their relationships with family and friends may start to deteriorate because of the difficulty in fully understanding what is going on around you.  Individuals may also begin to doubt their abilities and fear others, which could result in withdrawal from social activities.  Also after more and more time passes the individual may continue to lose hope that they will regain the abilities they have lost and that their future may not be so bright anymore.

In some cases, poor cognition may be reversible if the underlying cause is determined and treatment is provided.  In fact, what is observed to be poor cognition may actually just be an acute illness that can easily be treated without causing permanent cognitive decline.  You or your loved one should seek medical care promptly for any new onset of poor cognition, or if an existing condition is observed to worsen, or it begins to affect the way you go about your daily life.  Following are reasons to seek immediate emergency care related to poor cognition:

ü  Sudden onset of cognitive impairment

ü  If poor cognition is accompanied by a fever of greater than 101 degrees

ü  Neck stiffness or rigidity

ü  Development of a rash

ü  Head injury

ü  Changes in level of consciousness or alertness

ü  Flushed or dry skin

ü  Severe nausea and vomiting

ü  Fruity breath

The quicker you or your loved one seeks medical attention, the more successful your treatment will most likely be.  Total Home Health has a program that is right for you.  Our professional and compassionate staff understands how taxing caring for someone with a cognitive decline can be for the families involved.  We will be there for you during these difficult times and educate you on ways that you can better cope with your loved one.  Total Home Health will ensure safety and work to maintain the self-esteem of your loved one at all times, by working to find ways for them to adjust to the changes poor cognition has brought into their life.  Our staff is patient, empathetic, and nonjudgmental at all times and will provide the best care possible, enroll today!

Assistive Device Training

It seems as if development of disability and mobility problems is inevitable with age.  This is where assistive devices such as canes, crutches, and walkers can be used to allow you to adjust to the life you once knew.  By using assistive devices you will see an increase in your base of support, improvements in your balance, and an increase in your activity and independence.  However, many clients with assistive devices never have been instructed on their proper use, and are often provided with devices that are inappropriate for their body size, their condition, etc.  Selection of an appropriate assistive device for a client will be dependent upon the client’s strength, endurance, balance, cognitive function, and demands of their environment. 

Usually your care will be handled by a multidisciplinary team which will include your physician, nurse, therapist, dietician, etc.  The determining factors that are included in the decision of which assistive device is the most appropriate for you rely on the assessments completed by this multidisciplinary team.  Assistive devices may include a cane, walker or crutches.  Following are important factors in the use of each of these assistive devices.

Cane Facts and Use:

·      Helps to redistribute weight from a lower extremity that is painful or weak.

·      Improves stability by increasing the base of support.

·      Provides information about the layout of the ground in order to improve balance.

·      Canes can be standard, quad, or offset depending upon your needs.

·      Always look forward when you walk, not down at your feet.

·      Choose a cane with a comfortable handle.

·      Be aware the handle of the cane should be at the level of your waist and your elbow should be bent slightly when you hold it.

·      The cane should be held in the hand opposite the side that needs support

o   For example if your right leg is injured, hold the cane in your left hand.

·      Move your affected leg first with the cane when walking, and finish your step with your good leg

Walker Facts and Use:

·      This device provides the most help with balance and walking than either a cane or crutches.

·      Ideal following a total hip or total knee replacement.

·      Allows you to keep most of your weight off of your lower body as you take steps.

·      You still will use your arms to support some of your body weight.

·      To be the appropriate fit, the top of the walker should reach to the crease in your wrist.

·      Elbows should be slightly bent when holding onto the handles of the walker.

·      Always try to keep your back straight.

·      Check to see if rubber tips on the legs are in good shape to prevent accidents.

·      NEVER climb stairs or use an escalator with your walker.

·      To walk:

o   Position walker about one step ahead of you

o   Grip walker with both hands, move injured leg first, then follow with good leg.

Crutches Facts and Use:

·      Used if your injury or recent surgery allows NO weight bearing on your leg or foot.

·      To fit correctly, crutches should be about 1-2 inches below your armpits.

·      The handgrips of the crutches should be even with your hips.

·      Elbows should be slightly bent when you hold the handgrips.

·      Always remember to rest your weight on the handgrips; if weight is rested on the armpits, damage to nerves and blood vessels may occur.

·      To walk:

o   Slightly lean forward and place crutches about one foot in front of you.

o   Shift weight to the crutches to swing your injured leg/foot through.

o   Bring the rest of your body forward, slowly between the crutches.

o   Finish stride with good leg/foot.

o   ALWAYS look forward, and not down at your feet.

Adjusting to the use of an assistive device may take longer than you have planned.  Our patient and caring staff at Total Home Health will be by your side for any assistance and encouragement you may need during your time of adjustment.  We understand that it is a shot to your self-esteem and it has its way of making you feel helpless, but with us we will do all we can in our power to maximize your independence.

While enrolled with Total Home Health if at any time you have questions on the use or proper fitting of one of your assistive devices, please do not hesitate to ask one of our knowledgeable, professional staff members.  Also, if you feel you need to tackle a more daunting task such as climbing stairs with your crutches or standing up using your walker, our Total Home Health nursing staff will educate you if the need arises.  More advanced tasks with assistive devices are caught onto easier with in-person demonstration due to more in-depth steps.  Allow our staff at Total Home Health to be your educator and help during your journey, enroll today!

Transitional Care

How many times have you or your loved one been hospitalized and caught yourself wondering, “Well why didn’t my doctor tell them that?”  The ultimate goal is to get you stable enough to function in your own home either as you once did, or with the assistance of home health care professionals, such as Total Home Health.  Transitional care is a set of actions that is designed to ensure coordination and continuity of health care as clients transfer between different locations or different levels of care within the same location.  These locations could range from hospitals, to the client’s home, to their doctor’s office, and to the long-term care facility. 

The moment you are admitted into a health care facility your discharge planning begins and it will continue throughout your stay.  Transitional care planning is always client-centered and includes all members of the interdisciplinary team that will be involved in your care.  In order to keep up to date with client progress, ongoing consultation with members of the client care team and reassessment of the client’s changing medical functional, social, and cognitive capabilities will be carried out by Total Home Health professionals.  Clients and their families are always involved in decision-making processes and their opinions are highly valued.  Health care professionals will always inform clients and their families of any resources that are available in the community to work toward transitioning the client back into the community once they are stabilized.

Transitional care is based on a comprehensive care plan and the availability of the health care professionals who are highly-skilled in chronic care, and who have up to date information about the client’s goals, preferences, and clinical status.  It includes patient and family education and coordination among all the health care professionals involved in all levels of client care so that nothing goes unnoticed.  Transitional care, which encompasses both the sending and the receiving aspects of the transfer, is essential for individuals with complex care needs.  Following are some key factors in transitional care planning that you should be familiar with:

ü  Transitional care planning considers all aspects of your well-being, including your medical, physical, cognitive, economic and emotional strengths and abilities as well as your available support system.

ü  An assessment of your level of functioning prior to your admission will be carried out to provide insight into resources available after discharge.

ü  Your opinions, along with those in your support system will be valued and involved in decision-making to ensure your satisfaction with your care and allow you to be more in control of your condition.

ü  You and your family will be given the chance to select the providers of your care whenever possible.

Transitional care is also viewed like a bridge that extends between the health care facility you are in and getting you back home.  Care that is provided to you in transition should be excellent and delivered in the most optimal of environments that is dedicated to a quicker recovery for you in order to return you home as quickly as possible. 

Clients should always get the best possible care during their most vulnerable times if their health is compromised.  Included in providing the best care is to ensure continuity and that all professionals involved are fully aware of all pertinent information in order to ensure continued progress toward the ultimate goal of getting each client back home.  It is rather difficult to maintain strict continuity of care especially between different health care locations and between different health care professionals.  However, it is very crucial to providing the best care possible and maintaining therapeutic relationships with clients. 

Total Home Health has a program that is right for you and will welcome you home whole-heartedly as the next step in transitioning back to the way you used to be.  Our compassionate and highly skilled staff will be determined to work beside you to provide you with more support and motivation to get back to where you want to be.  The ultimate goal of Total Home Health is to see you in the element of your own home, satisfied, stable, and able to perform daily tasks just like you did before.  Don’t wait, enroll today!