Introduction
The circumstances involving the use of the client-feeding skill encompassed a seventy-five-years old female patient. Her name was Mary Jones, and her place of residence was Lakeview Nursing Home. At the time of the delivery of the service, she had been admitted for four years. Jones had suffered a left-sided Cerebral Vascular Accident, which left her mobility severely compromised.
Preparation for Task
I am the healthcare assistant who was responsible for assisting Mary with her meal consumption. During our first meeting, I explained to her that it was my responsibility to ensure the quality of her food and fluid intake. I asked what difficulties she experienced while eating. Mary answered that she was right-handed and could not quickly raise and hold a spoon with her right hand. She acknowledged that she required assistance transferring food to her mouth.
Level of Assistance
First, I asked the client directly whether she actually needed outside help. Second, I consulted the nurses who took care of Mary. They informed me of the necessity to be in close proximity to the client because of the lack of stability in her limbs. Finally, I requested her to attempt to eat the first spoon on her own, after which I came to the conclusion that she experienced pain when she delivered food to her mouth, especially when rotating her wrist.
Equipment Needed
The most evident problem was the final hand movement, which completes the delivery of the spoon to the lips. Mary was able to raise the spoon, but the rotation caused pain. Therefore, all her spoons were designed for her left hand, which had not been affected by the stroke. Moreover, all meals were served on plates with plate guards. These measures prevented food waste and facilitated eating (Anderson, 2017).
Infection Control
Before each meal, I informed Mary that it was essential that she had her hands washed. I explained that soap removes the bacteria, while warm water makes the procedure comfortable. Also, I cleaned and disinfected the table so that neither Mary nor I could contract any viruses. I washed all dishes and disinfected not only after mealtime but also prior to it. This practice ensured that dishes themselves did not contain any bacteria.
Communications Skills
- Good afternoon, Mary, are you hungry? It is lunchtime.
- Hello, yes I am.
- Would you want mashed potatoes with juice or broccoli with coffee?
- Potatoes with juice.
- Okay, do you need help?
- Yes.
- There is no need to rush.
During the conversation, I smiled and looked at Mary. I was in close proximity to her, enough to quickly gold her hand in case she drops a spoon or a glass.
Execution of the Task
I knocked on Mary’s door, waited until she allowed me in. I approached Mary, smiled, and informed her it was mealtime. I cleaned the table and the dishes. Then. I allowed Mary to choose what meals she wanted but explained that soft food to prevent dysphagia. Afterward, staying in close proximity, I would watch her consume her food. If she had trouble raising the spoon, I would stabilize her arm. After the mealtime, I washed dishes, asked her if she wanted anything else, and left.
Health and Safety
When the choice of food was considered, Mary’s allergy to tomatoes was addressed, and no tomatoes were served. Also, if any food needed cutting, I did it myself and removed the knives in order to prevent Mary from dropping them.
Communication
This task did not require any other personnel. I informed the supervisor upon the completion of the task via online messaging. I updated Mary’s charts regarding her food and fluid intake, which are measured in grams and millilitres.
Evaluation
As the client’s mobility gradually decreases, it may be necessary to use a tray so that Mary would not have to leave the bed to eat. It would save time because I would come to her with the tray, plates, and glasses already cleaned.
Conclusion
Altogether, the client experienced pain when moving her right limbs. In order to decrease her discomfort, her mobility should have been restricted by giving her the possibility to eat while in bed. Otherwise, unless Mary directly asked for help or it was evident that she was not able to hold a spoon or a glass, then I assisted her.
Assisting a Client with Personal Hygiene
Client Profile
The circumstances involving personal hygiene care encompassed a seventy-five-years old female patient. Her name was Mary Jones, and her place of residence was Lakeview Nursing Home. At the time of the delivery of the service, she had been admitted for four years. Jones had suffered a left-sided Cerebral Vascular Accident, which left her mobility severely compromised.
Preparation for Task
I am the healthcare assistant who was responsible for assisting Mary with her tub-bath, bed bathing, and showering. During our first meeting, I explained that it was my responsibility to the maintenance of her personal hygiene. I asked what obstacles she encountered while showering or washing. Mary answered that she had difficulties stepping over the side of the bathtub. She acknowledged that she required assistance washing her back and head.
Level of Assistance
First, I asked the client directly whether she actually needed outside help. Second, I consulted the nurses who took care of Mary. They informed me of the necessity to be in close proximity to the client because of the lack of stability in her limbs. Finally, I requested her to attempt to reach her spine with her hands, after which I came to the conclusion that she experienced pain.
Equipment Needed
First, there was the necessity for a shower chair. It helped Mary climb into the bath without elevating her feet to the point of pain (Clayton, 2017). Second, a bed bath was organized with three towels, two washbasins. When Mary felt she was in no condition to take a shower, I organized the bed bath for her.
Infection Control
Before and after each showering, I cleaned and disinfected the bath and the basins. I also made sure that all towels were clean and had them washed immediately after the procedure. Mary’s body was washed with a soup, which eliminated bacteria and any threat of viruses (Jin et al., 2020).
Communications Skills
- Hi Mary, it is time for a shower. Do you think you can take a shower now?
- Hi, yes.
- If you don’t mind, let me help you. Careful with stepping on the shower chair. Do you need help with your back?
- Yes, please.
- Okay, here, take this towel.
During the conversation, I made sure that I only touched her when she really needed physical support. I was in close proximity to her, enough to quickly gold her hand in case she loses her balance.
Execution of the Task
Before the shower, I cleaned the bathroom and the towels. I informed Mary that it was time for a hygiene procedure. I asked whether she was able to take a shower or wanted a bed bath. I accompanied her to the bathroom, helped her undress, climb into the bathroom and apply soap to her back and hair. After the shower, I assisted her with using a towel and dressing.
Health and Safety
The first problem with using a bath is the risk of falling. It was addressed with the removal of bath oils, which would make the surface slippery. I ensured the warm temperature of the water and the mildness of the water flow, which would not put too much pressure on Mary.
Communication
This task did not require any other personnel. I informed the supervisor upon the completion of the task via online messaging. I updated Mary’s charts regarding her personal hygiene procedures, pointing out the type of procedure done and any rashes or other body reactions, which had become apparent during the shower.
Evaluation
It was evident that Mary felt uncomfortable being assisted with her hygiene procedures. However, she was grateful that I had helped her stabilize when she could slip and fall. It was, therefore my recommendation that additional grab bars were installed in the bathroom for the patients to hold onto.
Conclusion
Mary’s primary problem was the restrained ability to lift the left arm and leg. It impaired her capabilities of dressing, washing, and using towels on their own. She required assistance with taking a shower. Sometimes, she needed to have a bed bath prepared for her. Mary experienced discomfort with being assisted during the shower, however, she realized the necessity of outside support.
Assisting a Client with Toileting
Client Profile
The circumstances involving personal hygiene care encompassed a seventy-five-years old female patient. Her name was Mary Jones, and her place of residence was Lakeview Nursing Home. At the time of the delivery of the service, she had been admitted for four years. Jones had suffered a left-sided Cerebral Vascular Accident, which left her mobility severely compromised.
Preparation for Task
I am the healthcare assistant who was responsible for assisting Mary with toileting. During our first meeting, I explained that it was my responsibility to provide assistance with her elimination needs. I inquired whether she had any difficulty with using a bathroom. Mary answered that she felt pain when rising from the toilet seat.
Level of Assistance
As the procedure is highly intimate, I did not insist on my presence during Mary’s elimination. However, I asked her to rise from the bed and observed her movement. I noticed the facial expression indicating pain when she attempted to rise from the bed. I also took notice that she sometimes needed help when taking a seat. Finally, Mary had difficulty with pulling up her clothes.
Equipment Needed
Mary’s mobility restriction required a raised toilet seat. Also, there were grab bars installed on the walls to help the client sit and stand without losing balance.
Infection Control
First and foremost, I cleaned and disinfected the toilet each day to prevent urinary tract infections (Pérez et al., 2019). It was also a necessity to wash Mary’s hands after the elimination to ensure the absence of bacteria.
Communications Skills
- I need to use the bathroom.
- Okay, if you don’t mind, you can hold on to me. Do you need help taking off your clothes?
- Yes, please.
- Here, careful, sit, you can hold on to me. I will be outside, you can call me once you need me.
The nature of the assistance required me to constantly hold the client, thus, possibly violating her privacy and compromising dignity. However, as soon as the necessity was lifted, I left the room.
Execution of the Task
Once a day, I cleaned and disinfected the toilet. When Mary called me, I also made sure that it was clean. I assisted her with walking towards the bathroom, undressing, and taking a seat. During the actual elimination, I waited outside. When she called me back, I entered the bathroom, helped her stand, dress, and leave.
Health and Safety
Mary’s lack of mobility increased the chances of her losing balance and falling. It was mitigated with grab bars on the walls, which she could hold in case of falling.
Communication
As no colleagues were required, I was alone in performing the assistance. The supervisor received the report about the successful elimination at the end of the day via online messaging. After the procedure, I completed Mary’s charts detailing her frequency of using the bathroom and the level of difficulty she experienced when using the bathroom.
Evaluation
As Mary’s mobility decreased, it might have been beneficial to install a catheter. It would not force her to move despite the pain and facilitate the process of controlling and managing incontinence.
Conclusion
Mary’s right limbs were not flexible enough to rise and sit as she willed. Moreover, she could not dress and undress on her own. My assistance was required at every stage excluding the actual elimination. Installing the catheter might have facilitated care and eased the movement difficulties.
Reference List
Anderson, L. (2017) ‘Assisting patients with eating and drinking to prevent malnutrition’, Nursing Times, 113(11), pp. 23-25.
Clayton, M. (2017) Care tips: personal hygiene care for the elderly. Web.
Jin, Y. H. et al. (2020). ‘Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey’, Military Medical Research, 7, pp. 1-13.
Pérez, R. P. et al. (2019). ‘Recommendations on the diagnosis and treatment of urinary tract infection’, Anales de Pediatría (English Edition), 90(6), 400-e1-400-e9.