Ngengozi okanye kuGwenxa? Ukubika Ukulimala Kwemvelaphi Engaziwayo
Esinye sezibonakaliso ezininzi zokuxhaphazwa ngokomzimba kubantu abadala abadala. Ngamanye amaxesha, kubonakala ngokucacileyo ukuba imivimbo ehlobene nokusetyenziswa kakubi. Basenokuhamba kunye nezinye iimpawu zentlungu, okanye umntu angabika ngokucacileyo oko kwenzekayo kwaye ngubani owenza ubuhlungu. Ngamanye amaxesha, akucaci kucace. Njengengcali yezobugqirha, ubunzima buza xa kutyhalwa kwaye akukho namnye owaziyo ukuba wafika njani.
Ingaba yingozi, ininzi imivimbo, okanye uyayikrokra kwaye ibonakaliso lokusetyenziswa kakubi?
Ukuxelwa okuMthethweni kokuShatshazwa
Oogqirha, abasebenzi bezentlalo, abahlengikazi, abasebenzi bezongxamiseko kubandakanywa namapolisa kunye nabaphangi bomlilo, abafundisi, oogqirha bezempilo yengqondo kunye nabanye abasebenzi kufuneka baxelele kakubi okanye bahoywa ngabantu abadala . Oku kubizwa ngokuba ngumbiko onikwe igunya.
Ukuba umntu uhlala kuluntu, le ngxelo mayibe ifakwe kwiSebe leNkonzo zoKhuselo lwabantu abadala. Iingxelo ze-APS zivame ukuveliswa xa umntu etshela umsebenzi wezempilo, ngokuzithandela okanye ekuphenduleni ukubuza imibuzo, ukuba bayaxhatshazwa, nokuba ngaba ngenxa yokuphathwa kakubi ngokomzimba, ngokomzwelo, kumlomo, ngokwesondo okanye ngokwemali.
Ukuba umntu uhlala kwikhaya labahlengikazi , abasebenzi basekho baphathiswa begunya kwaye kufuneka bafake le ngxelo kwi-arhente yelizwe. Bajamelana nemiphumo ebalulekileyo xa bengabikeli isiganeko, kubandakanywa isikhombiso sokungabhengezi ukusetyenziswa kakubi, icatshulwa lokungahambisani nomgaqo-nkqubo ofunekayo wokubika ukuphathwa kakubi, kunye neenkcukacha ezongezelelweyo kunye neenhlawulo xa ukusetyenziswa kakubi kufunyenwe ukuba kwenzeka.
Iimfuno zeCMS zokuBela ukuShatshazwa kweNtshutshiso kunye neNzakalo yeNkalo engaziwayo
Amaziko e-Medicare kunye neeNkonzo zeMedicaid ineemfuno ezininzi zokuthatha inxaxheba ukuba amaziko onesiqinisekiso abanomdla abanqwenela ukufumana imali yokubuyiselwa kwemali kubaxhasi babo. Enye into efunekayo kukuba isibonelelo kufuneka sichaze isityholo sokuxhaphazwa okanye ukulimala kwemvelaphi engaziwayo kwi-arhente yombuso ngaphakathi kweeyure ezimbini zokufumanisa kwayo.
I-arhente karhulumente (ejongene ne-CMS) ke igqibe ukuba ngaba uphando malunga nesityholo sokuxhaphazwa okanye okokulimala kwemvelaphi engaziwayo ngokukhawuleza, kwiiveki ezimbalwa okanye kwiinyanga, okanye kwi- survey ye-state engafumanwanga .
Ukuba umntu ohlalayo wenza isigwebo sokusetyenziswa gadalala, kungakhathaliseki ukuba ngumntu ohlala kuyo, abasebenzi basekhaya abahlengikazi kufuneka banike ingxelo, baqhube uphando olupheleleyo baze bafake uphando malunga ne-agency karhulumente kwisithuba seentsuku ezi-5 kweso siganeko. Nangona zixhalabisa kwiindawo, kulula ukuba wazi ukuba ezi zigwebo kufuneka zichazwe.
Isigqibo esinzima ngakumbi sokulawulwa kwezindlu kwabahlengikazi sinquma ukuba zeziphi iziganeko kufuneka zihlulwe njengengozi engaziwayo kwaye ke kufuneka ifune ingxelo. Ngokutsho kweCMS, ukulimala kwemvelaphi engaziwayo ichazwa ngale ndlela:
- Ukulimala akuzange kubonwe ngumntu okanye akakwazi ukuchazwa ngumhlali.
- Ukulimala kuyakrokra ngenxa yendawo leyo (kwindawo engasetyenziselwa ukutshatyalaliswa kwintlungu), ubunzima bokulimala, inani lokulimala okwenzeka ngexesha elifanayo, okanye inani lokulimala ngokuhamba kwesikhathi.
Injongo yeCMS ekufuneni ukubikwa kweemeko ezingaziwayo kukunciphisa nokukhusela naluphi na ukusetyenziswa kakubi kwabantu abadala.
Nangona kunjalo, ukuqhuba le nkcazo kuba nzima xa kukho ukuchazwa okuchaziweyo kwinto ebonakala ngathi "inqabileyo," ingakumbi ukwenzakalo okwenzeka rhoqo, njengemivimbo.
Ukuqhayisa abantu basekhaya abahlengikazi kuye kwachazwa ngokukhawuleza kwindalo, kwaye kuyaqondakala ke ngenxa yokungabikho kwabantu abadala ukuba baqhekeze. Nangona kunjalo, ezinye i-arhente zaseburhulumenteni ngoku zichaza ezinye izikrokra njengobungqina bendalo kwaye zikhankanya izixhobo zokungabhengezi ukulimala kwabo ukuphanda.
Umngeni we-CMS, i-arhente karhulumente, kunye namakhaya anesihlengikazi ukuba angaphuthelwa loo mivimbo engabonakalisa ukusetyenziswa kakubi, kodwa ayifuni okanye ayisebenzise ngokubhekiselele kwingxelo yemivimbo, eninzi eyenzeka ngengozi kwimvelo.
Ukunika ingxelo ngokubanzi, okuquka ukuphanda, ukubhala nokubhala iingxelo ezide, kufuna ukuba kusetyenziswe izixhobo ezintle apho kunokuthi zisetyenziswe ukubonelela izinga eliphezulu lokunyamekela abahlali.
Ukusebenzisa Uphando Ukunceda Ukugqiba Xa Ukuqhaqhaza Kuxhasayo
Ukungabikho kwezikhokelo ezicacileyo ezivela kwi-CMS, ezinye izakhiwo zisebenzisa uphando lwezesayensi ukuze luncede ngokuchanekileyo ukuchonga iimpawu ezibangelwa ngabantu abadala abadala abakwazi ukukrokrela ngokwemvelo kwaye ngaloo ndlela bafuna ukubika.
Umngcipheko wokuqhayisa abantu abadala
Okokuqala, kufuneka siqaphele ukuba ukunyundela kuyaqhelekile kubantu abadala, kunye nemivimbo eninzi eyenzeka ngaphandle kwesizathu esicacileyo. Kuhlolisiso olulodwa lokutyhafazeka ngengozi, abantu abangama-72 kwabangama-101 abadala abadala abaphandle abathathi-nxaxheba bafumana ubuncinci bodwa kwisithuba seveki ezimbini.
Okwesibini, kukho izinto ezininzi ezandisa amathuba okubetha abantu abadala. Ziquka:
- Ukuqhwala ngengozi kumadoda asebekhulile kunokwenzeka ukuba kwenzeke ngenxa yokuncipha kwamafutha phantsi kwesikhumba, isikhumba esincinci, kunye nama-capillary asemathambo.
- Abantu abafumana amachiza athile banomngcipheko wokwanda. Uphando lubonakalisa amayeza omhla wokudlula i-prednisone, i-Aspirin 325 mg, i-Warfarin kunye ne-Plavix, kunye ne- corticosteroids enganyakaliyo , ngokukhawuleza ukwandisa umngcipheko wokutyumza. Ininzi encinci kodwa isanda kakhulu inamathele kubantu abadala abafumana i-aspirin 81 mg, i-NSAID s (iintsuku ezingaphezu kweentsuku ezintathu ngeveki), kunye ne-ginkgo.
- Ukuphazamiseka kwamanzi kunye nokuphazamiseka konke kukhulisa amathuba okubetha.
- Abemi abafuna uncedo nge- ADL banokufumana ukutyumla.
- Ukusetyenziswa kwesixhobo sokuncedisa (njengomgcini, umkhwa, okanye isitulo sabakhubazekile) kwandisa ithuba lokutyumla.
- I-fibrillation ye-Atrial ngumqathango ohambelana nokutyumla ngenxa yokuba kaninzi kudala ukusetyenziswa kwee-counter kunye neyeza zonyango ezibizwa ngokuba yi-anticoagulants ezinciphisa ukuxubha kwegazi .
I-Dementia, UkuShatshazwa, nokuKhumbula kokuKhuselwa
Abantu abanesifo se-Alzheimer okanye ezinye iintlobo zomqondo weengqondo zibangelwa ingozi yokusetyenziswa kakubi. Ukukhubazeka kwabo kwenkumbulo , ukunciphisa amandla okunxibelelana , kunye nokugwetywa kakubi kwenza ukuba kube lula ngakumbi kunokuba abanye baqaphele ukuqonda kwabo. Ukukhunjulwa kwabo okanye ukutyhola kakubi ukusetyenziswa gadalala nakho kunokunciphisa ngenxa yememori yabo embi okanye imbali ye- paranoia okanye i- hallucinations . Ngaloo nto kubalulekile ukuba sisebenze ukukhusela abo bantu besengozini yokusetyenziswa gadalala.
Kuyathakazelisa ukuba xa umntu omdala engazi ukuba kuqhutywe umonakalo okanye akayikhumbuli, kunokwenzeka ukuba kubekho ukulimala kwengozi. Uphando olwenziwe ngokukhawuleza lufumanise ukuba kuphela i-17 ekhulwini yabantu abadala abadala abakhumbula ukukhubeka kwabo.
Ngokwahlukileyo, iipesenti ezingama-91 zabathathi-nxaxheba abahlukunyeziweyo kwisifundo esihlukeneyo basenokukhumbula isisombululo sabo, nangona abaninzi babo babhala ngaphantsi kwama-24 kwi-MMSE. (Amanqaku angama-19-24 kubonisa ukugula kwesifo se-Alzheimer). Ukukhumbula ukuxhaphazwa kwabo kwaqinisekiswa ngobunye ubungqina ukuqinisekisa ukuchaneka. Abaphandi balolu cwaningo babonisa ukuba ukutyekela kwabantu abaxhatshazwayo ukuba bakhumbule imvelaphi yokubethelwa okanye ukusetyenziswa kakubi nakwezinye iintlungu ngaphandle kweengxaki zememori zabonwa kwi-ofisi yokugqirha yezilwanyana ezigulana nezigulane zabo.
Lo mkhwa wokukhumbula iziganeko eziphathekayo (ezifana nokusetyenziswa kakubi) nangona u- dementia iye yaphandwa kwaye yabonisa kaninzi. Ukongezelela, iimvakalelo zesifo sengqondo zihlala zihlala ixesha elide kunezikhumbuzo ezithile, ngoko kubonakala ukuba kubalulekile ukuba umntu akhathazeke.
Ngenxa yokukwazi ukukhumbula iziganeko ezihlaselayo, abantu abadala kufuneka bahlale bebuzwa ngokunyanisekileyo malunga nemvelaphi yokuqhwala kwabo, kungakhathaliseki ukuba bakwazi ukuqonda okanye ukungazi.
Ukuguga kweBruises
Unokuqhelana nombono wokuthi ukunyunyuza utshintshe umbala njengoko unyaka. Nangona iinguqu zemibala zenzeke, zivame ukuba zenze njalo kumzekelo oqikelelweyo. Umzekelo, ngokuchasene "nokuqonda," uphando luye lwabonisa ukuba ngenxa yokuba isiqhumane siluhlaza, akubonakaliswanga ukuba sikhulu kunomtshatsheli obomvu. Oku kuthetha ukuba ukuzama ukufumanisa xa ukuqhuma okokuqala kwenzeka ngokusekelwe kumbala we-bruise ayikho indlela echanekileyo ukukhawuleza.
Iziganeko zokuBhubha ngokukhawuleza
- Iziphelo (iingalo kunye nemilenze) yabantu abadala asebekhulile ziphazamiseka lula ukusuka kwintlungu emancinci. Kwenye uphando olwenziwe ngengozi, iipesenti ezingama-90 zeemivimbo zazifumaneka kwimida.
- Ininzi engoziyo, iimvalo ezinkulu (ezichazwe njengezikhulu kunama-5 cm ngaphesheya naziphi na izikhokelo) zifumaneka kwimida.
- Abasetyhini bavame ukunyangwa ngokukhawuleza kwiindawo ezinobungozi abancinci kunamadoda, ngokukodwa kwintambo, iingalo ezingaphezulu kunye nezikhwelo.
Iimpawu zoKhukula
- Imivalo emikhulu (echazwe ngaphezu kwe-5 cm ngaphesheya nayiphi na indlela) engekho emaphethweni inokwenzeka ukuba inxulumene nokusetyenziswa kakubi.
- Ukuqhaqhaza kusekho entanyeni, ezindlebeni, entloko, ubuso, isalathisi sesandla sokunene, icala lesandla lesandla, umva, iintloko, izitho zangasese, kunye neengcambu zeenyawo zinokudityaniswa nokusetyenziswa kakubi. Nangona kunjalo, icala lesandla lesandla lendawo eqhelekileyo yokuqhwala ngengozi.
- Imivalo ephathekayo ebonisa amanqaku omnwe okanye amanqaku eminwe inokuthi idibene nokusetyenziswa kakubi.
- Ezinye izibonakaliso ezibonakalayo zokuxhaphazwa zibandakanya ukubethelwa kwezibilini, ukubethelwa kwamathanga angaphakathi, "ukumboza" imivimbo ejikeleza imilenze, iingalo okanye i-torso, kunye nemivimbo ebonakalayo ebonisa ukuba kukho ukulimala amaninzi emva kwexesha.
- Qaphela ukuba amabali angahambelaniyo, utshintsho oluchaziweyo okanye utshintsho lwezithuthi ngokukhawuleza lungabonakalisa ukusetyenziswa kakubi.
- Iingqungquthela ezivela ekuxhatshazweni ngamanye amaxesha zidibaniswa nezinye iingozi.
Ukuphanda ngokukhawuleza kunye nokuhlaselwa ngokutsha
Nangona ngezinye iinkqubo ukubetha kubonakaliswe njengendlela yokubonisa ukusetyenziswa kakubi, ngokukwenzeka ukuba uphando olungagqibekanga malunga nendlela yokuqhawula ngokukhawuleza okanye okuhlobene nokusetyenziswa kakubi. Njengabasebenzi bezonyango, kufuneka sizenzele ukukhusela ngokukhuselekileyo ukukhusela abantu abasengozini, kodwa singasebenzisi izixhobo ngokungenakuphikelela "ukuzingela umlingo" ukubethelwa ngesohlwayo kwintsimi ekhuselekileyo.
Uphando olululo luya kunceda ekunqumeni amanyathelo akho alandelayo xa kuziwa kukunyunyuza, iinyembezi zesikhumba, okanye ezinye ukulimala kubantu abadala. Uphando lwakho kufuneka lubandakanye oku kulandelayo:
- Udliwano-ndlebe kunye nomntu, iqela elixanduva, abanonophelo, kunye nawaphi na amangqina anokwenzeka
- Ukuhlaziywa kwerekhodi yezokwelapha ukuchonga ukuba ngaba amayeza okanye ukuxilongwa okwenzekayo kwandisa umngcipheko wokuqhwala okanye ukulimala
- Ukuhlaziywa kwanoma yimaphi ukuwa kwamatyala okutsha okunokubangela ukubetha
- Ukuhlaziywa kwendawo engqongileyo ukuvavanya ukuba kukho na into ebangela ukunyangwa okanye ukulimala
Isigqibo sakho sokuba ulungele utyumpozo njengokrkrha okanye ngokukhawuleza kuya kuba lula ukukhusela kubavoki belizwe bakho ukuba uthatha isikrato malunga neenkqubo zakho zokucinga ngokubhala ingqiqo yakho kunye neengxoxo zakho.
ILizwi
Kubalulekile ukuba uqaphele ukuba ezi ziphakamiso zokuvavanya ukuba ukuxhatshazwa kwabantu abadala bakhankanya kusekelwe kwizifundo zophando oluthile. Uphando olongezelelweyo lunokusinceda ngokuchanekileyo ukuchonga ingozi yokusetyenziswa kakubi, kunye nokusiqinisekisa ngokuphathelele ukunyangwa ngokukhawuleza kunye nezinye ukulimala.
Umngeni wokugcina abahlali kunye nezigulane zikhuselekile, kunye nokunamathela kwimimiselo yolawulo lokuxhatshazwa kunye nokulimala kwemvelaphi engaziwayo, kubalulekile. Ukuqhelana nophando olukhoyo lunceda sonke ukuba senze izigqibo ezinolwazi kwaye sisebenzise iindlela ezintle emsebenzini wethu weklinikhi.
> Imithombo:
> Mosqueda, L, Burnight, K, Liao, S. Isishwankathelo seSigqeba Ukunyuka kwabasebenzi baseGeriatric, iNIJ Grant # 2001-IJ-CX-KO14. https://www.ncjrs.gov/pdffiles1/nij/grants/214649.pdf
> ISiko leSizwe soBulungisa. Ukuchonga abadala. Meyi 6, 2013. https://www.nij.gov/topics/crime/elder-abuse/pages/identifying.aspx
> Yunivesithi yaseMichigan. EMichigan Medicine. Izibhambano kunye neengcambu zegazi phantsi kwe-Skin. Matshi 20, 2017. http://www.uofmhealth.org/health-library/bruse
> Wiglesworth, A, Mosqueda, L. Abantu abane-Dementia njengamaNgqina ngeemeko zengqondo. https://www.ncjrs.gov/pdffiles1/nij/grants/234132.pdf
> Wiglesworth, A, Austin, R, Corona, M, Mosqueda, L. Ukunyuka njengeMpawu zeNkcazo yeBakala eliPhathwa kakubi. https://www.ncjrs.gov/pdffiles1/nij/grants/226457.pdf