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IS IT POSSIBLE TO SEND THE PATIENT
HOME AGAIN?
OT Treatment to create safe living environment for individual living
Nurse assist at home with some exercises also ensure safety
Social Worker organize regular family check up on patient
Possible: Permanent Nursing Home
1)To increase the patients muscle strength in her shoulder to at least an MRC grade 4 in abduction, flexion, and extension. The patient receives daily treatments. There are no underlying conditions that would hinder her from regaining muscle strength in 4-6 weeks.
2)Prepare the patient to return home. Measuring her capabilities using the Bathel index, FES, TUG, MMSE. The patient should be able to return to her former level of health as she has no apparent incurable conditions. She was staying at home before injuring her shoulder. We aim to achieve this after 10 weeks.
Hypotheses:
-shoulder contractures,
-global atrophy,
-inability to perform ADLs
First assessment done in the hospital
Shoulder function: AROM, PROM, MRC, VAS
Functional capacity: Barthel index
Long term goals:
Administering medication
Surveillance of Delirium
D
Relearning of everyday activities
Help when possibly reintegrating her home
(Helping with) self-care
Overall assistance
Feeding if necessary
T
Delirium + Subcapital humerus fracture
Decrease hyperlipidemia
Weight-loss
Decrease further complications (cardio-vascular, GI, etc)
M
Help her with administrative work
Coping strategy
other legal & personal matters
Short term goals:
1.)To have the patient out of the delirium. The CAM will be used to assess the delirious state. Within the given time of 4 weeks a delirium should subside and the patient is under medical supervision and receives treatment.
2.)To increase the patients range of motion in her shoulder to near full range. Using goniometry to measure improvements. The fracture showed no complications and the healing process should be almost done after 6 weeks. 4 weeks are enough to make the transition towards long term goals like muscle strength