Programs and Services for Adult and Elderly Health in Primary Care

Posted on Aug 21, 2024 in Medicine & Health

A) Health Care Specific Problems

Care for Immobilized Persons:

This includes people who are normally in bed and need assistance, or those who never leave their homes except in exceptional cases. We must also assess the needs of their caregivers.

Care for the Terminally Ill:

Pay special attention to those suffering from chronic illnesses with no cure and a life expectancy of less than six months. Assess the family, primary caregiver, the emotional burden involved, and the circumstances surrounding the end of life. This includes palliative care for primary care.

Palliative Care:

Comprehensive Assessment
Attention: Care Plan
Important: “X Coping: It is important for both the patient and the family, as this will depend on the care being provided.”

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Attention to Grief: This is important not only when a patient has begun palliative care but also when the patient dies. This is to avoid pathological grief.

“X Control of Symptoms: Respiratory, circulatory, heart, and most importantly, pain control.

Coordination

“X Primary Care: A terminally ill patient at home must be attended by nurses, doctors, the UAF, and the basis of care.

“X Coordinated Palliative Care Teams (ECCP): These teams are usually interdisciplinary and can be found in districts, NGOs, provincial governments, or municipalities. They are responsible for caring for and assisting in special or complicated cases. They should always coordinate with primary care.

“X Palliative Care Unit (PCU): At the hospital level, these units are specific for terminally ill patients and often have outpatient visits and hospitalization.

“X Support Units of Palliative Care (UACP): These are specialized hospital care units, but not specific to a particular condition.

Note: At the household level, the first two are responsible for coordinating with others.

B) Care for Discharge from Hospital

This is for people who have been hospitalized and need home care after discharge. The Telecontinuidad Service (where the person is discharged from the hospital and informed that the person will receive health care needs at home) comes into contact with this person in the days following discharge if they need something. If everything goes well, the health center will communicate with the person in different ways (fax and internet) and will provide care within 24 hours (via telephone) and at 48 hours (at home).

Health answers are advised
The health center belongs.

Once the nurse comes to the home, they will assess the situation of the patient and caregiver, as well as collect all the information that the patient has been given in the hospital. The person must have the highest hospital discharge reports, as well as the report of continuity of care that is complementary to the previous one and is performed by the hospital’s nursing. This report is designed for primary care nursing and reflects the patient’s characteristics, interventions, and care needed.

Care for Elderly or High-Risk Individuals

This refers primarily to residences. Domestic care or CS

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This includes people who cannot leave their homes. Often, there are no family caregivers and professional care is provided. It is important to coordinate care with this type of care among professionals and practitioners in the institution. In the residence, these health professionals are those who provide care, but they can coordinate care. People admitted to these institutions must be vaccinated against influenza, tetanus and diphtheria, and pneumococcal vaccine.

Value the Needs of Home Care and Care for Caregivers

This is no different or exclusive from the previous four. It is included to emphasize how important care is for patients in the four previous groups of programs for the elderly who could be considered at risk but not in any previous group (disabled, over 70 years old, has no primary caregiver, income is insufficient). This includes primary caregivers and all those who care for people with great disabilities. It tries to be treated differently (positive discrimination) and also includes workshops for caregivers. It is also included in the summers when temperatures rise because people who need care can avoid having problems with high temperatures.

b) Care for People with Chronic Processes

Early Detection: This can be understood in two ways: uptake of patients who have the problem and also to healthy people with risk factors.

Note to Patients:

Diagnostic
Measurement
Treatment
Control and Monitoring
Rehabilitation

Important Strategies:

EPS: It is important to do this not only for the patient but also for the family and the community, as well as for prevention.
Home Care: This is not only for people with chronic diseases but also for those who belong to the group of people who are in the situation of home care.
Actions on the Environment: On the community…

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Among the chronic conditions would be:

Care for HTA
Care for people with diabetes
Care for people with COPD
Care for people with asthma
Care for people with HIV
Care for polypharmacy: Polypharmacy is a person who takes 5 or more medications for a time less than six months. This program should be included to try to increase the beneficial effects of drugs and reduce adverse drug reactions. The aim is to improve the benefit/risk ratio.
Care for oral anticoagulants: Control how many times daily, mg, the time at the outlet, and the number of doses. The daily dose is individualized. Currently, a new technique is being used that involves digital blood collection, i.e., taking a small drop of blood and the results will be referred to the hematologist in the event that there is any alteration. This is a new technique. It is very important in the EPS in this case that we have to say that it is important to be careful with injuries, bleeding, and foods such as: flatulent foods, green leafy vegetables…

Smoking Cessation or Providing Care for Smokers

The aim is to identify those who smoke and have a risk factor. This should also be done in health centers, with interventions tailored to the individual and their habit. This includes a set of activities that include assessment, diagnosis, and treatment of smokers or ex-smokers up to five years for addiction. Susceptible population: Pregnant women, adolescents, and youth.

Activities:

Collection and Identification: Smoker (since when you smoke, the smoke…), former smoker (since when, if maintenance ex-smoker (-1 year), unconsolidated former smoker (less than 5 years), consolidated ex-smokers (more than 5 years) smoke
Basic Intervention: Providing information about the benefits and harms of snuff.
Advanced Intervention: To assess the level of motivation to quit smoking

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People tracking ex-smokers:

Precontemplation
Contemplation (consider quitting)
Preparation (The person wants to quit and start in a few days)
Change and action (takes a few days without smoking)
Maintenance

Attention to relapse.

Health Screening Over 65 Years

Level of autonomy: Barthel
- Autonomous (90-100)
- Risk of dependency (61-90)
- Dependent (0-60)
Group activities as dependency:
- Prevention and health promotion (A, B, C)
- Comprehensive assessment and care plan (B, C)
- Home Care and Care for Carers (C)

Communicable Diseases

Detection, confirmation, and study of new cases
Treatment of confirmed cases
Monitoring of cases
Recording and notification of cases
Search for contacts
Acting on: reservoir of infection, the transmission mechanism, susceptible subject
Important strategies: EPS, home care, to act on the environment

Monitoring of Processes or Communicable Diseases:

Tuberculosis Care
STD
Not systemic immunization, (adults)
Influenza: 1 dose, the annual October November entity, susceptible individuals
- People over 65 years
- Persons under 65 years: the flu can cause complications or decompensation (children or people with respiratory problems (asthma, allergies), people who live in residence and persons with ASA (to avoid Reye’s syndrome – encephalopathy and hepatopatologia). Pregnant people: from Q2
- People who can spread influenza to others (health, family members of people with complications)
Other groups: People who are in contact with birds, or make international travel

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2. Tetanus and diphtheria: 3 doses (0,1,12 months), adults must be repeated every 10 years.

Immunization against Tetanus and Diphtheria

Group recommended vaccination:

Less than 50 years in rural or agricultural workers
Hospitalization in geriatric, psychiatric, and social-sanitary institutions
Work involving risk of infection
UDPV, piercing, tattoos
Sick high-risk individuals (HIV, diabetes, surgery)
People with wounds or burns who are unimmunized
Pregnant women

3. Hepatitis B

Immunization against Hepatitis B: