What plans have you made for continuity of services to clients you are working with? (At the end of the placement) (termination plan)
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Reflection Question: What plans have you made for continuity of services to clients you are working with? (At the end of the placement) (termination plan)
well on the way to the patient home. The DHR CM asked if it was okay to close the case since everything was going well with the patient. My field instructor stated everything was going well with the patient, and her son finally had got a sitter, but this just took effect two weeks ago, so to ensure the patient is getting the proper care that’s needed, my instructor asked the CM if she could wait 30 days before closing the case. The DHR asking for approval for 30 days from her supervisor, but it’s not guaranteed. I hope for the patient’s safety. They will be able to extend the time before closing the case. We went to the patient’s home and noticed she never ate her lunch because it was still on the counter. We contacted the family to let the sitters know that they need to ensure that the sitters stay with the patient to make sure she eats her lunch before they leave because the patient has dementia and is unaware of when to eat, drink, or take her meds. The patient’s husband has slight dementia, but it’s not that bad, and the patient will not listen to her husband. We will f/u next week with the patient and family.
We had another patient whom we visited today. She is a 65-year-old woman who used to do drugs and is now suffering from liver failure and kidney failure. She has also had four strokes. Her daughter notified my instructor that her mom had been up since 3 am, and no one had had any sleep in the house because her mom was in pain, shortness of breath, and scared to death of dying. The doctor prescribed Ativan to help the patient calm down, but that has not worked. The daughter stated her mom’s o2 stat was low, but her BP was slightly higher than usual, but that’s because the cannula was inserted in her nose correctly. The chaplain has come out several times to talk with the patient, but she is terrified of dying. The doctor has increased her dosage of Ativan. Hopefully, that helps. Before we left the patient, she was so exhausted she fell asleep. We encouraged her daughter to get some sleep as well. From looking at the patient skin coloration and other signs that the nurse has observed, this patient may be active. The nurse will follow up on Monday.
We went to see another active patient. The nurse thinks she may not make it to Christmas. The patient is declining faster than expected. The patient seems to be a bit confused. The patient’s niece said she was glad her family came to visit the patient for Thanksgiving. The patient is short of breath and laying in bed, shes not her usual self. We explained to the patient family how important it is to keep the patient comfortable as possible.
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