ACT AGAINST IATROGENIC DISABILITY IN ELDERLY PATIENTS ... · ACT AGAINST IATROGENIC DISABILITY IN...

ACT AGAINST IATROGENIC DISABILITY IN ELDERLY PATIENTS DURING HOSPITALIZATION 1 Margitic & al. J Am Geriatr Soc 1993 2 Sourdet & al. J Frailty Aging 2014 3 Katz & al. JAMA 1963 Nearly 30 % of older patients lose independence in basic activities of daily living during hospital stay 1 . This loss of independence may be due to illness leading to hospitalization… or to unadapted healthcare procedures. In more than half of the cases, disability is avoidable 2 . Did you know ? Prevenng disability during hospitalizaon is each one’s mission ② I observe the major risks of iatrogenic disability and I recommend an individual prevenon program for the paent ① I assess the funconal status of the paent at key moments with the ADL scale 3 Activity Situation 1: Receives no assitance 0,5: Receives asistance in bathing only one part of the body 0: Receives assistance in bathing more than one part of the body Bathing 1: Gets clothes and gets completely dressed without assitance 0,5: Gets clothes and gets dressed without assitance except for assitance in tying shoes 0: Receives assistance in getting clothes or in getting dressed, or stays partly or completely undressed Dressing 1: Goes to « toilet room » cleans self, and arranges clothes without assistance 0,5: Receives assistance in going to « toilet room » or in cleansing self or in arrangeing clothes after elimination or in use of night bedpan or commode 0: Doesn’t go to room termed « toilet » for the elimination process Toileting 1: Moves in and out of bed as well as in and out of chair without assistance 0,5: Moves in or out of bed with assistance 0: Doesn’t get out of bed Transfer 1: Controls urination and bowel movement completely by self 0,5: Has occasional « accidents » 0: Supervision helps keep urine or bowel control: catheter is used, or is incontinent Continence 1: Feeds self without assistance 0,5: Feeds self except for getting assistance in cutting meat or buttaring bread 0: Receives assistance in feeding or is fed partly or completely by using tubes or intrevenous fluid Feeding Keys moments J-15 Admission Once a week during hospitalization Discharge Do not neglect to ask the patient to provide date and place Upon admission, do not forget to anticipate hospital exit Help to dress and wash the patient only if he is unable to do so by himself Avoid using urinary protection products and catheters, if it is not necessary. Do not systematically renew a medical treatment. Avoid keeping the patient bedridden, encourage him to move Do not continue use of medical devices without a new evaluation Do not put the patient on a diet Risk of confusion Exit Attention Catheters and urinary protection products Treatments Immobility Oxygen, perfusions, catheters and devices Nutrition R E A C T I O N At-risk situations Warning !!! N°Siren 444 453 393 - Union régie par le Code de la Mutualité. Crédit photo : fotolia.com

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Transcript of ACT AGAINST IATROGENIC DISABILITY IN ELDERLY PATIENTS ... · ACT AGAINST IATROGENIC DISABILITY IN...

ACT AGAINST IATROGENIC DISABILITY IN ELDERLY PATIENTS DURING HOSPITALIZATION

1 Margitic & al. J Am Geriatr Soc 1993 2 Sourdet & al. J Frailty Aging 2014 3 Katz & al. JAMA 1963

Nearly 30 % of older patients lose independence in basic activities of daily living during hospital stay1. This loss of independence may be due to illness leading to hospitalization… or to unadapted healthcare procedures.

In more than half of the cases, disability is avoidable2.

Did you know ?

Preventing disability during hospitalization is each one’s mission

② I observe the major risks of iatrogenic disability and I recommend an individual prevention program for the patient

① I assess the functional status of the patient at key moments with the ADL scale3

Activity Situation1: Receives no assitance0,5: Receives asistance in bathing only one part of the body0: Receives assistance in bathing more than one part of the body

Bathing

1: Gets clothes and gets completely dressed without assitance0,5: Gets clothes and gets dressed without assitance except for assitance in tying shoes0: Receives assistance in getting clothes or in getting dressed, or stays partly or completely undressed

Dressing

1: Goes to « toilet room » cleans self, and arranges clothes without assistance0,5: Receives assistance in going to « toilet room » or in cleansing self or in arrangeing clothes after elimination or in use of night bedpan or commode0: Doesn’t go to room termed « toilet » for the elimination process

Toileting

1: Moves in and out of bed as well as in and out of chair without assistance 0,5: Moves in or out of bed with assistance0: Doesn’t get out of bed

Transfer

1: Controls urination and bowel movement completely by self0,5: Has occasional « accidents »0: Supervision helps keep urine or bowel control: catheter is used, or is incontinent

Continence

1: Feeds self without assistance0,5: Feeds self except for getting assistance in cutting meat or buttaring bread0: Receives assistance in feeding or is fed partly or completely by using tubes or intrevenous fluid

Feeding

Keys moments

J-15

Admission

Once a week during hospitalization

Discharge

Do not neglect to ask the patient to provide date and place

Upon admission, do not forget to anticipate hospital exit

Help to dress and wash the patient only if he is unable to do so by himself

Avoid using urinary protection products and catheters, if it is not necessary.

Do not systematically renew a medical treatment.

Avoid keeping the patient bedridden, encourage him to move