HOSPITALISATION for the Parkinson’s sufferer can be very daunting. The sufferer could become very distressed firstly by the change in their way of life and also very frightened as to what is going to happen next.
If you are having major thoracic, cardiac surgery or any surgery to your stomach or intestines, you should talk to your Surgeon about having a nasogastric tube put in place prior to surgery even if the surgeon does not usually do so for your particular type of surgery.
There are no anti-Parkinson’s drugs that can be given by injection or suppository. If you are unconscious or sedated postoperatively for a protracted length of time you will be unable to swallow your drugs by yourself. In an un-medicated state you will be very immobile. You will be at risk for aspiration pneumonia and blood clots.
As well, for reasons that are not understood, people with Parkinson’s are at a greater risk for paralytic ileum (peristalsis stops in the gut) and Volvulus (a twisted gut). If you have a tube, regular medication can be crushed in a little water and passed down the tube that is then clamped for 20 minutes. The importance of this can not be over emphasized.
Postoperatively you can ask to self medicate if your Neurologist or medical practitioner is not able to supervise your drug schedule. Busy surgical staff unfamiliar with Parkinson’s may not be aware of the importance of the timing of your drugs.
If drugs are not given on time and in the right amount this can make you anxious, which will increase your symptoms and delay your recovery.
Do be aware too, that some Parkinson's people do also develop Dementia as a part of the disease. This can affect them when they have to go into hospital.
Delirium and Dementia:
This Q&A sheet provides information about what delirium is, and, how it relates to people with dementia. It describes the causes, consequences, diagnosis and management of delirium. This Q&A sheet does not include information about delirium tremens (state of confusion caused by withdrawal from alcohol) or terminal delirium (delirium that may occur in a dying patient).
https://www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA21_Delirium_english.pdf
ANAESTHESIA for Older People and People with Dementia:
For a long time, there have been anecdotal reports from family members that their older relative “has never been the same since the operation”. This sheet describes the different types of problems that may occur.
https://www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA20-Anaethesia_english.pdf
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For an explanation of the Day to Day workings of the Hospital Ward... Keep yourself informed, speak to the staff, and the Doctors, and introduce yourself to the Social Worker who will often be your main point of contact, particularly if there needs to be a move for your loved one to go directly from hospital to a nursing home placement.
There may be a need for your family to come to grips with in-hospital Rehabilitation Care, Palliative Care, and the need to understand the Discharge Summary.
POSITIONING AND LIFTING PATIENTS-Title2
https://www.youtube.com/watch?v=H68Sa04s_1s
----------------------
Pharmacist review, home checks part of medication strategy for people with dementia
By: Dallas Bastian in News, Top Stories August 4, 2017
Australian researchers are hoping to improve outcomes for people with dementia after they are discharged from hospital through a medication strategy that starts in the lead-up to discharge and continues into the home.
Associate professor Ashley Kable, from the University of Newcastle, said medication generally changes for people once they’ve been treated in hospital, which makes self-administration even harder for people with dementia, and added the responsibility often falls back on carers.
Kable said currently, home medication reviews can be requested by a general practitioner following a patient’s discharge from hospital, but are not always done. She said the safe medication strategy will include clinical pharmacist review of medications and communication with the carer, training in hospital to use medication dose administration aids and provision of a discharge medication plan and explanation.
The discharge summary will include a note for general practitioners to request a home medicines review. These will be conducted by community pharmacists who will aim to identify any prescribed medications that may be a risk for people with dementia, such as those that may cause confusion or result in falls, any potential drug interactions or contraindicated medications, any adjuvant medications being used in addition to prescribed medications that may be a risk, and any modifications to medications that may be required for a person with dementia.
SO, when your loved one is discharged from hospital, do make sure to go to your usual Pharmacist and ask for a Home Medicines Review. Many of the usual medications may have been changed, upped in dosage, or Brand altered in the hospital. YOU, need to know as the result can be most serious for your loved one. YOU, as a Carer, can do this. Alternatively, have a chat with your loved one's GP and have him write a note to your Pharmacist to do this.
How the pharmacist can simplify a dosing schedule during an Home Medicines Review:
• Reduce dosing frequency and recommend long-acting dosage forms where possible
• Recommend a higher strength to reduce the number of dosage units for a specific medicine where two tablets of the same medicine are taken at different times in a day
• Recommend a lower strength product where the person is cutting tablets in half or into quarters
• Consolidate dosing times to fit in with the patient’s lifestyle
• Recommend a combination product if suitable to reduce the number of medicines being used
• Recommend a suitable adherence aid for the patient with cognitive or dexterity issues
for a closer look:
https://www.veteransmates.net.au/documents/10184/38810/Nov_2016_GP_Insert.pdf/e9b3126e-bf0e-4238-bd74-8cdd617458d0
"With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together."
If you are having major thoracic, cardiac surgery or any surgery to your stomach or intestines, you should talk to your Surgeon about having a nasogastric tube put in place prior to surgery even if the surgeon does not usually do so for your particular type of surgery.
There are no anti-Parkinson’s drugs that can be given by injection or suppository. If you are unconscious or sedated postoperatively for a protracted length of time you will be unable to swallow your drugs by yourself. In an un-medicated state you will be very immobile. You will be at risk for aspiration pneumonia and blood clots.
As well, for reasons that are not understood, people with Parkinson’s are at a greater risk for paralytic ileum (peristalsis stops in the gut) and Volvulus (a twisted gut). If you have a tube, regular medication can be crushed in a little water and passed down the tube that is then clamped for 20 minutes. The importance of this can not be over emphasized.
Postoperatively you can ask to self medicate if your Neurologist or medical practitioner is not able to supervise your drug schedule. Busy surgical staff unfamiliar with Parkinson’s may not be aware of the importance of the timing of your drugs.
If drugs are not given on time and in the right amount this can make you anxious, which will increase your symptoms and delay your recovery.
Do be aware too, that some Parkinson's people do also develop Dementia as a part of the disease. This can affect them when they have to go into hospital.
Delirium and Dementia:
This Q&A sheet provides information about what delirium is, and, how it relates to people with dementia. It describes the causes, consequences, diagnosis and management of delirium. This Q&A sheet does not include information about delirium tremens (state of confusion caused by withdrawal from alcohol) or terminal delirium (delirium that may occur in a dying patient).
https://www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA21_Delirium_english.pdf
ANAESTHESIA for Older People and People with Dementia:
For a long time, there have been anecdotal reports from family members that their older relative “has never been the same since the operation”. This sheet describes the different types of problems that may occur.
https://www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA20-Anaethesia_english.pdf
- - - - - - - - - - - - - - - - - - - - -
For an explanation of the Day to Day workings of the Hospital Ward... Keep yourself informed, speak to the staff, and the Doctors, and introduce yourself to the Social Worker who will often be your main point of contact, particularly if there needs to be a move for your loved one to go directly from hospital to a nursing home placement.
There may be a need for your family to come to grips with in-hospital Rehabilitation Care, Palliative Care, and the need to understand the Discharge Summary.
POSITIONING AND LIFTING PATIENTS-Title2
https://www.youtube.com/watch?v=H68Sa04s_1s
----------------------
Pharmacist review, home checks part of medication strategy for people with dementia
By: Dallas Bastian in News, Top Stories August 4, 2017
Australian researchers are hoping to improve outcomes for people with dementia after they are discharged from hospital through a medication strategy that starts in the lead-up to discharge and continues into the home.
Associate professor Ashley Kable, from the University of Newcastle, said medication generally changes for people once they’ve been treated in hospital, which makes self-administration even harder for people with dementia, and added the responsibility often falls back on carers.
Kable said currently, home medication reviews can be requested by a general practitioner following a patient’s discharge from hospital, but are not always done. She said the safe medication strategy will include clinical pharmacist review of medications and communication with the carer, training in hospital to use medication dose administration aids and provision of a discharge medication plan and explanation.
The discharge summary will include a note for general practitioners to request a home medicines review. These will be conducted by community pharmacists who will aim to identify any prescribed medications that may be a risk for people with dementia, such as those that may cause confusion or result in falls, any potential drug interactions or contraindicated medications, any adjuvant medications being used in addition to prescribed medications that may be a risk, and any modifications to medications that may be required for a person with dementia.
SO, when your loved one is discharged from hospital, do make sure to go to your usual Pharmacist and ask for a Home Medicines Review. Many of the usual medications may have been changed, upped in dosage, or Brand altered in the hospital. YOU, need to know as the result can be most serious for your loved one. YOU, as a Carer, can do this. Alternatively, have a chat with your loved one's GP and have him write a note to your Pharmacist to do this.
How the pharmacist can simplify a dosing schedule during an Home Medicines Review:
• Reduce dosing frequency and recommend long-acting dosage forms where possible
• Recommend a higher strength to reduce the number of dosage units for a specific medicine where two tablets of the same medicine are taken at different times in a day
• Recommend a lower strength product where the person is cutting tablets in half or into quarters
• Consolidate dosing times to fit in with the patient’s lifestyle
• Recommend a combination product if suitable to reduce the number of medicines being used
• Recommend a suitable adherence aid for the patient with cognitive or dexterity issues
for a closer look:
https://www.veteransmates.net.au/documents/10184/38810/Nov_2016_GP_Insert.pdf/e9b3126e-bf0e-4238-bd74-8cdd617458d0
"With the focus on medicines and older Australians in these lists, we urge people to consider if they are on the right medicine, or whether they could be taking too many medicines and if you are due for a review. It’s always timely to check with your doctor or pharmacist to see if any medicines are unnecessary and if they could cause harm if taken together."