Assignment of Care skills

Student: Yiping Chen

Contact:[email protected]

The Situation we are facing about Michael as follows:

Michael is an 74 years old overweight gentleman who has recently been admitted to
an acute hospital following a fall in which he sustained a fractured wrist.Michael lives
alone and is not very active and has a poor diet.On admission it was discovered
Michael had a Grade 1 pressure sore on his Sacrum.
Task: Using the criteria given discuss what can be done to improve Michael’s health
and prevent further pressure sores developing.
According to the instructions ,my analysis and solutions are as follows.
The first important thing we need to do is to know clear about our client’s needs both
in physical and mental . Michael faces 6 aspect problems:old,overweight,fractured
wrist,alone,not active,sacrum sore.How to solve these problems to help him
recovery,my analysis as follows.
1、Mental Health
I think the most important part of life for a human is emotion and social.we can’t have
no friends and don’t communicate with others.As a human,we need social
activity.Michael lives alone,I think this is the main reason to cause his overweight and
not active.Michael might be dealing with feelings of frustration, anxiety, or even
depression due to his health problems and his inability to care for himself as he used
to.To improve his physical health ,we need to solve his mental health first.Listening
and hearing both are good ways to help him.Hearing is the physical process,natural.
Listening is the physical and mental process;active:learned process,a skill.
Emotion Care:As much as we can do to listen to and chat with him,not just caring his
illness.Listening is hard,so we must be patient and have effective listening.Michael
lives alone,we work as his carer we are the only person that spend a long time with
him each day,so we should keep an open mind and eye contact with him,to make him
feel warmth.To know more about his life as a friend.His experience before,his family
and hobbies and so on.To make him feel not alone,I think this would make him more
like to be active.and he would love to do exercises and eating more health.
Social promote:Involve Michael’s family or friends in his care. Family members can
be encouraged to visit or call regularly, providing emotional support and reducing
loneliness.
Telephone or video calls: If Michael's family cannot visit in person, setting up regular
video calls (via platforms like Skype or Zoom) can help him feel more connected.
If he doesn’t has family members ,community can help him to call a volunteer to visit
him regularly.
Social Groups or Support Networks: Encouraging him to engage with community
support groups, such as those for elderly people, can help alleviate social isolation.
These groups can offer peer support and social activities, which are vital for mental
health.

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Hospital Social Services: Social workers within the hospital can assist in helping
Michael connect with local community services that may provide home visits, social
activities, and emotional support.
Volunteers: Many organizations have volunteer programs where people can visit
elderly individuals in the hospital or at home, offering companionship and emotional
support.
2、Physical Health
Vital signs:Michael is an old man,everyday we should to measure vital signs of
him ,like body temperature,pulse rate,blood pressure,respirations.Body temperature is
crucial for maintaining overall health and proper bodily functions.The normal body
temperature is 36.1℃-37.5℃.The Pulse,normal reading is 74 times per minute in
health.Blood Pressure,normal reading is about 80mmHg.Since Michael is
overweight,he might has a high blood pressure,if he has,we should check it everyday
and take medicines to reduce it.
Balanced Diet:During his treatment in hospital,I need to take care of his physical
health.The basic care of daily life is important to him.Since Michael is overweight
and has a poor diet,he needs to lose some weight.so he should do more activities and
change his eating habits.About eating,I have a food recipe for him.Non-fried
foods,more vegetables,fruits,fish,meat,milk,egg and have Vitamin A--C.The daily
food intake is strictly controlled.The protein is an important nutrition for muscle to
keep your strength and wounds recovering ,so old people can walk stable and get
recovered quickly.Vitamin is essential for skin repair and immune function.The last,to
drink at least 1.5-2L of water per day to keeps skin hydrated and elastic.
Promote Physical Activity:Michael is not active I think he lives alone to cause
this.so I need to talk to him a lot to make him feel passionate about his life,he might
like to do some activity if I invite him .Since he is overweight,gentle movement and
physical therapy can help improve circulation, reduce the risk of further pressure
sores, and increase his overall mobility.
Equipment:Seated exercise quipment(1)Pedal exerciser allows him to move his
legs while sitting and adjustable resistance to suit his ability.(2)Resistance Bands can
be used for gentle lge exercises while seated and help maintain muscle strength
without strain.Standing& Weight-bearing support (1)Parallel Bars or Grab Rails
help with balance and stability when attempting to stand or walk.(2)Walker or rollator
with seat provides supprot for walking and allows him to rest when needed.
Bariatric Shower chair or Bench a wide,heavy-duty shower chair supports higher
weight capacities.and provides seating stablilty,reducing the risk of falls. Adjustable
height for easier transfers in and out of the shower.Grab Bars and handrails helps him
maintain balance when entering or exiting the shower.Long-handled shower sponge
helps with independent bathing.
Physical Therapy: Involve physiotherapists to help Michael with mobility exercises.
Encourage activities such as passive range-of-motion exercises or assisted walking,
depending on his physical abilities and comfort.
Gradual Weight Loss: Since Michael is overweight, reducing his weight can help to
decrease the pressure on his joints and bony prominences. Simple exercises, as

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approved by the physiotherapist, can be introduced to improve his mobility and
reduce weight, thereby preventing additional health complications.
3、Pressure Sore Prevention and Solution
Grade 1 Pressure Sore: This indicates a non-blanchable erythema (redness) of intact
skin, commonly on bony prominences (like the sacrum). Early intervention is crucial
to prevent further deterioration.
Regular Repositioning: Michael should be repositioned every 2 hours to relieve
pressure on the sacrum and prevent the development of further sores. Nurses or
caregivers should help him change positions to alternate between lying on his back,
sides, and sitting positions.
Equipment -use: Mattresses & cushions.
Foam or Air Mattress to distribute pressure evenly.Gel Cushions for wheelchair users.
Heel protectors & Positioning Aids: to relive pressure from bony areas.If in a
chair:encourage weight shifts every 30 minutes.
Support Surfaces: The use of specialized mattresses or overlays, such as foam or air
mattresses, can help to reduce pressure on vulnerable areas, including the sacrum.
Skin Care: The skin over pressure points should be kept clean and dry.Use a
mild,pH-balanced cleanser and pat dry gently. Moisture, particularly from sweat or
incontinence, can contribute to skin breakdown. Gentle cleansing, followed by the
application of barrier creams, can protect the skin,like Zinc oxide or Cavilon cream.
Assessing Skin Regularly: Check the skin for signs of redness, skin breakdown, or
other pressure sores. Proper documentation and reporting are critical.
4. Infection Control and Wound Management
Wound Care for Pressure Sore: Grade 1 pressure sores generally require basic wound
care, but they must be monitored carefully to prevent infection and deterioration:
Keep the wound clean: Clean the pressure sore with sterile water or saline solution,
avoiding harsh soaps or chemicals that may irritate the skin.
Dressings: Use appropriate dressings, such as hydrocolloid or foam dressings, to
protect the wound from friction, moisture, and infection. Ensure the dressing is
changed regularly, as per hospital protocol.
Monitor for Signs of Infection: Monitor the wound for increased redness, warmth, or
discharge, which could indicate infection.
Proper infection control techniques are critical to prevent complications such as
sepsis.
5. Patient Education and Family Involvement
Education for Michael: He may need to be educated on the importance of
mobilization and nutrition in preventing further pressure sores and improving his
health.
Teach him about repositioning techniques and why these are necessary to avoid
prolonged pressure on certain body parts.
Discuss the importance of a healthy diet for wound healing and overall well-being.
Encourage him to consume meals high in protein and vitamins, particularly during his
recovery period.

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Involve Family or Caregivers: Since Michael lives alone, it would be beneficial to
involve family members or caregivers in his care. Teaching them how to assist with
repositioning, dressing changes, and monitoring his skin health is important.

Conclusion
To improve Michael's health and prevent further pressure sores can do from physical
and mental .
Physical solutions：
（1）Regular repositioning and use of support surfaces to alleviate pressure.
（2）Nutritional improvements to support wound healing and overall health.
（ 3 ） Physical activity and mobilization to improve circulation and prevent further
complications.
（4）Wound care management for his Grade 1 pressure sore to prevent infection and
promote healing.
Mental solutions:
Providing social and emotional support ,reducing isolation and stress.
By utilizing these care skills, Michael’s risk of developing further pressure sores can
be reduced, and his overall health can improve, supporting both his recovery and
quality of life.