HOME CARE for Mrs. Murphy

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In the last 15 years we have seen marked changes in the health picture in this country. These are the result of new drugs, new equipment, and perhaps most important, new ideas.

Concepts about rehabilitation, early ambulation, home care, psychological and sociological influences have resulted in better coordinated and more comprehensive plans of care for patients, shorter periods of hospitalization, and greater emphasis on teaching patients to care for themselves at home.

At the New England Center Hospital in Boston, we have developed a plan of care for patients who are discharged while they are still convalescent. A key person in the successful operation of this plan is the public health integrator, whose job it is to coordinate the plans for the patient's care at home. She must evaluate his nursing problems and devise a plan of nursing care that is tailored to the needs of the individual patient and his family.

She must determine what the patient needs to learn, according to his medical or surgical problems, his emotional stability, and his attitude toward learning to care for himself. She must help him obtain the equipment he will need, or improvise it, and she must show him how to use it properly. She must be familiar with the social agencies in the community which can be called on when their services will help meet the patient's needs.

In developing her plan with the patient for his care at home, the public health integrator must respect individual differences and consider such factors as the patient's educational level, background, age, sex, nationality, his religious beliefs and customs, and what his diagnosis and prognosis mean to him and to his family and community.

Here is the report of a case that illustrates how coordinated efforts can effect comprehensive care for a geriatric patient.

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