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    Tracheostomy means creating an artificial opening in the windpipe ( trachea ) by a surgical procedure. It is done to facilitate breathing in patients where normal breathing is not possible or in patients who have to be weaned off from the ventilator. Air goes in and out through this opening and whatever secretions the lungs produce can be removed from this opening.


    There are many indications, few of them are

    Congenital conditions affecting wind pipe and larynx.

    2. Tumours affecting the wind pipe.

    3. Injury affecting respiration.

    4. Fractures affecting head and neck

    5. As a precaution in major head and neck surgeries.

    6. In certain patients requiring long term convalescence.


    Care of tracheostomy differs in patients who can do self care or in bed ridden patients who have to be helped with tracheostomy care.

    The basic principle is to keep the air moist as the natural organs that is the mouth and the nose which moisten the air before it enters the wind pipe are bypassed because of tracheostomy. Few tips to keep the air moist are

    1. Drinking lots of water if not contraindicated medically.

    2. Saline wash as advised by doctor.

    3. Humidifying the air in the room by humidifiers.

    4. Care of skin around the tracheostomy

    a. Special care of skin around the tracheostomy should be done in such a way that the water and soap does not enter the tracheostomy. It is best to clean it with sterile piece of gauze. Any secretion or mucus which gathers near the skin should be dislodged gently without disturbing the tracheostomy. Any redness or soreness on the skin should be noted and reported.

    b. If mucoid secretions tend to collect around the tracheostomy then plain gauze can be kept around the opening.

    5. Suction :- it is required time to time to bring out secretions from the lungs. In a patient who is able to take care of the tracheostomy himself it is easy for him to bring it out and the patient will know when to do suction if the chest feels heavy. In bed ridden patients the attendant has to be taught to do gentle suction as and when the secretions can be heard in the chest or when they are coming out.

    6. Few tips for doing suction

    a. Keep the machine off while inserting the suction tube.

    b. Don’t insert the catheter inside for more than 10 seconds specially in patients requiring oxygen.

    c. After insertion of the tube pull out tube a little before switching on the machine.

    d. Rinse the catheter with water or saline in between suctions.

    e. Keep the head up.

    f. Wipe out whatever secretions accumulate around the tracheostomy or in the mouth.

    These are few tips regarding tracheostomy care but ALWAYS CONSULT your Doctor or a senior nursing attendant before doing tracheostomy care by yourself.
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Old age homes ppt Old age homes ppt Presentation Transcript

  • OLD AGE HOMES FOR THE ELDERLY Team Members: Harsh Khatri, Shyam Rajgarhia, Chayan Dhall, Rishabh Bhandari, Kripa Grover, Tanya Aggarwal, Simran Mattu, Radhika Ahuja
  • Changing world Scenario      The world will have more people who live to see their 80s or 90s than ever before. The past century has seen remarkable improvements in life expectancy. Soon, the world will have more older people than children. The world population is rapidly ageing. Low- and middle-income countries will experience the most rapid and dramatic demographic change. Source :WHO 2010 2
  • Ageing: The Indian Scenario…  India is one of the few countries in the world where sex ratio of aged is in favor of males. Population above 60 years 10% suffer from impaired physical mobility.  10% Hospitalized at given point of time. Age more than 70 years More than 50% suffer form 1 or more chronic conditions like CHD, Cancer and HT . 3
  • Problems faced by Elderly
  • Caregivers’ perspectives on elder care  demanding behaviors of older people  selfishness and self centeredness  rigid and opinionated  authoritarian nature  nagging and criticizing  interfering  being jealous and impatient
  • Experience of abuse and neglect An elder is physically abused when she is not attended by her caregivers who are in most cases family members. They need timely care  (a) when they experience a simple head ache or back ache and cold  (b) if family members or caregivers are not taking the elderly to doctor when sick  (c) when elderly are not served meals  (d) do not help elderly with personal chores in spite of the elderly assisting in the family chores
  • Old Age People in Joint Family Advantages Disadvantages • The joint family system has been prevalent in India since ancient times and has always given a special place to the elder generation. • The elderly are not only revered and well taken care of, but also enjoy and amuse themselves in the company of their counterparts. The others in the family also benefit from their presence. • Even today, elder people in joint families live convenient lives due to availability of care and company. • In a fast pacing world, joint families prove difficult in formation. • They are decreasing by the day, which is why, many veterans who traditionally lived in joint families(but now live in nuclear homes) are compelled to shift to old age homes.
  • Old Age People in Nuclear Family Advantages Disadvantages • The primary reason for the formation of nuclear families is job opportunities available in the city. • Nuclear families can prove useful to veterans. Moreover veterans can be useful to such households. • With both working parents, children derive guidance from their grandparents. • Grandparents too, if living in cities, find company their age. • Full time care has to be ensured for elders which can prove to be expensive. • The grandchildren and grandparents may have a generation gap in the case of which, both parties end up lonely. • People in nuclear families are not able to devote due to time to their elderly, even if they pay for their expenses. • The emotional support is not provided and may cause relation gaps to widen.
  • HOW TO ACHIEVE OPTIMUM ELDERLY CARE? • Active advocacy at various levels of planning. • Need for reorganization of the facilities and approach. • Efforts need to be made to revive cultural values and reinforce the traditional practice of interdependence among generations. • Surveillance of the on-going programmes and evaluation of their effectiveness.
  • Solutions for the Elderly Increasing Awareness Education & Media • Increasing awareness among physicians, mental health professionals, home health care workers and others who provide services to older adults and family members can help break patterns of abuse or neglect, and both the person experiencing the abuse and the abuser can receive needed help. • Education is the cornerstone of preventing elder abuse. As most cases of abuse occur in the home by family members or caregivers, there needs to be a concerted effort to educate the public about the special needs and problems of older adults and the risk factors for abuse.
  • Respite Care Counselling • Respite care — having someone else care for the elder, even for a few hours each week is essential to reducing caregiver stress, a major contributing factor in elder abuse. Respite care is especially important for caregivers of people suffering from Alzheimer's disease or of older people who are severely disabled. Area Agencies on Aging are a local resource for services that might help family caregivers find respite and in-home help with difficult care tasks, such as bathing, dressing and cooking. • Counselling for behavioural or personal problems in the family or for the individual with mental health and/or substance abuse problems can play a significant role in helping people change lifelong patterns of behaviour or find solutions to problems emerging from current stresses. If there is a substance abuse problem in the family, treatment is the first step in preventing violence against the older family member.
  • Social Contact and Support • Social contact and support can be a boon to older persons and to family members and caregivers as well. Having other people to talk to is an important part of relieving tensions. Many times, families in similar circumstances can band together to share solutions and provide informal respite for each other. In addition, when there is a larger social circle, abuse is less likely to go unnoticed. Isolation of elders increases the probability of abuse, and it may even be a sign that abuse is occurring. Sometimes abusers will threaten to keep people away from the older person.
  • Advantages of Old Age Homes  Old age homes are meant for senior citizens who are unable to stay with their families or are destitute. These old age homes have special medical facilities for senior citizens such as mobile health care systems, ambulances, nurses and provision of well-balanced meals. So they can live a healthy life.  Good services and good behavior of the staff, food being palatable and wholesome are the main advantage of old age homes.  Apart from food, shelter and medical amenities, old age homes also provide yoga classes to senior citizens.  Old age homes also provide access to telephones and other forms of communication so that residents may keep in touch with their loved ones.  The entertainment and library facilities are also available for the sole purpose of the senior citizens.
  • Disadvantages of Old Age Homes Some elders are not taken care of properly. Some have to share rooms with others, and sometimes they don’t get along. Generally children send their parents to old age home to stay away from them. It’s not a good example for a country like India where old people are considered a lucky charm. Sometimes there is lack of facilities at these old age homes as well as lack of caretakers also. These old persons are left to themselves and there is no body that can take care of them at this age. Their management is profit driven. Patient care is low on their priority's. Employees are poorly trained. badly paid, and not usually treated well.
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