During Margaret’s first few weeks at Christian Health Care Adult Day Services of Wyckoff, Marie Lemme, RN, Nursing Services Director, noticed that the 70-year-old client was making frequent visits to the restroom. Ms. Lemme contacted Margaret’s family and suggested that the senior be evaluated by a urologist. A subsequent examination with the medical specialist revealed a bladder dysfunction. Once placed on the proper medication, the condition was resolved.
Bill, 73, had diabetes and was on dialysis when he joined Christian Health Care Adult Day Services of Wayne. Nursing Director Jamie Crowell, RN, began wound-care treatment and coordinated care with a podiatrist. Bill’s quality of life improved, and inevitable podiatric surgery was able to be postponed.
Margaret and Bill’s cases illustrate the benefits of the comprehensive medical services provided by the programs’ professional registered nurses. The nurses, all with extensive geriatric experience, coordinate physical assessments, diagnostic tests, and consultations; monitor vital signs; administer and monitor medications; coordinate written care plans for every client; and ensure the timeliness of services provided. If the nurse determines that a client’s condition warrants a visit to a physician, she’ll alert the family and even call the physician to make an appointment.
A medical director and pharmacy consultant for each site complement the nurses’ professional services. The medical directors review charts and assure that policies and procedures adhere to state and federal guidelines. Medications are reviewed by the pharmacy consultant. If necessary, recommendations for drug modifications are submitted to clients’ personal physicians.
“The medical team’s goal is proactive wellness,” Ms. Lemme says. “We strive to keep our clients as healthy as possible so they can maintain maximum independence and remain in the community.”
Each client undergoes a comprehensive medical assessment upon joining the program. Physical function and status, hearing, vision, psychological well-being, cognitive function, nutritional status, dental hygiene, skin condition, and medication usage are evaluated and documented. Past surgeries and current conditions are discussed. Findings are then combined with information received from the client’s personal physician to create a comprehensive medical record.
Once this chart is established, regular health monitoring can be tailored to each client. Weight and blood pressure, for instance, are typically checked every other month. Clients on blood-pressure medication, though, need monthly monitoring of vital signs. Some conditions may require monthly, or even daily, checks.
The greatest tool for health monitoring, however, is observation. The entire staff, from the nurses to the activities professionals, closely watches clients while they are walking, exercising, eating, etc. The slightest deviation from a client’s normal functioning can be immediately picked up.
“In an elderly person, a urinary tract infection (UTI) won’t present with typical symptoms. Instead, mental changes are one of the first indications. Even if the person has dementia, he or she will suddenly become even more disoriented. If a UTI isn’t treated, the person could wind up in the hospital,” Ms. Crowell says. “If seniors are diagnosed and treated early, they have a good chance of staying out of the hospital.”
One of the greatest benefits of the medical services provided is the sense of safety and security clients develop.
“A client might say, ‘I’m glad you’re here because you’re my support,’ or ‘I feel comfortable here because it’s like an extension of my home,’ “ Ms. Lemme says. “That’s when you know you’re their lifeline.”