Biomedical subjects
Publications and source records attributed to D O Staats.
The nursing home medical director faces many overlapping responsibilities. Fostering the development of an interdisciplinary team provides a means of maximizing the influence of the medical director. Setting standards of care and humanizing life in the nursing home are other tasks of the medical director.
Fecal impactions are a common problem in debilitated elderly people and may present as a life-threatening event. The atypical presentations of fecal impactions are not well-recognized, and the incidence, morbidity and mortality of fecal impactions in the elderly are largely unknown. Elderly debilitated people have reduced organ system reserve. An acute illness may worsen underlying chronic diseases. Fecal impactions may upset the fragile homeostasis of an elderly debilitated person. The signs and symptoms of fecal impaction may not be manifested in the gastrointestinal system; rather, the patient may present with circulatory, cardiac or respiratory symptoms. If the diagnosis of fecal impaction is unrecognized and untreated, signs and symptoms may progress, leading to death. The causes, mechanisms, appropriate history, physical examination, diagnostic techniques, therapy and prevention of fecal impactions in elderly people are presented.
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Tuberculosis surveillance efforts in the nursing home for elderly persons need organization into an effective program. The ability to tally results of testing gives reliable parameters for comparison and may alert practitioners to early active disease presentation and transmission within the setting. Such efforts based on current research and recommendations ensure provision of prudent and useful standards of elderly care. Our experience during a 10-year period shows that tuberculosis may be an active problem for nursing home populations.
This article has described a self-care model of teaching infection control to CNAs in nursing homes. How the CNAs know and detect illness in themselves becomes the basis for learning about the presentation of acute illness in nursing home residents. This model begins with a discussion of the different meanings of feelings, then the awareness of changes during acute illness, and the factors affecting nursing home residents that change their perceptions of acute illness. With this knowledge, CNAs empathically detect the changes of common acute infectious illnesses in elderly nursing home residents to accomplish infection control. This model uses self-care as a motivational tool, blending greater knowledge with self-confidence.