A6 Home Health Discussion.
A6 Home Health Discussion.
Mr. B. is an 83 year old male referred to home health services following a hospital admission for congestive heart failure. His payor source is Medicare (traditional). He lives alone and indicates he does not have sufficient financial resources to afford private-pay in home supportive care. His daughter, who lives in the neighboring county about 30 miles away, has offered her father to move in with her – he has refused and she is not “forcing the issue”. Mr. B. is also not open to discussing moving to an assisted living environment.
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This is his third hospital admission for the same problem over the last 12 months and his second admission to a home health agency. He was discharged from the previous home health agency 6 weeks ago. Physician orders are for the home health agency to provide skilled nursing for assessment of his cardiac condition and to teach him about his care and medication regime. Physical therapy has been ordered to establish a home exercise program. Home health aide services have been ordered 3 times a week to assist Mr. B. with his personal care needs.
By the end of the third week of service, it is clear to the RN Case Manager that Mr. B. is not making progress to the established goals. She reports during case conference that he is not a good candidate for teaching because of intermittent confusion and forgetfulness. According to the nurse, no matter what she has tried to teach him and regardless of the aids she has used, Mr. B. continues to take is medication incorrectly. She states, “I know he needs services, but I am not sure that he is in the right environment. I am concerned about Mr. B. – I am not sure why his daughter won’t just step up and put her foot down.”
The physical therapist reports at case conference that the “client lacks motivation”. The home exercise program has been established with Mr. B.; however, he does not complete the exercises between therapy visits.
An improvement in his personal hygiene has been noted with the Home Health Aide (HHA) services. The HHA has also been successful in decluttering his living space. The HHA reports that she is concerned that he is not eating regular meals.
This situation offers an ethical challenge to the professional caregivers and to the agency for which they work.
Discuss how you would handle this ethical dilemma. Address the following questions as a part of your response:
- What are your concerns about this case?
- How does the RN Case Manager meet her ethical responsibilities to the patient and to the organization?
- What is the best plan of action to ensure the client’s safety and well-being?
- What are realistic outcomes and goals for this client?
- Who will provide the ongoing care needs required by this client?
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy
For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
A6 Home Health Discussion.