Discharge And Home Healthcare Guidelines

Be sure the patient or caregiver understands all medications, including the dosage, route, action, and adverse reactions. Avoid the use of alcohol, reserpine, pyridoxine, and phenothiazine while taking levodopa. In general, recommend massage and relaxation techniques, and reinforce exercises recommended by the physical therapist. Several techniques facilitate mobility and enhance safety in Parkinson's disease patients. Instruct the patient to try the following strategies: (1) To assist in maintaining balance, concentrate on taking larger steps with feet apart, keeping back straight and swinging the arms; (2) to overcome akinesia, tape the "frozen" leg to initiate movement; (3) to reduce tremors, hold objects (coins, keys, or purse) in the hand; (4) to obtain partial control of tremors when seated, grasp chair arms; (5) to reduce rigidity before exercise, take a warm bath; (6) to initiate movement, rock back and forth; (7) to prevent spine flexion, periodically lie prone and avoid using a neck pillow; and (8) teach the patient to eliminate loose carpeting, install grab bars, and elevate the toilet seat. Use of chair lifts can also be beneficial.

Explore coping strategies with the patient and family. Support groups for the Parkinson's disease patient and family are available in most cities. Contact the American Parkinson's Disease Association and Referral Center (APDA), 116 John Street, New York, NY (1-800-223-2732). Encourage the patient to be independent in the activities of daily living. Use devices and assistance as necessary. Provide ample time to complete self-care.

Pelvic Fractures DRG Category: 236

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