Kategorier: Alle - comunicação - funcional - memória - sintomas

af TALITA MARQUES DO NASCIMENTO 3 år siden

141

AVALIAÇÃO DO IDOSO

A avaliação de idosos requer atenção especial a diversos fatores que podem influenciar a precisão e a eficácia do diagnóstico. Deficits sensoriais, como problemas de visão e audição, devem ser corrigidos com o uso de óculos, dentaduras ou aparelhos auditivos para facilitar a comunicação durante a entrevista.

AVALIAÇÃO DO IDOSO

Where to next?

If after constructing the VMOST tree for your organization you have no open questions, then you can be confident that your organization is well informed and well-aligned around your vision, mission, and strategy.

If you have any open issues from the analysis, then you should resolve these and communicate your vision, mission, and strategy again.

Many organizations have a vision, mission, and objectives but go straight to action, without having a strategy for understanding and solving difficult problems. This is the most likely area for further leadership.

AVALIAÇÃO DO IDOSO

Type in the name of your organization.

Strategy

How should your Strategies change?

You might need to add, remove or clarify strategies to achieve each objective.

Make some notes about how your Strategies could be changed.

Will your strategies achieve your objectives?

Consider each objective together with the strategies that solve future problems and obstacles.

You might need realign your strategies to ensure that there are no contradictions.

Make some notes about how your strategies should change.

Do all your strategies fit together?

Review all your strategies across objectives.

YesNoOther
How should your Strategies be strengthened?

Consider replacing strategies that do not solve problems.

Make some notes about how your Strategies should change.

Are your strategies really strategies?

Review each of your strategies and check that they really are strategies.

YesNoOther

You might need to clarify your objectives to include other strategies, or maybe some of your strategies are not really aligned with objectives and should be changed.

Make some notes about how your objectives or strategies should change.

Are all your strategies in the VMOST tree?
Add a strategy for this objective:

To deliver this objective, you will need to work strategically.

For any objective, there will be obstacles and problems.

Your strategy should show that you understand the key problems, and know how to solve them.

Example: Establish a high-value exclusive brand to limit competition.

Tactics

You might need to add, remove or clarify tactics to execute each strategy.

Make some notes about how your tactics could be changed.

Will your tactics deliver your strategies?

Consider each Strategy together with the tactical projects for executing it.

You might need to restructure your tactical projects to eliminate duplication and ensure that the outcomes contribute to strategy.

Make some notes about how your tactics should change.

Do all your tactical projects complement each other?
YesNoOther

You might need to clarify your strategies to include other tactical activities, or maybe some of your projects are not aligned with strategy and should be dropped.

Make some notes about how your strategies or tactics should change.

Are all your tactical projects in the VMOST tree?
Add a tactic for this strategy:

To execute your strategy, it will break down into a number of tactical activities.
Tactics are practical projects that bring your strategy to life.

Example: Make a list of preferred areas and research the independent food retail outlets in each.

Tactic

Communication

What actions should you take?

How can you ensure that your staff are making decisions that are influenced by bigger goals?

Make some notes about how you will do this.

Does your VMOST drive decisions?
What action should you take?

You might need to ensure that everyone understands your plan.

Make some notes about how you will do this.

Are all your staff aware of your vision, mission, objectives, strategy and tactics?

It is not uncommon for those who are working on the tactics of an organization to be unaware of the strategy, objectives, mission, and vision behind them.

Entrevista

How should your objectives change?

You might need to add, remove or clarify objectives to achieve your mission.

Make some notes about how your objectives could be changed.

Are your objectives enough to deliver your Mission?

Review your objectives together with your mission statement.

Add your answer
What should change?

You might need to review your objectives to ensure that they work as a group and support each other.

Make some notes about how your objectives should change.

História nutricional

Review all your objectives.

YesNoOther
O tipo, a quantidade e a frequência das refeições são determinados. O paciente que se alimenta ≤ 2 vezes/dia corre o risco de desnutrição.
História de álcool, tabaco e uso de drogas

You might need to clarify your mission to embrace other objectives, or maybe your objectives are not really aligned with your real mission.

Make some notes about how your mission statement or objectives should be changed.

Observar: sinais de enfermidades ocasionadas pelo alcoolismo, que são pouco diagnosticadas no idoso. Tais sinais incluem confusão, raiva, hostilidade, odor etílico na respiração, diminuição do equilíbrio e da marcha, tremores, neuropatia periférica e deficiência nutricional.
O Short Michigan Alcohol Screening Test-Geriatric Version (ou SMAST-G)
História de fármacos
Natureza precisa de quaisquer alergias a fármacos
Motivo para a prescrição do fármaco
Prescritor
Horário de dosagem
Dose
Fármacos usados
História clínica

To deliver your mission, you will need a number of primary objectives.

These are major milestones, showing that you are achieving your mission. These should be written as SMART objectives, which means they are


Example: To partner with 5 new organic food retail outlets this year.

Perguntar sobre as enfermidades mais comuns (p. ex., febre reumática ou poliomielite) e sobre tratamentos antigos (p. ex., terapia de pneumotórax para tuberculose ou com mercúrio para sífilis) ao interpelar o idoso sobre a história dos fármacos usados. Uma história de imunizações (p. ex., tétano, influenza ou pneumococo), reações adversas às imunizações e resultados de teste cutâneo para tuberculose é necessário.

Atenção

Distúrbios e problemas associados à idade
Os indivíduos com degeneração da função cognitiva podem ter problemas em descrever as dificuldades, impedindo a avaliação.
Medo
O idoso pode relutar em informar determinados sintomas pelo receio de ser hospitalizado, pois associa esse fato à morte.
Dificuldades em recordar
Não se lembrar com precisão de doenças passadas, internações, cirurgias e uso de fármacos; Devendo obter tais informações por meio dos membros da família, cuidador ou prontuários.
Declínio funcional como única manifestação
Ex .: Perguntas sobre a duração do declínio funcional ("Quanto tempo vou conseguir para fazer suas compras?") Podemos extrair informações úteis.
Manifestações incomuns de determinado distúrbio
As manifestações típicas de determinada doença podem estar ausentes. Em vez disso, o idoso pode apresentar sintomas inespecíficos (p. ex., fadiga, confusão, perda ponderal).
Relato incompleto de sintomas

Review your Vision statement:

Does your vision really reflect the values and beliefs that motivate you and your staff?

YesNoOther
Não relatar alguns sintomas por considerarem que fazem parte do envelhecimento normal (p. ex., dispneia, deficits auditivos e visuais, problemas de memória, incontinência, distúrbios de marcha, constipação intestinal, tontura, quedas).
Deficits sensoriais

In one sentence, describe the vision of your organization. Your vision should:


Example: You believe that sustainable organic foods are better for people and the environment

Dentaduras, óculos de grau ou aparelhos auditivos devem ser usados, se for o caso, para facilitar a comunicação durante a entrevista. Iluminação adequada e eliminação da distração visual ou auditiva também ajudam.

Levantamento do histórico

Negligência ou abuso do cuidador
Medo inexplicável do cuidador no paciente.
Queimaduras peculiares;
Hematomas nas genitálias;
Hematomas por pressão no membro superior;
Hematomas frequentes, especialmente em áreas menos visíveis (por exemplo, nenhuma coluna me fornece);
Diagnóstico tardio ou equivocado

Make some notes about how your Mission statement could be improved.

Normalmente, os primeiros sinais de distúrbios físicos são comportamentais, mentais ou emocionais.
Polifarmácia

Review your vision statement and mission statement together.

Does your mission statement bring your vision to life? Do the targets in your mission statement align with your vision?

YesNoOther
Com múltiplas doenças pode ser necessário o uso de muitas drogas.
múltiplas doenças

In one sentence, summarise your mission.

Your mission states how you express your vision - what you are aiming to do, to make your vision into reality.

Example: to be the leading supplier of organic foods in your area

O tratamento de uma determinada doença não deve ocorrer negligenciando-se outra.