Deprecated: mysql_connect(): The mysql extension is deprecated and will be removed in the future: use mysqli or PDO instead in /irehabilitujemy/config/database.php on line 13

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Opieka domowa dla osób obłożnie i przewlekle chorych pytania i odpowiedzi - Fizjoterapeuta. Rehabilitacja. | iRehabilitujemy.pl
    • 18
      sie
      2013

    Opieka domowa dla osób obłożnie i przewlekle chorych pytania i odpowiedzi

    Lekarz pierwszego kontaktu z wizytą domową

    Jeśli Pacjent jest obłożnie chory i przebywa w domu - warto pamiętać, że ma prawo do pomocy ze strony lekarza pierwszego kontaktu. Jeśli  Pacjent nie dokonał wcześniej wyboru lekarza pierwszego kontaktu może zrobić to w każdej chwili. W tym celu wystarczy wypełnić i przekazać do przychodni deklarację - druk znaleźć można w każdej przychodni lub na stronie internetowej NFZ.


    Jak uzyskać pomoc lekarską w domu dla osoby obłożnie chorej?

    W przypadkach uzasadnionych wskazaniami medycznymi można zgłosić telefonicznie potrzebę wizyty domowej u chorego w godzinach pracy przychodni (od 8.00 do 18.00). Podczas wizyty lekarz zbada chorego, skontroluje jego stan, doradzi sposoby leczenia i pielęgnacji, wystawi recepty na leki. Warto również sprawdzić w przychodni, pod jaki numer telefonu należy dzwonić, jeśli będzie potrzebna pilnie wizyta lekarza pierwszego kontaktu wieczorem, nocą, w niedzielę czy święta. Taką pomoc można uzyskać w ramach tzw. opieki całodobowej. Każda przychodnia powinna umieścić w sposób widocznym informację o miejscu świadczonej opieki całodobowej- wraz z adresem i numerem telefonu. 

    Czy pacjent przebywający w domu w razie konieczności może liczyć na transport do szpitala?

    Może zdarzyć się, że podczas wizyty domowej lekarz stwierdzi, iż ze względu na pogorszenie stanu zdrowia konieczne jest przewiezienie chorego do szpitala, Pacjent może w takiej sytuacji liczyć na transport do najbliższego zakładu opieki zdrowotnej. W każdym przypadku zagrożenia życia lub nagłego pogorszenia stanu zdrowia każdy ma prawo również wezwać Pogotowie Ratunkowe.

    Czy lekarz specjalista może udzielić pomocy domowej?

    Pacjent lub opiekun może również w razie konieczności zgłosić potrzebę wizyty domowej lekarza specjalisty. Każda poradnia specjalistyczna mająca umowę z NFZ może udzielić takiej pomocy, należy jednak pamiętać, że do znacznej części specjalistów wymagane są skierowania, tak jak w przypadku wizyt w gabinecie (nie wymagane jest skierowanie do ginekologa, dermatologa, onkologa, okulisty, a także dla osób chorych na gruźlicę, HIV, inwalidów wojennych i osób represjonowanych)

    Domowa pomoc pielęgniarska dla osób obłożnie chorych

    W przypadku osoby obłożnie chorej często konieczna jest zmiana opatrunków czy np. regularne zastrzyki. Pacjent może  wówczas liczyć na pomoc pielęgniarki Podstawowej Opieki Zdrowotnej (POZ). Pielęgniarską opieką domową mogą być objęci pacjenci, którzy złożą deklarację wyboru do pielęgniarki POZ. Jeśli stan chorego będzie wymagał zachowania ciągłości udzielania świadczeń pielęgniarskich również po godz. 18.00 lub w soboty, niedziele oraz dni wolne od pracy – wówczas Pacjent uzyska pomoc w ramach tzw. opieki całodobowej.

    W czym może być pomocna pielęgniarka Podstawowej Opieki Zdrowotnej (POZ)?

    Pielęgniarka pomaga w terapii prowadzonej przez lekarza, aplikuje zastrzyki, zmienia opatrunki, wykonuje podstawowe zabiegi pielęgnacyjno-lecznicze - także w stomiach, przetokach i trudno gojących się ranach. Jeśli osoba chora wymaga specjalnej diety i karmienia może liczyć na wsparcie pielęgniarki w ustaleniu sposobu żywienia i rodzaju pokarmu. Fachowa opieka pielęgniarska pozwoli także zapobiec powikłaniom wywołanym długotrwałym unieruchomieniem, pielęgniarka pomaga bowiem również w podstawowych ćwiczeniach rehabilitacyjnych. Opiekun zajmujący się chorym - może liczyć na rady w zakresie codziennej opieki i pielęgnacji.

     
    Jak długo chory może korzystać z pomocy pielęgniarki POZ?

    Pielęgniarka rodzinna pomaga osobie obłożnie i przewlekle chorej tak długo, jak długo wymaga tego jej stan. Jeśli jednak chory potrzebuje na okres dłuższy niż 2 tygodnie dożylnej kroplówki, cewnikowania, zabiegów w przypadku stomii, przetoki; karmienia przez zgłębnik, płukania pęcherza moczowego bądź pielęgnacji ze względu na rurkę tracheotomijną warto wówczas skorzystać z pielęgniarskiej opieki długoterminowej. W uzyskaniu takiej opieki pomoże Państwu pielęgniarka POZ opiekująca się chorym, potrzebne będzie również skierowanie wystawione przez lekarza np. podstawowej opieki zdrowotnej.

    Pomoc położnej podstawowej opieki zdrowotnej

    Warto, by każda z pań pamiętała również o złożeniu deklaracji wyboru swojej położnej. Położna prowadzi edukację przedporodową dla kobiet w ciąży, wspomaga opiekę nad noworodkiem/ niemowlęciem do ukończenia 2 miesiąca życia oraz kobietą w okresie połogu. Ponadto, kobieta w każdym okresie swojego życia może zwrócić się do niej po fachową pomoc i opiekę w domu po operacjach ginekologiczno-położniczych, gdy konieczne jest np. aplikowanie zastrzyków domięśniowych czy dożylnych, leczenie i opatrywanie oparzeń, ran, odleżyn.

    Pielęgniarska opieka długoterminowa. Komu może być przydatna pielęgniarska opieka długoterminowa?

    Jeśli Pacjent jest obłożnie chory, nie wymaga pobytu w szpitalu, ale potrzebuje systematycznej opieki pielęgniarskiej może zostać zakwalifikowany do pielęgniarskiej opieki długoterminowej.

    Do pielęgniarskiej opieki długoterminowej mogą być zakwalifikowani pacjenci przewlekle chorzy, którzy w ocenie wg zmodyfikowanej skali Barthel uzyskali od 0 do 40 punktów.


    Jak uzyskać długoterminową opiekę pielęgniarki?

    W zakwalifikowaniu chorej osoby do objęcia opieką pomoże Pacjentowi lekarz pierwszego kontaktu oraz pielęgniarka środowiskowa. Lekarz wystawia stosowne skierowanie określając stan chorego i rodzaj niezbędnej pomocy; pielęgniarka wypełnia druk kwalifikacji opisując stopień samodzielności chorej osoby (m.in. w zakresie poruszania się, czynności higienicznych itp). Na podstawie tych dokumentów może zostać choremu przydzielona pielęgniarka opieki długoterminowej.

    Na co Pacjent może liczyć w ramach pomocy pielęgniarki opieki długoterminowej?

    Pielęgniarka opieki długoterminowej odwiedza chorego co najmniej 4 razy w tygodniu. W razie potrzeby dostępna jest również w niedzielę, święta i dni wolne od pracy. Chory może liczyć na pomoc w zakresie toalety, higieny, pielęgnacji; pomoc w poruszaniu się, podawaniu posiłków, zmianie opatrunków, dbałości o sprzęt np.: stomijny czy cewnik, aplikowaniu leków i zastrzyków. Opiekun natomiast, uzyska od pielęgniarki istotne wskazówki jak pielęgnować chorego na co dzień.

    Czy objęcie opieką długoterminową jest ograniczone czasowo?

    Czas objęcia chorego tą formą opieki jest uzależniony od stanu zdrowia pacjenta. Ocena jego stanu zdrowia odbywa się co miesiąc przez pielęgniarkę. W przypadku gdy pacjent uzyska więcej niż 40 punktów wg skali Barthel MOW NFZ nie finansuje dalszej opieki.

     

    REHABILITACJA -przywracanie sprawności u chorych z zaburzeniami narządów ruchu

    Kto może skorzystać z rehabilitacji domowej?

    Jeśli chory wymaga rehabilitacji i cierpi na zaburzenia narządów ruchu, które utrudniają samodzielne przemieszczanie się, co wyklucza wizyty w ambulatorium, może być objęty rehabilitacją w warunkach domowych.

    Ta forma opieki przeznaczona jest dla chorych:

    - z uszkodzeniami mózgu np. po zatorach mózgowych, udarach krwotocznych mózgu, urazach (do 12 miesięcy od zdarzenia)

    - z uszkodzeniem rdzenia kręgowego (do 12 miesięcy od powstania uszkodzenia)

    - ze schorzeniami przewlekle postępującymi (miopatia, choroba Parkinsona, zapalenia wielomięśniowe, rdzeniowy zanik mięśni, guzy mózgu, kolagenozy, przewlekłe zespoły pozapiramidowe, reumatoidalne zapalenie stawów)

    - ze zwyrodnieniami stawów biodrowych lub kolanowych po zabiegach endoprotezoplastyki stawu (do 6 miesięcy po operacji)

    - z urazami kończyn dolnych (do 6 miesięcy po urazie)

    Jak uzyskać rehabilitację domową dla chorego?

    W uzyskaniu tego typu opieki pomoże lekarz, który wyda skierowanie do poradni rehabilitacyjnej. Po otrzymaniu takiego skierowania należy zgłosić się do placówki mającej umowę z NFZ (każda poradnia rehabilitacyjna mająca kontrakt ma obowiązek świadczyć opiekę domową) i ustalić w wybranej placówce termin wizyty lekarskiej w domu.

    Jak przebiega rehabilitacja?

    Dokładny przebieg rehabilitacji, którą zostanie objęty Pacjent, zależy od wskazań lekarskich. Lekarz określa częstotliwość zabiegów zgodnie z potrzebami zdrowotnymi chorego.


    Czy istnieją ograniczenia czasowe w prowadzeniu rehabilitacji?

    Czas rehabilitacji w warunkach domowych wynosi do 80 dni zabiegowych w roku kalendarzowym oraz nie więcej niż 5 zabiegów dziennie

     

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