Question

Using Dorothea Orem's Self-Care Deficit theory:

Determine Caregiver and patient goals for the following scenerio:

• Patient is a 25-yr old construction worker, lives with his fiancé who is 8 months pregnant with their first child. He has a younger brother who lives with their parents.
• Motorcycle head-on collision, was wearing his helmet
• Treated at local ER Trauma Hospital
• Taken to surgery for emergent surgical procedure to repair lacerated liver, kidneys and pancreas, with massive internal bleeding.
• Fractured right leg, pins placed on R leg, on orthopedic leg traction
• Extensive surgery done to save right foot
• Taken to Surgical ICU (SICU) post operatively, sedated, on mechanical ventilator (respirator), with multiple IV drips to maintain blood pressure, on dialysis for acute kidney failure, on a special orthopedic bed with traction.

Answer 1

Caregiver goals to be followed are::

• Accept help. Be prepared with a list of ways that others can help you, and let the helper choose what he or she would like to do. For instance, a friend may offer to take the person you care for on a walk a couple of times a week. Or a friend or family member may be able to run an errand, pick up your groceries or cook for you.
• Focus on what you are able to provide. It's normal to feel guilty sometimes, but understand that no one is a "perfect" caregiver. Believe that you are doing the best you can and making the best decisions you can at any given time.
• Set realistic goals. Break large tasks into smaller steps that you can do one at a time. Prioritize, make lists and establish a daily routine. Begin to say no to requests that are draining, such as hosting holiday meals.
• Get connected. Find out about caregiving resources in your community. Many communities have classes specifically about the disease your loved one is facing. Caregiving services such as transportation, meal delivery or housekeeping may be available.
• Join a support group. A support group can provide validation and encouragement, as well as problem-solving strategies for difficult situations. People in support groups understand what you may be going through. A support group can also be a good place to create meaningful friendships.
• Seek social support. Make an effort to stay well-connected with family and friends who can offer nonjudgmental emotional support. Set aside time each week for connecting, even if it's just a walk with a friend.

• Set personal health goals. For example, set goals to establish a good sleep routine, find time to be physically active on most days of the week, eat a healthy diet and drink plenty of water.

Patient goals are::

The first, most obvious place to begin with trauma therapies is in the immediate management of the physical effects of the trauma. Physical injuries are first stabilized and then treated in a chain of medical actions that begin in the field with effective emergency care and end with discharge to physical therapy. Obviously, the exact course followed through the recovery process will differ from one patient to the next, but, in general, the central focus will be on preventing further harm, stabilizing the patient’s present condition and moving forward with repair of the physical damage. Apart from any equipment or medications used in the course of this process, the techniques of physical therapy — special exercises, massage and practice at using necessary equipment such as prosthetic devices — will be employed to salvage as much of the individual’s prior quality of life as possible.