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Skilled nursing services are provided by specially trained registered nurses and licensed vocational nurses that begin all cases with an assessment to obtain information to establish a plan of care. The services are prescribed by a doctor on an intermittent basis and include such things as dressing changes, teaching and administration of medications, intravenous therapy, catheter care, diabetic care, wound care, and teaching the family how to care for the patient in the home.
Home Health Aides work under the supervision of a registered nurse or therapist. Services primarily consist of assistance with personal care. A home health aide may give a bath, give oral care, foot care, shampoo, shaving, skin care, and change linens. Under Medicare, a home health aide may stay in the home for a limited time or for a visit only and is authorized to provide personal care only.
Physical Therapy services are provided on an intermittent basis in the home as needed for patients who have functional limitations or sensory deficits.
FALLS
Falls are the most frequent and most serious accidents in the home. There are several things you can do to prevent falls:
• Remove throw rugs when patient is relying on ambulatory aides such as walkers and canes or has a shuffling gait
• Use non skid tape or backing on throw rugs. Tack down the edges of all carpets
• Be sure there are firmly anchored non-slip treads, good lighting and a solid, easy-to grasp handrail that is rounded or knobbed at the end of stairs
• Consider painting or taping the top and bottom steps so they’ll be easily noticed
• Make sure there is a clear walkway through every room. Don’t use halls or stairways for storage
• Be sure halls and stairways arc well lit
• Don’t walk on a freshly washed or waxed floor until it is dry
• Wipe up any spills immediately
• Avoid wearing only socks, smooth-soled shoes, or slippers on uncarpeted floors
• In the bathroom, be sure mats are non skid and there are treads in the tub or shower to prevent slips
• Keep outdoor stairs, porches, and walkways free of wet leaves, snow, and ice
• Make sure stairs and walkways are in good repair.
FIRE SAFETY/BURN PRECAUTIONS
• Don’t smoke in bed or when sleepy, or while under sedation, or around oxygen
• Use portable heaters according to manufacturer’s instructions. Turn off before going to bed
• Have your home checked if there are signs of wiring problems
• Check hot water temperature. Experts suggest setting hot water at 120 degrees Fahrenheit or lower
• Keep pot handles turned away from the front of the stove. Use pot holders when necessary.
• Never leave unattended food cooking on the stove
Be Prepared
• Install smoke detectors and check them regularly
• Keep multipurpose fire extinguishers charged and handy
• Make a fire escape plan. Check fire exits to be sure they open easily and are free of clutter
• If you live in an area where weather conditions change suddenly, make sure you have an evacuation plan or call your city hall regarding the emergency evacuation plan
MEDICATION SAFETY
• Do not take medications that are not prescribed for someone else.
• Create a complete list of current medications and keep this list with you at all times in the event of emergency situations.
• Report medication allergies or side effects to your health care provider.
• Do not use alcohol when you are taking medicine
• Do not stop or change medicines without your doctor’s approval, even if you are feeling better.
• Store medications in their original containers in a safe, cool and dry place.
HAZARDOUS ITEMS AND POISONS
• Know how to contact your poison control team.
• Carefully store hazardous items in their original containers.
• Do not mix products that contain chlorine or bleach with other chemicals.
• Keep hazardous items, cleaners, and chemicals out of reach of children and confused or impaired adults.
• Dispose of hazardous items and poisons only as directed.
MEDICAL EQUIPMENT SAFETY
• Keep manufacturer’s instructions with or near specialized medical equipment.
• Keep phone numbers available in the home to obtain service in case of equipment problems or failure.
• Have backup equipment available, if indicated.
• Provide adequate electrical power for medical equipment such as ventilators, oxygen concentrators and other equipment.
• Test equipment alarms periodically to make sure that you can hear them.
• Have equipment batteries checked regularly by a qualified service person.
• Register with your local utility company if you have electrically powered equipment such as oxygen or ventilator.
OXYGEN SAFETY
• Use oxygen only as directed.
• Oxygen creates a high risk for fire because it causes an acceleration of flame in the presence of flammable substance and open flames.
• Do not smoke around oxygen. Post “No Smoking” signs inside and outside the home.
• Store oxygen cylinders away from heat and direct sunlight.
• Dust the oxygen cylinder with a cotton cloth.
• Keep open flames (such as gas stove and candles) at least 10 feet away from the oxygen source.
• Keep at least 6 inches of clearance around an oxygen concentrator at all times.
• Have a backup portable oxygen cylinder in case of a power or oxygen concentrator failure.
• Alert property management of oxygen use when living in a multi-dwelling residence.
Prepare different kits for different places and situations
(Carry on You, Grab-and-Go, Bedside, Home)
Keep important items in a consistent, convenient and secured place, so you can quickly and easily get to them. (Items such as teeth, hearing aids, prostheses, canes, crutches, walkers, wheelchairs, respirators, communication devices, artificial larynx, sanitary aids, batteries, eyeglasses, contact lens with cleaning solutions, etc.)
Stay indoors and wear warm clothes. Layers of loose-fitting, lightweight, warm clothing will keep you warmer than a bulky sweater. If you feel too warm, remove layers to avoid sweating; if you feel chilled, add layers.
Listen to a local station on battery-powered radio or television or NOAA Weather Radio for updated emergency information.
Bring your companion animals inside before the storm begins.
Move other animals to sheltered areas with a supply of non-frozen water. Most animal deaths in winter storms are caused by dehydration.
Eat regularly. Food provides the body with energy for producing its own heat.
Keep the body replenished with fluids to prevent dehydration. Drink liquids such as warm broth or juice. Avoid caffeine and alcohol. Caffeine, a stimulant, accelerates the symptoms of hypothermia. Alcohol such as brandy, is a depressant and hastens the effects of cold on the body. Alcohol also slows circulation and can make you less aware of the effects of cold. Both caffeine and alcohol can cause dehydration.
Conserve fuel. Winter storms can last for several days, placing great demand on electric, gas, and other fuel distribution systems (fuel oil, propane, etc.). Lower the thermostat to 65° F (18° C) during the day and to 55° F (13° C) at night. Close off unused rooms, and stuff towels or rags in cracks under the doors. Cover the windows at night.
Staying Safe Indoors
1) Turn off the power and water mains if instructed to do so by local authorities.
2) Boil tap water until water sources have been declared safe.
3) Avoid contact with floodwater. It may be contaminated with sewage or contain dangerous insects or animals.
4) Continue listening to local area radio, NOAA radio or TV stations for the latest information and updates.
5) Don’t use gas or electrical appliances that have been flooded.
6) Dispose of any food that comes into contact with flood water .
Staying Safe Outdoors
1) Don't walk, swim or drive through floodwater. Just six inches of fast-flowing water can knock you over and two feet will
float a car.
2) If caught on a flooded road with rapidly rising waters, get out of the car quickly and move to higher ground.
3) Don't walk on beaches or riverbanks.
4) Don’t allow children to play in or near flood water.
5) Avoid contact with floodwater. It may be contaminated with sewage or contain dangerous insects or animals.
6) Stay out of areas subject to flooding. Underpasses, dips, low spots, canyons, washes, etc. can become filled with water.
FACT vs. FICTION
FICTION:
If you have a truck or SUV, it’s okay to drive across rushing flood water.
FACT:
Just two feet of rushing water can carry away most vehicles, including SUVs and pickup trucks. Never try to drive across rushing flood water.
If a Fire Starts:
1) Know how to safely operate a fire extinguisher
2) Remember to GET OUT, STAY OUT and CALL 9-1-1 or your local emergency phone number.
3) Yell "Fire!" several times and go outside right away. If you live in a building with elevators, use the stairs. Leave all your
things where they are and save yourself.
4) If closed doors or handles are warm or smoke blocks your primary escape route, use your second way out. Never open
doors that are warm to the touch.
5) If you must escape through smoke, get low and go under the smoke to your exit. Close doors behind you.
6) If smoke, heat or flames block your exit routes, stay in the room with doors closed. Place a wet towel under the door
and call the fire department or 9-1-1. Open a window and wave a brightly colored cloth or flashlight to signal for help.
7) Once you are outside, go to your meeting place and then send one person to call the fire department. If you cannot get
to your meeting place, follow your family emergency communication plan.
8) If your clothes catch on fire:
9) Stop what you’re doing.
10) Drop to the ground and cover your face if you can.
11) Roll over and over or back and forth until the flames go out. Running will only make the fire burn faster.
THEN:
Once the flames are out, cool the burned skin with water for three to five minutes. Call for medical attention.
1) Seek shelter in a basement, shelter or sturdy building.
2) If you cannot quickly walk to a shelter, immediately get into a vehicle and try to drive to the closest sturdy shelter.
3) Remember to buckle your seat belt.
4) Stay away from bridge/highway overpasses.
5) If strong winds and flying debris occurs while driving, pull over and park, keeping your seat belt on and the engine running. 6) Put your head down below the windows, covering your head with your hands and a blanket.
If you do nothing else:
1) Let friends and family know you’re safe
2) If evacuated, return only when authorities say it is safe to do so.
3) Continue listening to local news or a NOAA Weather Radio for updated information and instructions.
4) Check for injuries. If you are trained, provide first aid to persons in need until emergency responders arrive.
Top Tips
1) To escape a tsunami, go as high and as far as you can – ideally to a spot 100 feet above sea level or 2 miles away.
2) Every foot inland or upward may make a difference!
3) If you can see the wave, you are too close for safety.
4) Know the difference!
REMEMBER:
A Tsunami WARNING means a tsunami may have been generated and could be close to your area.
A Tsunami WATCH means a tsunami has not yet been verified but could exist and may be as little as an hour away.
If You Feel a Strong Coastal Earthquake
• Drop, cover, and hold on to protect yourself from the earthquake.
• When the shaking stops, gather members of your household and review your evacuation plan. A tsunami may be coming within minutes.
• Use a NOAA Weather Radio or stay tuned to a Coast Guard emergency frequency station, or a local radio or television stations for updated emergency information.
• Follow instructions issued by local authorities. Recommended evacuation routes may be different from the one you planned, or you may be advised to climb higher.
• If you hear an official tsunami warning or detect signs of a tsunami, evacuate at once. A tsunami warning is issued when authorities are certain that a tsunami threat exists, and there may be little time to get out.
• Take your emergency preparedness kit. Having supplies will make you more comfortable during the evacuation.
• If you evacuate, take your animals with you. If it is not safe for you, it is not safe for them.
• Get to higher ground as far inland as possible. Watching a tsunami from the beach or cliffs could put you in grave danger. If you can see the wave, you are too close to escape it.
• Avoid downed power lines and stay away from buildings and bridges from which heavy objects might fall during an aftershock.
• Stay away until local officials tell you it is safe. A tsunami is a series of waves that may continue for hours. Do not assume that after one wave the danger is over. The next wave may be larger than the first one.
• If you evacuate, take your animals with you. If it is not safe for you, it is not safe for them.
• Get to higher ground as far inland as possible. Watching a tsunami from the beach or cliffs could put you in grave danger. If you can see the wave, you are too close to escape it.
• Avoid downed power lines and stay away from buildings and bridges from which heavy objects might fall during an aftershock.
• Stay away until local officials tell you it is safe. A tsunami is a series of waves that may continue for hours. Do not assume that after one wave the danger is over. The next wave may be larger than the first one.
Staying Safe After a Power Outage
1) If electrical power lines are down, don’t touch them. Keep your family and pets away. Report downed lines to your utility
company.
2) Throw Out Unsafe Food
3) Throw away any food (particularly meat, poultry, fish, eggs and leftovers) that has been exposed to temperatures higher
than 40° F (4° C) for 2 hours or more, or that has an unusual odor, color or texture. When in doubt, throw it out!
4) Never taste food or rely on appearance or odor to determine its safety. Some foods may look and smell fine, but if they
have been at room temperature too long, bacteria causing food-borne illnesses can start growing quickly. Some types
of bacteria produce toxins that cannot be destroyed by cooking.
5) If you are not sure food is cold enough, take its temperature with a food thermometer.
6) If food in the freezer is colder than 40° F and has ice crystals on it, you can refreeze it.