Monday, December 7, 2009

An example of clinical reasoning

I have a patient (male, 86 years) at the moment who was admitted to the ward with a fractured humerus. He is known to the community rehab team, and there have been safety concerns voiced by various team members over recent months.
He has poor vision, postural HTN and Parkinson's disease. He lives in a two storied home and before he fell he was basically living in bed, and taking himself to the toilet.
The medical/surgical team were talking to the patient about considering RH level care. However, this NOK was very much against this. When i talked to the patient he wanted to return home if at all possible.
I want to encourage the patient to make his own decision, as well as providing some sort of recommendation as to if he would be safe at home. So due to his poor vision, decline in occ performance and postural HTN I decided the best way he can make an informed decision is to take him home, assess how he would manage and make my recommendations.
So the home visit is booked and il reflect on my recommendations and decisions post visit.


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