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Dignity in Care for Patients and Families with Progressive Neurological…
Dignity in Care
for Patients and Families with
Progressive Neurological Degeneration
Non-Pharmacological Management
Physiotherapy for Lung physio and Mobilising( active or passive)
Occupational therapist for ADL's
Respiratory physiologist : Ventilation humidified air
Speech therapist for dysphagia and communication, indicating need for gastrostomy to avoid aspiration
Dietitian advising re food consistancy
Psychosocial support both patient and caregiver
Cough augmentation
Nursing care e.g. pressure sore prevention,tracheostomy care
Spiritual Care
Pharmacological Management
Baclofen
Oxygen
Anti-depressants
Benzodiazepines
Antibiotics
Opioids
Riluzole
Botox (intrasalivary)
Carbocisteiene
Buscopain (atropine)
Assessment
Lungfunction testing FVC, SNIP MIP
Oxygen saturation
Sleep assessment
Cough into a peak flow meter
QOL questionaire
Respiratory symptoms Assessment questionaire
Depression assessment questionaire
Caregiver questionaire
Advanced Care planning, Serious illness conversation and implementation of NIV pros and complications, use of tracheostomy or not
Symptoms or Presentation
Respiratory infections from aspiration, immobility, poor mucus clearance
Malnutrition, high metabolism, anorexia
Caregiver Burn out
Fatigue, weakness, Muscle Atrophy , cramps, stiffness
Respiratory failure, Ortopnea , Dyspnea, Sleep disordered breathing,
Dysphagia leading to pureed food and eventually peg tube feed
Immobility
Anxiety and Depression