Best Care Practices for Homebound Patients with Respiratory Issues

Q: Best Care Practices for Homebound Patients with Respiratory Issues

Hello, Miss： Thank you for your inquiry. Here are my responses and suggestions： 1. Generally, there is a lack of oxygen equipment at home (which can be expensive). It is difficult to adjust the oxygen levels in the blood. If the difference is significant, and

Home care patients

Hello, Director Chen! My family member has been in the respiratory unit for a year, and their condition has stabilized.
They recently returned home for home care, but their blood oxygen levels are unstable, fluctuating frequently.
Their hands and feet often feel stiff, and due to the tracheostomy, they cannot communicate, often staring wide-eyed at family members.
How can we best care for a patient in this condition? Thank you!

a a, 30~39 year old female. Ask Date: 2007/08/04

Dr. Chen Xianchang reply Rehabilitation

Hello, Miss: Thank you for your inquiry.
Here are my responses and suggestions:
1.
Generally, there is a lack of oxygen equipment at home (which can be expensive).
It is difficult to adjust the oxygen levels in the blood.
If the difference is significant, and the patient often experiences shortness of breath or has cyanosis (bluish discoloration of the fingertips), it is advisable to seek care at a nursing facility equipped with oxygen supply.
2.
If the difference is not significant, ensure that the room is well-ventilated, and consult a professional for guidance on breathing exercises, techniques for clearing secretions, and proper positioning in bed.
3.
For bedridden patients, it is essential to reposition them at least every two hours.
Each joint should be moved as much as possible to promote mobility throughout the body; a physical or occupational therapist can provide guidance on this.

Reply Date: 2007/08/04

More Info

Caring for homebound patients with respiratory issues, especially those who have undergone tracheostomy, requires a comprehensive approach that addresses both their physical and emotional needs. Here are some best care practices to consider:

1. Monitoring Respiratory Status
Regularly monitor the patient’s respiratory status, including oxygen saturation levels, respiratory rate, and effort. Use a pulse oximeter to check oxygen saturation frequently, aiming to maintain levels above 92%. If the patient experiences fluctuations, consult with a healthcare provider to adjust oxygen therapy or medications as necessary.

2. Effective Airway Management
Patients with tracheostomy may have difficulty clearing secretions. It is essential to have suctioning equipment available and to be trained in its use. Regular suctioning can help prevent mucus buildup, which can lead to respiratory distress or infections. Ensure that the suctioning is done gently and only when necessary to avoid discomfort.

3. Positioning and Mobility
Proper positioning can significantly impact respiratory function. Encourage the patient to sit upright or at a 30-45 degree angle when possible, as this can help improve lung expansion and oxygenation. If the patient is unable to change positions independently, assist them regularly to prevent pressure sores and promote circulation.

4. Hydration and Nutrition
Maintaining hydration is crucial for patients with respiratory issues, as adequate fluid intake helps thin mucus secretions, making them easier to clear. If the patient has difficulty swallowing, consult with a speech therapist for safe swallowing strategies or consider enteral feeding options if necessary. Nutritional support is vital for overall health and recovery.

5. Emotional and Psychological Support
Patients with respiratory issues, especially those who are unable to communicate verbally, may experience feelings of isolation or frustration. Engage with them through gentle touch, eye contact, and verbal reassurance. Use non-verbal communication methods, such as gestures or picture boards, to help them express their needs and feelings.

6. Regular Health Check-ups
Schedule regular follow-ups with healthcare providers to monitor the patient’s condition and adjust care plans as needed. This includes routine assessments of lung function, oxygen needs, and overall health status.

7. Education and Training for Caregivers
Family members and caregivers should receive training on how to care for a patient with respiratory issues, including how to manage tracheostomy care, suctioning, and recognizing signs of respiratory distress. Understanding the patient’s condition and care requirements can empower caregivers and improve patient outcomes.

8. Emergency Preparedness
Have an emergency plan in place. This includes knowing when to seek medical help, having emergency contact numbers readily available, and ensuring that caregivers are trained in basic life support and how to respond to respiratory emergencies.

9. Environmental Considerations
Ensure that the home environment is conducive to respiratory health. This includes maintaining good air quality, avoiding exposure to smoke or strong odors, and ensuring that the living space is clean and free of allergens.

Conclusion
Caring for a homebound patient with respiratory issues requires a multifaceted approach that prioritizes their physical health, emotional well-being, and effective communication. By implementing these best practices, caregivers can provide a supportive environment that enhances the quality of life for their loved ones. Always consult with healthcare professionals for personalized advice and support tailored to the specific needs of the patient.

Similar Q&A

Managing Chronic Obstructive Pulmonary Disease After Tracheostomy

Hello, Dr. Hong. My father has a history of chronic obstructive pulmonary disease (COPD) and severe pulmonary fibrosis. A few years ago, he required intubation due to respiratory failure, but he successfully underwent respiratory therapy and was extubated. However, this time it i...

Dr. Hong Yuanbin reply Internal Medicine
Based on your description, your father has chronic obstructive pulmonary disease (COPD) along with severe pulmonary fibrosis. The chances of him being weaned off the ventilator are indeed very low. Additionally, the fact that he can only maintain respiratory training for 1-2 hour...

Addressing Breathing Difficulties: When to Seek Medical Help

Hello, doctor! I would like to ask you three questions: 1. I have recently noticed that I sometimes forget to breathe during the day and at night, and I have to force myself to take deep breaths. Which specialty should I consult for treatment? Neurology, Family Medicine, or Psy...

Dr. Jiang Junyi reply Neurology
Hello Mr. A-Shun, 1. I have recently noticed that I experience episodes of forgetting to breathe both during the day and at night, and I need to force myself to take deep breaths. Which specialty should I consult for treatment? Neurology? Family Medicine? Psychiatry? A: The ac...

Home Care for Tuberculosis: Prevention Tips to Avoid Infection

Yesterday, my father-in-law was diagnosed with pulmonary tuberculosis. Due to his advanced age (79 years) and limited mobility, he was unable to be admitted to the hospital promptly when the physician recommended it. In previous cases, treatment primarily involved medication. I w...

Dr. Tao Ruiming reply Pulmonology
1. Home care: After 14 days of medication, the infectiousness of the patient significantly decreases. 2. Home care: Ensure proper ventilation and avoid keeping doors and windows tightly closed. If the patient has a cough or sneezes, they should cover their mouth and nose. It is ...

Managing Sleep and Breathing Issues in Elderly Patients with Lung Conditions

Grandma is 81 years old and has been in a respiratory care center for three weeks, undergoing rehabilitation treatment for lung collapse. She needs to wear a continuous positive airway pressure (CPAP) mask for six hours at night to reduce carbon dioxide levels, but she is unable ...

Dr. Huang Yiwen reply Pulmonology
Dear Xiao Wei: Using a CPAP machine helps reduce carbon dioxide levels, especially since nighttime sleep can lead to easier occurrences of elevated CO2. It is not recommended to stop using it at night as it may disrupt your sleep. You might consider trying a nasal CPAP machine. P...