The Care Home Handbook -- Copyright -- Contents -- Forewords -- Preface -- List of Contributors -- Review Panel -- List of Abbreviations -- Section A The Resident's Journey -- Chapter 1 Admissions and Discharges -- 1.1 Admissions and discharges: principles, processes and planning -- The Nursing Process -- Further reading -- 1.2 Assessment on admission to the care home -- Allow time for adjustment -- The initial holistic assessment -- Focused assessments -- Problem identification -- Short-stay admissions -- Further reading -- 1.3 Assessment of residents before admission to the care home -- Location -- Confidentiality -- The purpose -- The need for compassion -- Further reading -- 1.4 Supporting and dealing with families -- Capacity -- Cultural and religious considerations -- Further reading -- 1.5 Documentation and record-keeping -- Further reading -- 1.6 Generating a care plan -- Anticipated outcomes -- Planned interventions -- Care pathways -- Further reading -- 1.7 Nursing handover -- References -- Further reading -- 1.8 Discharge arrangements -- Further reading -- Chapter 2 Life in a Care Home -- 2.1 Healthy lifestyles -- Eating well -- Staying hydrated -- Alcohol and smoking -- Are residential care homes and hospices covered by the legislation? -- Can residents smoke in their bedrooms? -- Advice from the Fire Service -- Useful web sites -- 2.2 Religion and spirituality -- Spirituality in practice -- Religious care in practice -- When to refer to the chaplain -- Respect the person -- References -- 2.3 Mealtimes -- Planning -- Offer residents a choice -- Menus -- If a resident needs help and assistance -- Further reading -- 2.4 Specialised diets -- Diabetes mellitus -- Dysphagia diets -- Pureed diet -- Soft diet -- Liquids -- Renal failure diet (low protein) -- Hyperlipidaemia and cardiac diets -- High calorie for people losing weight.

Obesity in nursing home residents -- Further reading -- 2.5 Activities for care home residents -- Useful web sites -- 2.6 Intimacy, sexuality and sexual health -- Three stages of importance in an individual's residency -- Important considerations -- When sexuality is seen as a problem -- Case examples -- Reference -- Further reading -- Useful web sites -- 2.7 Pets -- About pets in care homes -- Which pet? -- Benefits of pets -- Dangers of pets -- Policy on pets -- Pet review -- Role of charities -- Further reading -- Useful web sites -- 2.8 Managing trips out of the care home -- Organising an outing -- Further reading -- 2.9 Malodour (or unpleasant smells) -- Tips on how to reduce smells -- Tips on using fragrant aromas -- Managing malodour in individuals -- Further reading -- 2.10 Noise -- Attempt to minimise noise wherever possible -- Noise at night -- Reference -- Section B Values, Standards, Ethics and Probity -- Chapter 3 Respect and Dignity -- 3.1 Nursing professional accountability -- Reference -- Useful web sites -- 3.2 Unprofessional behaviour -- Definition -- Confidentiality -- Bullying and harassment -- Whistle-blowing -- Failure to keep appropriate professional boundaries -- Receiving gifts -- Finally -- Further reading -- Useful web sites -- 3.3 Aggression -- The problem -- Management of violence -- Prevention of violence -- Education and training for staff -- Assessment and care planning -- Restraint of residents -- Reference -- Further reading -- 3.4 Dignity in the care home -- Reference -- Further reading -- Chapter 4 Rights and Legal Considerations -- 4.1 Human rights -- Article 2 - the right to life -- Article 3 - the right to freedom from degrading and humiliating treatment -- Article 8 - the right to a private and family life -- References -- 4.2 Restraint in the care home -- Further reading -- 4.3 Abuse -- When to suspect abuse.

What to do -- Further reading -- Useful web sites -- 4.4 Dealing with complaints and concerns -- Unacceptable behaviours -- Restricting access -- Further reading -- 4.5 Incident reporting and root cause analysis -- Case study of a safety incident -- Outcome of RCA -- Reference -- Useful web sites -- 4.6 Capacity -- The UK Mental Capacity Act -- Establishing an individual's capacity -- Advocacy of an individual -- Legal responsibilities -- Reference -- Further reading -- Section C Core Nursing and Personal Care Skills -- Chapter 5 Feeding and Nutrition, Hygiene, and Promotion of Continence -- 5.1 Nutrition -- Factors which affect nutrition in older residents -- Nutritional screening -- Management strategies -- Tips on food and nutritional supplements -- Useful web sites -- 5.2 Swallowing difficulties and associated problems -- How do we swallow? -- Why is it important to recognise dysphagia? -- How can I recognise dysphagia? -- How can I assess someone's swallow? -- How can we improve swallowing? -- References -- Further reading -- 5.3 Hydration -- Fluid intake in older people -- Causes of dehydration in older people -- Common symptoms or signs suggesting dehydration -- Requirements to ensure adequate hydration -- Managing dehydration -- Using subcutaneous fluids (hypodermoclysis) -- Further reading -- 5.4 Urinary incontinence -- Urinary incontinence (UI) assessment -- Diagnosis -- Treatment -- Pads, catheters and appliances -- Ongoing assessment and management -- References -- Further reading -- 5.5 Faecal soiling, constipation and stoma care -- Principles of promoting a normal bowel habit in the care home -- Constipation -- Diarrhoea -- Faecal soiling and incontinence -- Sudden changes in bowel pattern -- Medications and bowel pattern -- Stoma care in the care home -- Further reading -- Useful web site -- 5.6 Skin care -- The functions of the skin.

Skin changes with age -- Wound healing -- Dressing selection -- Useful web sites -- 5.7 Personal grooming -- Grooming procedures -- Oral/dental care -- Personal grooming of residents who have behavioral problems -- Useful web sites -- 5.8 Washing and dressing -- Washing and dressing -- Dental care -- Independence -- Lifting, moving and handling -- Further reading -- Section D Common Clinical Conditions -- Chapter 6 Mobility and Falls -- 6.1 Exercise and mobility -- Impaired mobility -- Impaired mobility: what to assess and discuss in the multidisciplinary team as a nurse -- Positioning -- Exercise -- Further reading -- 6.2 Transferring: bed, chair, moving and handling -- Risk assessment -- The 'sit to stand' transfer -- Risks and controversial techniques -- Reference -- Further reading -- Useful web site -- 6.3 Using a hoist -- Maintaining safety -- Operating the hoist -- Further reading -- 6.4 Examining a walking aid and wheelchair -- Walking aids -- Walking sticks -- Walking frames -- Other aids -- Safe use of a walking aid -- Wheelchairs -- Further reading -- 6.5 Seating -- The ideal sitting position -- Goals of seating -- Reference -- Further reading -- 6.6 Falls -- Which residents fall? -- Why do they fall? -- Facts and figures -- What are the effects of falls? -- How can falls be prevented? -- How to manage falls -- What to do if an individual falls -- What to do after a fall -- Falls audits -- Unanswered questions -- Further reading -- Useful web site -- Chapter 7 Vision, Hearing and Foot Care -- 7.1 Eye care -- Visual assessment -- Procedures -- Sore red eye(s) -- Artificial eye care -- Contact lenses (hard and soft) -- 7.2 Hearing impairment -- Recognising deafness -- Communicating with a deaf person -- Hearing aids and how to care for them -- Ear wax (cerumen) -- Contacting audiology -- 7.3 Everyday foot care and footwear -- Foot care.

Footwear -- Further reading -- Section D Major Medical Problems -- 8.1 Stroke -- Causes and consequences -- Therapy -- Secondary prevention -- Mood changes -- What to do if you think someone is having a stroke -- Further reading -- 8.2 Speech and language difficulties after a stroke -- How a person's language can be affected by a stroke -- How to support a resident's communication -- Further reading -- 8.3 Parkinson's disease -- Medications -- Bowel dysfunction -- Bladder dysfunction -- Mobility -- Mental dysfunction -- Communication problems -- Swallowing problems -- Further reading -- Useful web sites -- 8.4 Diabetes -- Complications -- Diabetes management -- Care plans -- Future perspectives -- Further reading -- 8.5 Heart failure -- Introduction -- Heart failure in elderly and care home residents -- What causes heart failure? -- Signs and symptoms of heart failure -- Investigations -- Management of heart failure -- Progression of heart failure -- Consideration to palliative care (Heart Foundation New Zealand, 2009) -- References -- Further reading -- 8.6 Pain -- How common is pain and why does it matter in care home residents? -- Who is best placed to diagnose pain in care home residents? -- How should I record whether pain is present? -- What measures can be used by care home residents to treat pain? -- Reference -- Chapter 9 Medical Emergencies -- 9.1 Anaphylaxis -- How anaphylaxis happens -- Clinical features -- What you must do -- Adult dose of intramuscular (IM) adrenalin in anaphylaxis -- Adrenalin auto-injectors -- Reference -- Further reading -- 9.2 Asthma -- Further reading -- Useful web site -- 9.3 Bleeding -- Diagnosis of bleeding -- Hypovolaemic shock -- Causes -- Nursing assessment -- Reference -- 9.4 Collapse -- Collapse -- Syncope -- Causes -- Nursing assessment -- Seizure or syncope? -- Medical assessment -- Further reading.

9.5 Seizures.