Kodi Mwachidziwitso Kapena Mwachipongwe? Kufotokoza Zovulala Zopanda Kudziwika
Chimodzi mwa zizindikiro zambiri za kuzunzidwa mwakuthupi ndi akuluakulu. Nthawi zina, zikuwonekera momveka bwino kuti zovutazo zikugwirizana ndi nkhanza. Angakhale limodzi ndi zizindikiro zina zachisokonezo, kapena munthuyo akhoza kufotokozera momveka bwino zomwe zinachitika ndi omwe amawapweteka. Nthawi zina, sizowoneka bwino. Monga dokotala, vuto limabwera pamene kuvulaza kulipo ndipo palibe amene akudziwa momwe zinakhalira kumeneko.
Kodi ndizomangika, monga zovunda zambiri, kapena ndizokayikira ndi chizindikiro chosachitidwa nkhanza?
Kulankhulidwa kovomerezedwa kozunza
Madokotala, ogwira nawo ntchito, athandizi, ogwira ntchito mwadzidzidzi kuphatikizapo apolisi ndi omenyana ndi moto, atsogoleri achipatala, ogwira ntchito zachipatala, ndi ogwira ntchito ena akuyenera kunena za nkhanza kapena kunyalanyaza akuluakulu . Izi zimatchedwa lipoti lovomerezedwa.
Ngati munthuyo amakhala m'deralo, lipotili liyenera kutumizidwa ndi dera lamtundu wautetezi wa akuluakulu. Mauthenga a APS amalembedwa kawirikawiri pamene wina amauza wogwira ntchito zachipatala, mwadzidzidzi kapena poyankha mafunso, kuti akukhumudwa, kaya ndi chifukwa cha thupi, maganizo, mawu, chiwerewere, kapena kugwiritsira ntchito ndalama.
Ngati munthuyo akukhala m'nyumba yosungirako anthu okalamba , ogwira ntchito kumeneko ali ovomerezedwa ndi olemba nkhani ndipo ayenera kufalitsa lipotilo ndi bungwe lofufuza za boma. Iwo amakumana ndi zotsatira zazikulu ngati sakunena zomwe zinachitika, kuphatikizapo kusafotokozera kuti angathe kuchitiridwa nkhanza, potsata ndondomeko yosatsata ndondomeko yofunikira yofotokozera nkhanza, ndi zifukwa zowonjezera ndi zolipirira ngati chiwonetsero chikupezeka kuti chachitikadi.
Malamulo a CMS Kufotokoza Zoipa Zotsutsa ndi Zovulala Zosadziwika
Centers for Medicare ndi Medicaid Services ali ndi zofunikira zambiri zoti athe kutenga nawo mbali ngati aubwino odziwa zamwino akufuna kulandira ndalama kubweza chisamaliro kwa okhalamo. Chinthu chimodzi chofunika ndi chakuti malowa ayenera kulongosola kuti akuchitiridwa nkhanza kapena kuvulazidwa kosadziwika kochokera ku bungwe lawo la boma mkati mwa maola awiri atapezeka.
Bungwe la boma (limene liyang'aniridwa ndi CMS) limasankha ngati kufufuzira chilango cha nkhanza kapena chivulazo cha chidziwitso chosadziwika nthawi yomweyo, mkati mwa masabata angapo kapena miyezi ingapo, kapena pa kafukufuku wina wotsatira wosadziwika .
Ngati munthu wokhalamo akudzudzula, mosasamala kanthu za luso lakumudziwa, ogwira ntchito kumudzi akuyamwitsa ayenera kufotokozera milanduyo, kufufuza ndi kufufuza kafukufuku ndi bungwe la boma mkati mwa masiku asanu achitika. Ngakhale zovuta ku malo, n'zosavuta kudziwa kuti zifukwa izi ziyenera kuwonetsedwa.
Chisankho chovuta kwambiri kwa aubwino oyang'anira nyumba ndikutulukira zomwe zikuyenera kuwonetsedwa ngati kuvulazidwa kwa chiyambi chosadziwika ndipo zimafuna kupereka malipoti. Malingana ndi CMS, kuvulala kwa chiyambi chosadziwika kumatanthauzira motere:
- Chovulalacho sichinawonedwe ndi aliyense kapena sangathe kufotokozedwa ndi wokhalamo.
- Kuvulala kumakhala kokayikitsa chifukwa cha malo (m'dera lomwe silingakhale loopsya kuopsa), kukula kwa kuvulala, kuvulala kochuluka komwe kumachitika panthawi imodzimodzi, kapena kuwerengeka kwa nthawi.
Cholinga cha CMS pakufuna kulengeza za kuvulazidwa kwa chiyambi chosadziwika ndi kuchepetsera ndi kuteteza kuchitiridwa nkhanza kwa akulu akulu.
Komabe, kugwiritsira ntchito tanthawuzo limeneli kumakhala kovuta pamene pali kusiyana kotanthauzira kwa zomwe zimawoneka "zokayikitsa," makamaka kuvulala komwe kumachitika nthawi zambiri, monga kuvunda.
Anthu okalamba akudandaula kuti nyumbayi ndi yowonongeka, ndipo nthawi zambiri anthu amatha kuvulaza. Komabe, mabungwe ena a boma tsopano akutanthauzira kuvulaza monga chilengedwe chokayikira ndipo akulongosola malo oti asamafotokoze zovulazidwa kwa iwo kuti afufuze.
Vuto la CMS, mabungwe a boma, ndi nyumba zosungirako okalamba ndikuti asaphonye mikwingwirima yomwe ikhoza kusonyeza kupwetekedwa, koma osati kufunsa kapena kuchitapo kanthu kuwonongeka kwa mikwingwirima, zambiri zomwe zimakhala mwachisawawa.
Kupereka malipoti owonjezereka, omwe amaphatikizapo kufufuzira, kulemba ndi kulembetsa malipoti aatali, amafuna kugwiritsa ntchito zida zamtengo wapatali zomwe zingagwiritsidwe ntchito popereka chisamaliro chapamwamba kwa anthu okhalamo.
Kugwiritsa Ntchito Kafufuzidwe Kuthandiza Kusankha Pamene Kudandaula Kukutsutsa
Popanda malangizo ena ochokera ku CMS, zipangizo zina zimagwiritsa ntchito kafukufuku wa sayansi kuti athandize kuzindikira bwino zomwe zimavulaza anthu achikulire zomwe zingakhale zokayikitsa m'chilengedwe ndipo ziyenera kutero.
Kuopsa kwa Kulira M'Akalamba Achikulire
Choyamba, tifunika kuzindikira kuti kuvulaza ndi kofala kwambiri kwa akulu akulu, ndi mikwingwirima yambiri ikuchitika popanda chifukwa chomveka. Mu kafukufuku wina wa kuvuta mwangozi, anthu 72 mwa 101 omwe anafufuza akuluakulu akuluakulu adakumanapo ndi vuto limodzi pa nthawi ya masabata awiri.
Chachiwiri, pali zinthu zambiri zomwe zimapangitsa kuti anthu okalamba azivulazidwa. Zikuphatikizapo:
- Kuvulaza mwangozi kwa akulu akulu kumakhala kovuta chifukwa cha kuchepa kwa mafuta pansi pa khungu, khungu lofewa, ndi zotupa zowonongeka.
- Anthu omwe amamwa mankhwala ena ali ndi chiopsezo chowonjezereka. Kafukufuku amadziwitsa tsiku lililonse mankhwala a prednisone, Aspirin 325 mg, Warfarin ndi Plavix, komanso mavitamini a corticosteroids , makamaka omwe amachititsa kuti pakhale ngozi. Matenda ang'onoang'ono koma omwe akuwonjezeka kwambiri amamangidwa ndi akuluakulu omwe amalandira aspirin 81 mg, NSAID s (masiku oposa atatu pa sabata), ndi ginkgo.
- Kusokonezeka kwa mathithi ndi gait onse kumapangitsa kuti phokoso likhale lopweteka.
- Nzika zomwe zimafuna thandizo ndi ADL zimakhala zovulaza.
- Kugwiritsira ntchito chipangizo chothandizira (monga woyendayenda, ndodo, kapena olumala) kumawonjezera mpata wokulira.
- Matenda a atrial ndi omwe amagwirizanitsidwa ndi kuvulaza chifukwa nthawi zambiri amachititsa kugwiritsidwa ntchito pa mankhwala ndi mankhwala omwe amatchedwa antiticoagulants omwe amachepetsa kutaya magazi .
Dementia, Nkhanza, ndi Kukumbukira Kuvulala
Anthu omwe ali ndi matenda a Alzheimer kapena matenda ena a dementia ali pangozi yowonongeka. Kulephera kwawo kukumbukira , kuchepa pa luso loyankhulana , ndi kusaganiza bwino kumawapangitsa kukhala kosavuta kwambiri kuposa ena omwe kuzindikira kwawo kuli kovuta. Kukumbukira kwawo kapena kuneneza kuti akuchitiridwa nkhanza kungakhalenso kuchepetsedwa chifukwa cha kukumbukira kwawo kosauka kapena mbiriyakale ya kukhumudwa . Choncho, ndikofunika kuti tithandizire kuteteza anthuwa ku chiopsezo.
Chochititsa chidwi n'chakuti ngati munthu wamkulu sangadziwe mmene kuvulala kunachitikira kapena sakumbukira, zimakhala zovulaza mwangozi. Kafukufuku wokhudza kuvuta mwangozi anapeza kuti 17 peresenti yokha ya akuluakulu amatha kukumbukira momwe kuvulaza kwawo kunachitika.
Mosiyana ndi iwo, 91 peresenti ya ophunzira omwe amachitiridwa nkhanza pa phunziro losiyana akhoza kukumbukira chifukwa cha kuvulaza kwawo, ngakhale ambiri mwa anthu omwe akulemba zochepera 24 pa MMSE. (Maphunziro a 19-24 ndi omwe amasonyeza matenda oyambirira a Alzheimer's.) Kukumbukira kuzunzidwa kwawo kunatsimikiziridwa ndi umboni wina kuti zitsimikizire. Ofufuza ofufuzawa adanena kuti chizoloŵezi cha anthu ozunzidwa kukumbukira chiyambi cha kuvulaza kwawo kapena kuchitiridwa nkhanza ngakhale kuti zovuta kukumbukira zinawonekeranso ku ofesi ya udokotala wodalirika akuyendera odwala awo.
Chizoloŵezi chimenechi chakumbukira zochitika (monga kuchitiridwa nkhanza) ngakhale kuti matenda a dementia afufuzidwa ndikuwonetsedwa kangapo. Kuwonjezera apo, malingaliro odwala matenda a maganizo amatenga nthawi yayitali kusiyana ndi kukumbukira kwake, kotero kuzindikira momwe munthuyo akumvera ndikofunikira.
Chifukwa cha zomwe zingatheke kukumbukira zochitika zowopsya, akulu ayenera kufunsidwa mosamala za chiyambi cha kuvunda kwawo, mosasamala kanthu za luso la kulingalira kapena kusatheka.
Kulamba Kwambiri
Mwinamwake mumadziwa bwino kuti kugunda kumasintha mtundu ngati zaka. Ngakhale kuti mtundu umasintha nthawi zambiri, nthawi zambiri samachita motere. Mwachitsanzo, mosiyana ndi "kulingalira," kafukufuku wasonyeza kuti chifukwa chakuti kuvulaza kuli wachikasu, sikutanthauza kuti ndi wamkulu kuposa kupweteka kumene kuli kofiirira. Izi zikutanthawuza kuti kuyesa kuzindikira pamene kuvunda koyamba kunachitika motsatira mtundu wa kuvulaza si njira yolondola yothetsera kuvulaza.
Makhalidwe Odzidzimutsa
- Mapeto (mikono ndi miyendo) ya akulu akulu amavutitsidwa mosavuta kuvulala kochepa. Pa kafukufuku wina wophulika mwangozi, 90% ya mikwingwirima inali pamapeto.
- Zowopsa kwambiri, zovunda zazikulu (zomwe zimafotokozedwa kukhala zazikulu kuposa masentimita asanu mbali iliyonse) zili pamapeto.
- Azimayi amakonda kuvulazidwa mosavuta kusiyana ndi amuna, makamaka pa ntchafu, mikono ndi manja.
Makhalidwe Otukwana
- Kuphwanya kwakukulu (kutchulidwa kwakukulu kuposa masentimita asanu kudutsa mbali iliyonse) yomwe sikumapeto kwenikweni kumakhudzana ndi nkhanza.
- Kuwomba kumakhala pamutu, makutu, mutu, nkhope, thunthu la dzanja lamanja, mbali ya kanjedza, mkono, nsana, ziwalo, ndi miyendo ya mapazi amakhala okhudzana ndi nkhanza. Komabe, mbali yamanja ya mkono ndi malo omwe anthu amavutitsa mwangozi.
- Kuvunda komwe kumaphatikizapo zizindikiro za manja kapena zizindikiro zazitsulo zingakhale zogwirizana ndi nkhanza.
- Zizindikiro zina zogwiritsira ntchito nkhanza zimaphatikizapo kuzunzidwa kwapakati pa zida, kuvulaza kwapakatikati kwa ntchafu zamkati, "kukulunga" kuzunzika komwe kumayendetsa miyendo, mikono kapena miyendo, ndi mikwingwirima yambiri yomwe ingasonyeze kuti kuvulala kwambiri kunapezedwa pakapita nthawi.
- Dziwani kuti nkhani zosagwirizana, kusintha malingaliro kapena kusintha kwadzidzidzi kungakhale chizindikiro cha nkhanza.
- Zowonongeka zomwe zimachokera ku nkhanza nthawi zina zimagwirizanitsidwa ndi kuvulala kwina.
Kufufuza Mwadzidzidzi ndi Kudandaula Kwambiri
Ngakhale kuti nthawi zina kuvulaza kumayikidwa ngati chizindikiro chochitira nkhanza, mwatsoka, kafukufuku wochepa wokhudzana ndi momwe angadziwire ngati kuvuta kuli koopsa kapena kugwirizana ndi nkhanza. Monga ogwira ntchito zachipatala, tifunika kuchita khama kuteteza akuluakulu omwe ali pachiopsezo, koma osagwiritsira ntchito zinthu mosasamala pa "kufunafuna mfiti" kuti anthu azidandaula ndi anthu omwe amawopsya kwambiri.
Kufufuzidwa bwino kudzakuthandizani kudziwa momwe mukutsatira pakuthwa, misonzi ya khungu, kapena kuvulala kwina kwa akulu akulu. Kafukufuku wanu ayenera kuphatikizapo zotsatirazi:
- Kufunsana ndi munthuyo, phwando lapadera, omusamalira, ndi mboni zina zotheka
- Kuwerengera kafukufuku wa zachipatala kuti mudziwe ngati mankhwala kapena zizindikiro zilipo zomwe zimawonjezera chiopsezo cha kuvunda kapena kuvulala
- Kubwereza kwa kugwa kwaposachedwa kumene kukutheka kuti kunayambitsa kuvulaza
- Kubwereza kwa malo athupi kuti tiwone ngati china chake chingachititse kuvulaza kapena kuvulala
Zosankha zanu zoti muzitha kuvulaza monga zokayikitsa kapena zosavuta zingakhale zosavuta kuteteza kwa oyang'anira kafukufuku wanu wa boma ngati mutenga ngongole chifukwa cha malingaliro anu polemba zolemba zanu ndi zokambirana zanu.
Mawu Ochokera
Ndikofunika kuzindikira kuti malingaliro awa pofuna kufufuza ngati kuvunda kwa akuluakulu akukayikira akuchokera pa kafukufuku wochepa wofufuza. Kafukufuku wowonjezera angatithandize kutanthauzira molondola zoopsa zowononga, komanso kutitsimikizira za mikwingwirima yowonongeka ndi kuvulala kwina.
Vuto la kusunga anthu komanso odwala ali otetezeka, komanso kutsatira malamulo okhudza kuchitiridwa nkhanza ndi kuvulala kosadziwika, ndizofunikira. Kudziŵika ndi kafukufukuyu kumatithandiza tonsefe kupanga chisankho chodziwika bwino ndikugwiritsa ntchito bwino ntchito yathu yachipatala.
> Zotsatira:
> Mosqueda, L, Burnight, K,, Liao, S. Chidule cha Otsogolera Kukwera m'magulu a anthu, NIJ Grant # 2001-IJ-CX-KO14. https://www.ncjrs.gov/pdffiles1/nij/grants/214649.pdf
> National Institute of Justice. Kuzindikira Akulu Ozunzidwa. May 6, 2013. https://www.nij.gov/topics/crime/elder-abuse/pages/identifying.aspx
> University of Michigan. Michigan Medicine. Ziphuphu ndi Magazi Pansi pa Khungu. March 20, 2017. http://www.uofmhealth.org/health-library/bruse
> Wiglesworth, A, Mosqueda, L. Anthu omwe ali ndi dementia ali Mboni za zochitika za mumtima. https://www.ncjrs.gov/pdffiles1/nij/grants/234132.pdf
> Wiglesworth, A, Austin, R, Corona, M, Mosqueda, L. Bruising monga Chiwonetsero Chowonetseratu za Anthu Okalamba. https://www.ncjrs.gov/pdffiles1/nij/grants/226457.pdf