Management of Patients with Heart Failure - Essay Example

The couple should visit a nutritionist to assist them in creating a weekly menu and an attendant shopping list of what they will need to ensure good health.  This also acknowledges the wife’s need to be included in the care plan process (Quaglietti, Atwood, Ackerman, & Froelicher, 2000, 261).  A schedule of medications needs to be created and made accessible to the couple.  The caregiver should meet them, on a weekly basis, and portion out the pills into daily containers, marked with the day and time that the medication should be ingested.  This process should be reviewed with them to ensure they understand which pills are taken and why.  A moderate exercise program that both can follow, e.g., walking, should be developed, and a walking route appropriate to the weather and their living circumstances worked out.  This should be part of a daily timetable that includes meal times, exercise times, and medication times.  A monthly review of all activities should be undertaken by the care team (Grady, et al., 2000, 2452).  There should be frequent telephone contact between visits by the nurse to ensure that the couple is managing his care plan and that the wife is feeling less overwhelmed.  A nurse should visit the family weekly and review (i) nutritional intake and advise of any adjustments; (ii) medication intake and subsequent medication division and packaging for the following week; and, (iii) the amount of exercise taken and adjustments made as needed.  A nutritionist should also visit once per week to plan and review weekly menus and to assist with creating shopping lists.   A social worker should be contracted to come into the home two or three times a week (i) to assist with the grocery and any other shopping; (ii) to go with the couple for exercise; and, (iii) to ensure that proper personal care is also taking place, along with maintaining a clean and healthy environment.

Health Education for Patient & Family & Supporting Rationale

            Health education is needed to ensure that the couple understands the necessity of managing the patient’s care.  Initial visits from the in-home care team should involve an assessment of what the couple knows about his condition, medication, health management, and care.  Knowledge gaps can be filled through appropriate level conversations and personalized tools, e.g., brochures, and reading material.  The rationale for this is that they are an elderly couple and are feeling overwhelmed; they have no family.  In such a situation, assistance needs to be provided so that they can help. 

Teaching Plan          

The health community should have tools such as small posters and brochures that can explain, in simple language, what cardiomyopathy and congestive heart failure mean.  In addition to providing these tools, the in-home care team can slowly read through the material with them.  The medication should be color coded so that there is no mistake made in medication administration or ingestion.  The couple should be told about what signs to look for in order to identify risks, and should be provided with phone numbers for telephone health services, should they have questions when the in-home team is not there or not available. The social worker should ensure that they know how to prepare appropriate meals and that they also know how much walking exercise is too much.