Post-acute Care | Health Dictionary

See “transitional care”.


Post-acute Care | Health Dictionary

Keywords of this word: Post Acute Care


ABDOMEN, ACUTE

Medical Dictionary

See ABDOMEN, DISEASES OF.... Medical Dictionary

ACUTE

Medical Dictionary

A type of disease or disorder having a sudden onset with severe symptoms, and generally a short or self-limited duration (such as a head cold or sprain). The opposite of CHRONIC.... Medical Dictionary

ACUTE

Herbal Medical

Occurring suddenly or over a short period of time.... Herbal Medical

ACUTE

Dictionary of Tropical Medicine

A condition of short duration that starts quickly and has severe symptoms. It may also refer to a symptom, for example, severe pain. An ‘acute’ abdomen is a serious disorder of the abdomen requiring urgent treatment, usually surgery. Acute heart failure is the sudden stopping of or defect in the action of the heart. Acute LEUKAEMIA is a rapid growth in the number of white blood cells, which is fatal if untreated. (Opposite: chronic – see CHRONIC DISORDER.)... Dictionary of Tropical Medicine

ACUTE CARE / ACUTE HEALTH CARE

Community Health

Care that is generally provided for a short period of time to treat a new illness or a flare-up of an existing condition. This type of care may include treatment at home, short-term hospital stays, professional care, surgery, X-rays and scans, as well as emergency medical services.... Community Health

ACUTE DISEASE / ILLNESS

Community Health

A disease which is characterized by a single or repeated episode of relatively rapid onset and short duration from which the patient usually returns to his/her normal or previous state or level of activity. An acute episode of a chronic disease (for example, an episode of diabetic coma in a patient with diabetes) is often treated as an acute disease.... Community Health

ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)

Medical Dictionary

Formerly known as adult respiratory distress syndrome. A form of acute respiratory failure in which a variety of di?erent disorders give rise to lung injury by what is thought to be a common pathway. The condition has a high mortality rate (about 70 per cent); it is a complex clinical problem in which a disproportionate immunological response plays a major role. (See IMMUNITY.)

The exact trigger is unknown, but it is thought that, whatever the stimulus, chemical mediators produced by cells of the immune system or elsewhere in the body spread and sustain an in?ammatory reaction. Cascade mechanisms with multiple interactions are provoked. CYTOTOXIC substances (which damage or kill cells) such as oxygen-free radicals and PROTEASE damage the alveolar capillary membranes (see ALVEOLUS). Once this happens, protein-rich ?uid leaks into the alveoli and interstitial spaces. SURFACTANT is also lost. This impairs the exchange of oxygen and carbon dioxide in the lungs and gives rise to the clinical and pathological picture of acute respiratory failure.

The typical patient with ARDS has rapidly worsening hypoxaemia (lack of oxygen in the blood), often requiring mechanical ventilation. There are all the signs of respiratory failure (see TACHYPNOEA; TACHYCARDIA; CYANOSIS), although the chest may be clear apart from a few crackles. Radiographs show bilateral, patchy, peripheral shadowing. Blood gases will show a low PaO2 (concentration of oxygen in arterial blood) and usually a high PaCO2 (concentration of carbon dioxide in arterial blood). The lungs are ‘sti?’ – they are less e?ective because of the loss of surfactant and the PULMONARY OEDEMA.

Causes The causes of ARDS may be broadly divided into the following:... Medical Dictionary

ADULT CARE HOME / RESIDENTIAL FACILITY

Community Health

A residence which offers housing and personal care services to a number of residents. Services (such as meals, supervision and transportation) are usually provided by the owner or manager. Usually 24-hour professional health care is not provided on site. See also “assisted living facility”.... Community Health

ADULT DAY CARE

Community Health

See “day care centre”.... Community Health

ADVANCE CARE PLANNING

Community Health

Planning in advance for decisions that may have to be made prior to incapability or at the end of life. People may choose to do this planning formally, by means of advance directives, or informally, through discussions with family members, friends and health care and social service providers, or a combination of both methods.... Community Health

AFTER-CARE

Community Health

Care provided to individuals after their release from institutional care.... Community Health

AGED CARE

Community Health

Services provided to people deemed to be aged or elderly.... Community Health

AGED CARE ASSESSMENT TEAM

Community Health

Multidisciplinary team of health professionals that is responsible for comprehensive assessments of the needs of older persons, including their suitability for hospital, home or institutional care.... Community Health

ALTERNATIVE AND COMPLEMENTARY HEALTH CARE / MEDICINE / THERAPIES

Community Health

Health care practices that are not currently an integral part of conventional medicine. The list of these practices changes over time as the practices and therapies are proven safe and effective and become accepted as mainstream health care practices. These unorthodox approaches to health care are not based on biomedical explanations for their effectiveness. Examples include homeopathy, herbal formulas, and use of other natural products as preventive and treatment agents.... Community Health

AMBULATORY CARE

Community Health

Health services provided on an outpatient basis in contrast to services provided in the home or to persons who are inpatients. While many inpatients may be ambulatory, the term ambulatory care usually implies the patient travels to a location to receive services and no overnight stay in hospital is required. Many surgeries and treatments are now provided on an outpatient basis, while previously they were considered reason for inpatient hospitalization.... Community Health

ANTENATAL CARE

Medical Dictionary

The protocol which doctors and midwives follow to ensure that the pregnant mother and her FETUS are kept in good health, and that the pregnancy and birth have a satisfactory outcome. The pregnant mother is seen regularly at a clinic where, for example, her blood pressure is checked, the growth and development of her child-to-be are carefully assessed, and any problem or potential problems dealt with. Most antenatal care deals with normal pregnancies and is supervised by general practitioners and midwives in primary-care clinics. If any serious problems are identi?ed, the mother can be referred to specialists’ clinics in hospitals. (See PREGNANCY AND LABOUR.)... Medical Dictionary

ASSISTED LIVING FACILITY / ASSISTED CARE LIVING FACILITY

Community Health

Establishment which provides accommodation and care for older or disabled persons who cannot live independently but do not need nursing care. Residents are also provided with domestic assistance (meals, laundry, personal care).... Community Health

ATTENDANT CARE

Community Health

Personal care for people with disabilities in non-institutionalized settings generally by paid, non-family carers.... Community Health

BOARD AND CARE HOME

Community Health

See “adult care home”.... Community Health

CARE

Community Health

The application of knowledge to the benefit of a community or individual. There are various levels of care:... Community Health

CARE CHAIN / CHAIN OF CARE

Community Health

1 A well planned entity of inter- and intra-organizational care processes to solve the complexity of problems of an individual, and accompanied by systematic follow-up actions. Care chains are integrated to the extent that there are no gaps, barriers or breaks in the process leaving the older person without proper care. 2 A description of the different parts of care.... Community Health

CARE HOME

Community Health

A residential facility that provides accommodation and offers a range of care and support services. Care homes may provide a limited number of services to support low dependency or may provide a wide range of services to cater for the continuum from low to high dependency care. See “assisted living facility”; “high dependency care facility”.... Community Health

CARE IN COMMUNITY

Medical Dictionary

See COMMUNITY CARE.... Medical Dictionary

CARE MANAGEMENT

Community Health

See “case management”.... Community Health

CARE NEED

Community Health

Some state of deficiency decreasing quality of life and affecting a demand for certain goods and services. For the older population, lowered functional and mental abilities are decisive factors that lead to the need for external help.... Community Health

CARE PACKAGE

Community Health

A combination of services designed to meet a person’s assessed needs.... Community Health

CARE PATHWAY

Community Health

An agreed and explicit route an individual takes through health and social care services. Agreements between the various providers involved will typically cover the type of care and treatment, which professional will be involved and their level of skills, and where treatment or care will take place. See also “care plan”; “care programme”.... Community Health

CARE PLAN

Community Health

A dynamic document based on an assessment which outlines the types and frequency of care services that a client receives. It may include strategies, interventions, continued evaluation and actions intended to help an older person to achieve or maintain goals.... Community Health

CARE PROGRAMME

Community Health

A documented arrangement of integrated care, based on the analysed needs of a specific group of people, from intake to supply of care and services, as well as the intended outcomes, and including a description of the way the arrangement should be applied in order to match the needs of individual persons.... Community Health

CARE STANDARDS ACT

Medical Dictionary

Legislation (approved by the UK parliament in 2001) that sets up a new, independent regulatory body for social care and private and voluntary health-care services. The new body is called the National Care Standards Commission and covers England and Wales, but in the latter the National Assembly is the regulatory body. Independent councils register social-care workers, set social-care work standards and regulate the education and training of social workers in England and Wales. The Act also gives the Secretary of State for Health the authority to keep a list of individuals considered unsuitable to work with vulnerable adults. In addition, the legislation reforms the regulation of childminders and day-care provision for young children, responsibility for overseeing these services having been transferred from local authorities to the Chief Inspector of Schools. Services covered by the Act range from residential care homes and nursing homes, children’s homes, domiciliary-care agencies, fostering agencies and voluntary adoption agencies through to private and voluntary health-care services. This includes private hospitals and clinics and private primary-care premises. For the ?rst time, local authorities will have to meet the same standards as independent-sector providers.... Medical Dictionary

CARE SUPPLY

Community Health

The types and volumes of services available.... Community Health

CARE-DEPENDENT

Community Health

Persons with chronic illnesses and/or impairments which lead to long-lasting disabilities in functioning and reliance on care (personal care, domestic life, mobility, self direction).... Community Health

CAREGIVER

Community Health

A person who provides support and assistance, formal or informal, with various activities to persons with disabilities or long-term conditions, or persons who are elderly. This person may provide emotional or financial support, as well as hands-on help with different tasks. Caregiving may also be done from long distance. See also “formal assistance”; “informal assistance”.... Community Health

CAREGIVER BURDEN

Community Health

The emotional, physical and financial demands and responsibilities of an individual’s illness that are placed on family members, friends or other individuals involved with the individual outside the health care system.... Community Health

CAREGIVER BURNOUT

Community Health

A severe reaction to the caregiving burden, requiring intervention to enable care to continue.... Community Health

CARER

Community Health

See “caregiver”; “formal assistance”; “informal assistance”.... Community Health

CARESSE

Medical Dictionary

(French) A woman with a tender touch

Caress, Caressa, Carressa... Medical Dictionary

CAREW

Medical Dictionary

(Latin) One who rides a chariot Carewe, Crewe, Crew... Medical Dictionary

CAREYA ARBOREA

Indian Medicinal Plants

Roxb.

Family: Barringtoniaceae.

Habitat: Sub-Himalayan tract, from Jammu eastwards to West Bengal, Madhya Pradesh and Tamil Nadu.

English: Kumbi, Slow-Match tree.

Ayurvedic: Katabhi, Kumbhi- ka, Kumbhi, Kumbi, Kaitrya, Kumudikaa.

Siddha/Tamil: Kumbi, Ayma.

Action: Bark—demulcent (in coughs and colds), antipyretic and antipruritic (in eruptive fevers), anthelmintic, antidiarrhoeal. An infusion of flowers is given after child birth.

Seeds contain triterpenoid sapo- genols, sterols; leaves contain a tri- terpene ester, beta-amyrin, hexaco- sanol, taraxerol, beta-sitosterol, quer- cetin and taraxeryl acetate.

Careya herbacea Roxb., a related species, is known as Kumbhaadu-lataa in Bengal.

Dosage: Bark—50-100 ml decoction. (CCRAS.)... Indian Medicinal Plants

CHRONIC CARE

Community Health

The ongoing provision of medical, functional, psychological, social, environmental and spiritual care services that enable people with serious and persistent health and/or mental conditions to optimize their functional independence and well-being, from the time of condition onset until problem resolution or death. Chronic care conditions are multidimensional, interdependent, complex and ongoing.... Community Health

CLINICAL CARE

Community Health

Professional specialized or therapeutic care that requires ongoing assessment, planning, intervention and evaluation by health care professionals.... Community Health

COMMUNAL CARE

Community Health

Assistance provided free of charge or at reduced rates to members of a group or society. Other members of the group or society generally provide care on a voluntary basis.... Community Health

COMMUNITY CARE

Community Health

Services and support to help people with care needs to live as independently as possible in their communities.... Community Health

COMMUNITY CARE

Medical Dictionary

Community care is intended to enable people to lead independent lives at home or in local residential units for as long as they are able to do so. For many years there has been a trend in Britain for care of elderly people and those with mental or physical problems to be shifted from hospitals and into community settings. In 1988 Sir Roy Gri?ths’s report to the Secretaries of State for Social Services, Community Care: Agenda for Action, advised on the best use of public funds to provide e?ective community care. The White Paper Caring for People, published in 1989, outlined the government’s ideas for developing these proposals further. The plans were then enshrined in law with the National Health Service and Community Care Act of 1990.

Since April 1993, local social-services departments have been responsible for assessing what help people need from community-care services: these can include home helps, meals on wheels, sheltered housing, etc. Recipients of such services are means-tested and make variable contributions towards the costs. Policies on charging vary from one area to another and there are wide geographical variations in the range of services provided free and the charges levied for others.

People with complex needs may be assigned a case manager to coordinate the care package and ensure that appropriate responses are made to changing circumstances. The success of community care hinges on e?ective coordination of the services of an often large number of providers from the health and social-services sectors. Poor communication between sectors and inadequate coordination of services have been among the most common complaints about the community-care reforms.

Health care for people being cared for in the community remains largely free under the NHS arrangements, although there are regular debates about where the boundaries should be drawn between free health services and means-tested social care. A distinction has been made between necessary nursing care (funded by the state) and normal personal care (the responsibility of the patient), but the dividing line often proves hard to de?ne.

As care has shifted increasingly into the community, previous hospital facilities have become redundant. Vast numbers of beds in long-stay geriatric hospitals and in-patient psychiatric wards have been closed. There is now concern that too few beds remain to provide essential emergency and respite services. In some areas, patients ?t for discharge are kept in hospital because of delay in setting up community services for the elderly, or because of the inability of the local authority to fund appropriate care in a nursing home or at home with community-care support for other patients; the resulting BED-BLOCKING has an adverse e?ect on acutely ill patients needing hospital admission.

Community care, if correctly funded and coordinated, is an excellent way of caring for people with long-term needs, but considerable work is still needed in Britain to ensure that all patients have access to high-quality community care when they need it. Problems in providing such are are not con?ned to the UK.... Medical Dictionary

COMMUNITY HEALTH CARE

Community Health

Includes health services and integrates social care. It promotes self care, independence and family support networks.... Community Health

COMMUNITY-BASED CARE / COMMUNITY-BASED SERVICES / PROGRAMMES

Community Health

The blend of health and social services provided to an individual or family in his/her place of residence for the purpose of promoting, maintaining or restoring health or minimizing the effects of illness and disability. These services are usually designed to help older people remain independent and in their own homes. They can include senior centres, transportation, delivered meals or congregate meals sites, visiting nurses or home health aides, adult day care and homemaker services.... Community Health

COMPREHENSIVE HEALTH CARE

Community Health

Provision of a complete range of health services, from diagnosis to rehabilitation.... Community Health

CONTINUING CARE

Community Health

The provision of one or more elements of care (nursing, medical, health-related services, protection or supervision, or assistance with personal daily living activities) to an older person for the rest of his or her life.... Community Health

CONTINUING CARE FACILITY

Community Health

A facility which provides continuing care.... Community Health

CONTINUING CARE RETIREMENT COMMUNITY

Community Health

A community which provides several levels of housing and services for older people, ranging from independent living units to nursing homes, on one site but generally in separate buildings.... Community Health

CONTINUITY OF CARE

Community Health

The provision of barrier-free access to the necessary range of health care services over any given period of time, with the level of care varying according to individual needs.... Community Health

CONTINUITY OF CARE

Medical Dictionary

A term describing a system of medical care in which individuals requiring advice on their health consult a named primary care physician (GENERAL PRACTITIONER (GP)) or partnership of practitioners. The availability of an individual’s medical records, and the doctor’s knowledge of his or her medical, family and social history, should facilitate prompt, appropriate decisions about investigations, treatment or referral to specialists. What the doctor(s) know(s) about the patient can, for example, save time, alert hospitals to allergies, avoid the duplication of investigations and provide hospitals with practical domestic information when a patient is ready for discharge. The traditional 24-hours-aday, 365-days-a-year care by a personal physician is now a rarity: continuity of care has evolved and is now commonly based on a multi-disciplinary health team working from common premises. Changing social structures, population mobility and the complexity and cost of health care have driven this evolution. Some experts have argued that the changes are so great as to make continuity of care an unrealistic concept in the 21st century. Nevertheless, support inside and outside conventional medical practice for HOLISTIC medicine – a related concept for treating the whole person, body and mind – and the fact that many people still appreciate the facility to see their own doctors suggest that continuity of care is still a valid objective of value to the community.... Medical Dictionary

CONTINUUM OF CARE

Community Health

The entire spectrum of specialized health, rehabilitative and residential services available to the frail and chronically ill. The services focus on the social, residential, rehabilitative and supportive needs of individuals, as well as needs that are essentially medical in nature.... Community Health

COORDINATED CARE

Community Health

A collaborative process that promotes quality care, continuity of care and cost-effective outcomes which enhance the physical, psychosocial and vocational health of individuals. It includes assessing, planning, implementing, coordinating, monitoring and evaluating health-related service options. It may also include advocating for the older person.... Community Health

CORONARY CARE UNIT (CCU)

Medical Dictionary

A specialised hospital unit equipped and sta?ed to provide intensive care (see INTENSIVE THERAPY UNIT (ITU)) for patients who have had severe heart attacks or undergone surgery on the heart.... Medical Dictionary

COUNCIL FOR HEALTHCARE REGULATORY EXCELLENCE

Medical Dictionary

In 2002 the UK government set up this new statutory council with the aim of improving consistency of action across the eight existing regulatory bodies for professional sta? involved in the provision of various aspects of health care. These bodies are: General Medical Council; General Dental Council; General Optical Council; Royal Pharmaceutical Society of Great Britain; General Chiropractic Council; General Osteopathic Council; Health Professions Council; and Nursing and Midwifery Council.

The new Council for Healthcare Regulatory Excellence will help to promote the interests of patients and to improve co-operation between the existing regulatory bodies – providing, in e?ect, a quality-control mechanism for their activities. The government and relevant professions will nominate individuals for this overarching council. The new council will not have the authority to intervene in the determination by the eight regulatory bodies of individual ?tness-to-practise cases unless these concern complaints about maladministration.... Medical Dictionary

CURATIVE CARE

Community Health

Medical treatment and care that cures a disease or relieves pain and promotes recovery.... Community Health

CUSTODIAL CARE

Community Health

Board, room and other personal assistance services generally provided on a long-term basis. It excludes regular medical care.... Community Health

DAY CARE CENTRE

Community Health

A facility, operated by a local authority, voluntary organization, geriatric centre or acute hospital, providing activities for older people. These activities, usually during the day for a determined period, are intended to promote independence and enhance living skills, and can include the provision of personal care and preparation of meals.... Community Health

DIRECT PATIENT CARE

Community Health

Any activities by a health professional involving direct interaction, treatment, administration of medications or other therapy or involvement with a patient.... Community Health

DISABILITY POSTPONEMENT

Community Health

Measures that can be initiated among those with a disease, usually a chronic disease, to lessen or delay the impact of disability from that disease, e.g. averting renal complications among those with diabetes.... Community Health

DOMICILIARY CARE

Community Health

Care provided in an individual’s own home.... Community Health

DUTY OF CARE

Community Health

A legal requirement that a person act towards others and the public with the watchfulness, attention, caution and prudence that a reasonable person would use in the circumstance. If a person’s actions do not meet this standard of care, then the acts are considered negligent, and any damages resulting may be claimed in a lawsuit for negligence.... Community Health

ECONOMY OF CARE

Community Health

Costs are the measure of the economic function of care. Total costs and unit costs are the basic indicators.... Community Health

ELDER CARE

Community Health

See “aged care”.... Community Health

END-OF-LIFE CARE

Community Health

Care of older persons who are dying.... Community Health

EPISODE OF CARE

Community Health

The description and measurement of the various health care services and encounters rendered in connection with an identified injury or period of illness.... Community Health

EQUITY OF CARE

Community Health

Fair treatment of needs, regarding both the distribution of services and allocation of resources.... Community Health

ETHICS (OF CARE)

Community Health

The basic evaluative principles which (should) guide “good” care. Principles typically refer to respect for, and the dignity of, human beings. Basic dimensions are “autonomy” (respect for self determination), “well-being” (respect for happiness, health and mental integrity) and “social justice” (justifiable distribution of scarce goods and services). More specifically, ethics of care refer to ethical standards developed for the care professions which are designed to implement ethical principles in the practice of care provision.... Community Health

EVIDENCE-BASED CARE

Community Health

The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individuals. This approach must balance the best external evidence with the desires of the individual and the clinical expertise of health care providers.... Community Health

EXTENDED CARE FACILITY (ECF)

Community Health

A facility that offers sub-acute care, providing treatment services for people requiring inpatient care who do not currently require continuous acute care services, and admitting people who require convalescent or restorative services or rehabilitative services or people with terminal disease requiring maximal nursing care.... Community Health

EXTRA CARE SHELTERED HOUSING

Community Health

Housing where there is additional support (such as the provision of meals and extra communal facilities) to that usually found in sheltered housing. Sometimes called ‘very sheltered housing’.... Community Health

FORMAL CARE

Community Health

See “formal assistance”.... Community Health

FOSTER CARE

Community Health

A form of assisted housing, usually provided in private homes owned and occupied by individuals or families, offering a place of residence, meals, housekeeping services, minimum supervision, and personal care for a fee to non-family members who do not require supervision by skilled medical personnel.... Community Health

GERIATRIC CARE

Community Health

Care of older persons that encompasses a wide range of treatments from intensive care to palliative care.... Community Health

HEALTH CARE

Community Health

Services provided to individuals or communities by health service providers for the purpose of promoting, maintaining, monitoring or restoring health.... Community Health

HEALTH CARE DELIVERY SYSTEM

Community Health

See “health system”.... Community Health

HEALTH CARE INSTITUTION / FACILITY

Community Health

Any establishment that is engaged in direct patient care on site.... Community Health

HEALTH CARE TEAM

Community Health

A group comprising a variety of professionals (medical practitioners, nurses, physical and occupational therapists, social workers, pharmacists, spiritual counsellors), as well as family members, who are involved in providing coordinated and comprehensive care. There are three types of health care team, defined by the degree of interaction among members and the sharing of responsibility for care:... Community Health

HEALTH CARE TECHNOLOGY ASSESSMENT (HCTA)

Community Health

The systematic evaluation of properties, effects and/or impacts of health care technology. It may address the direct, intended consequences of technologies as well as their indirect, unintended consequences.... Community Health

HEALTH-CARE PRIORITIES

Medical Dictionary

As the needs and demands of patients, and the costs of health care of populations, have risen sharply in recent years, governments and health-care providers – whether tax-funded, insurance-based, employer-provided or a mix of these – have had increasingly to face the dilemma of what services a country or a community can a?ord to provide. As a result, various techniques for deciding priorities of care and treatment are evolving. In the United Kingdom, priorities were for many years based on the decisions of individual clinicians who had wide freedom to prescribe the most appropriate care. Increasingly, this clinical freedom is being circumscribed by managerial, community and political decisions driven in part by the availability of resources and by what people want. Rationing services, however, is not popular and as yet no broadly agreed consensus has emerged, either in western Europe or in North America, as to how priorities can be decided that have broad community support and which can be a?orded. (See CLINICAL GOVERNANCE; EVIDENCE-BASED MEDICINE.)... Medical Dictionary

HEALTHCARE COMMISSION (COMMISSION FOR HEALTH IMPROVEMENT)

Medical Dictionary

Launched in 1999 in England and Wales as CHI, this is an inspectorate charged with protecting patients from ‘unacceptable failings in the National Health Service’. A statutory body under the 1999 Health Act, it evaluates and re?nes local systems designed to safeguard standards of clinical quality. Working separately from the NHS and the health departments, it o?ers an independent safeguard that provides systems to monitor and improve clinical quality in primary care, community services and hospitals. As of 2004 it became responsible for dealing with patients’ complaints if they could not be settled by the trust concerned. The board members include health professionals, academics and eight lay members. Scotland has set up a similar statutory body. (See APPENDIX 7: STATUTORY ORGANISATIONS.)... Medical Dictionary

HIGH DEPENDENCY CARE FACILITY

Community Health

An establishment primarily engaged in providing inpatient nursing and rehabilitative services to individuals requiring nursing care.... Community Health

HOME HEALTH AGENCY (HHA) / HOME HEALTH CARE AGENCY

Community Health

A public or private organization that provides home health services supervised by a licensed health professional in a person’s home, either directly or through arrangements with other organizations.... Community Health

HOME HEALTH CARE / HOME CARE

Community Health

See “domiciliary care”.... Community Health

HOME-FROM-HOSPITAL / HOSPITAL AFTER-CARE SCHEMES

Community Health

Schemes providing nursing care, personal care or practical help for older people who have returned home after a stay in hospital.... Community Health

HOSPICE CARE

Community Health

A cluster of comprehensive services that address the needs of dying persons and their families, including medical, spiritual, legal, financial and family support services.... Community Health

HOUSING WITH CARE

Community Health

A range of housing schemes providing high levels of care.... Community Health

HYPOSTASIS

Medical Dictionary

The term applied to the condition in which blood accumulates in a dependent part of the body as a result of poor circulation. Congestion of the base of the lungs in old people from this cause, and infection, is called hypostatic PNEUMONIA.... Medical Dictionary

INFORMAL CARE

Community Health

See “informal assistance”.... Community Health

INSTITUTIONAL (CARE) HEALTH SERVICES

Community Health

Health services delivered on an inpatient basis in hospitals, nursing homes or other inpatient institutions. The term may also refer to services delivered on an outpatient basis by departments or other organizational units of such institutions, or sponsored by them.... Community Health

INTEGRATED CARE

Community Health

The methods and strategies for linking and coordinating the various aspects of care delivered by different care systems, such as the work of general practitioners, primary and specialty care, preventive and curative services, and acute and long-term care, as well as physical and mental health services and social care, to meet the multiple needs/problems of an individual client or category of persons with similar needs/problems.... Community Health

INTENSIVE CARE

Community Health

Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in a specially equipped unit of a health care facility. It can also be administered at home under certain circumstances (dialysis, respirators, etc.).... Community Health

INTENSIVE CARE MEDICINE

Medical Dictionary

The origin of this important branch of medicine lies in the e?ective use of positive-pressure VENTILATION of the lungs to treat respiratory breathing failure in patients a?ected by POLIOMYELITIS in an outbreak of this potentially fatal disease in Denmark in 1952. Doctors reduced to 40 per cent, the 90 per cent mortality in patients receiving respiratory support with the traditional cuirass ventilator by using the new technique. They achieved this with a combination of manual positive-pressure ventilation provided through a TRACHEOSTOMY by medical students, and by looking after the patients in a speci?c area of the hospital, allowing the necessary sta?ng and equipment resources to be concentrated in one place.

The principle of one-to-one, 24-hours-a-day care for seriously ill patients has been widely adopted and developed for the initial treatment of many patients with life-threatening conditions. Thus, severely injured patients – those with serious medical conditions such as coronary thrombosis or who have undergone major surgery, and individuals su?ering from potentially lethal toxic a?ects of poisons – are treated in an INTENSIVE THERAPY UNIT (ITU). Patients whose respiratory or circulatory systems have failed bene?t especially by being intensively treated. Most patients, especially post-operative ones, leave intensive care when their condition has been stabilised, usually after 24 or 48 hours. Some, however, need support for several weeks or even months. Since 1952, intensive medicine has become a valued specialty and a demanding one because of the range of skills needed by the doctors and nurses manning the ITUs.... Medical Dictionary

INTERIM NURSING HOME CARE

Community Health

Care provided in geriatric centres and acute hospitals to older persons who are in need of limited medical care and who are awaiting nursing home placement.... Community Health

INTERMEDIATE CARE

Community Health

A short period of intensive rehabilitation and treatment to enable people to return home following hospitalization or to prevent admission to hospital or residential care.... Community Health

INTERMEDIATE CARE

Medical Dictionary

See “care”.... Medical Dictionary

INTERMEDIATE CARE

Community Health

Described by the UK government as ‘a bridge between hospital and home’ to speed discharge from acute care and provide recovery and rehabilitation services, this concept was a key element in the NHS Plan: plan for investment; a plan for reform, published in 2000. The government sees cottage hospitals, private nursing homes, and domiciliary and community settings as providing the heart of the proposed intermediate-care sector. Also in the plan, however, is the warning that the NHS would meet the costs only of nursing care for nursing-home residents: personal care would in future be charged for. (In Scotland the NHS funds personal-care costs.) The change in England would alter the principles on which the NHS was founded in 1948 – that all citizens would receive a universal, comprehensive service funded by the government. New care trusts will commission and deliver both primary and community health care as well as social care. The trusts will hold uni?ed, capped budgets and they will de?ne what is NHS care and what is social care. The social-care elements will be subject to the charging policies of local authorities. Of the 160,000 or so nursing-home residents in England, under 10 per cent have their care fully funded by the NHS. The funding future of this 10 per cent is uncertain, as will be the personal-care funding of 270,000 NHS patients expected to transfer from hospital into intermediate care each year. It is too early to say what e?ect these changes will have on a vulnerable section of the population. While the principle of using intermediate care to free expensive hospital beds is sensible, the uncertainties over funding and the grey area between the need for nursing and/or residential care will be a worry for elderly people, especially those of limited means. (Legislation to implement the government’s planned changes to the NHS was going through Parliament as this text was going to press, so modi?cations to them are possible.)... Community Health

INTERMEDIATE CARE FACILITY (ICF)

Community Health

An institution which is licensed to provide, on a regular basis, health-related care and services to individuals who do not require the degree of care or treatment which a hospital or skilled nursing facility is designed to provide.... Community Health

INTERNATIONAL CLASSIFICATION OF HEALTH PROBLEMS IN PRIMARY CARE (ICHPPC)

Community Health

A classification of diseases, conditions and other reasons for attendance for primary care. This classification is an adaptation of the ICD but makes allowance for the diagnostic uncertainty that prevails in primary care.... Community Health

INTERNATIONAL CLASSIFICATION OF PRIMARY CARE (ICPC)

Community Health

The official classification of the World Organisation of Family Doctors. It includes three elements of the doctor-patient encounter: the reason for the encounter; the diagnosis; and the treatment or other action or intervention.... Community Health

LONG-TERM CARE (LTC) / LONG-TERM AGED CARE

Community Health

A range of health care, personal care and social services provided to individuals who, due to frailty or level of physical or intellectual disability, are no longer able to live independently. Services may be for varying periods of time and may be provided in a person’s home, in the community or in residential facilities (e.g. nursing homes or assisted living facilities). These people have relatively stable medical conditions and are unlikely to greatly improve their level of functioning through medical intervention.... Community Health

LONG-TERM CARE FACILITY

Community Health

See “high dependency care facility”.... Community Health

LONG-TERM CARE INSURANCE

Community Health

Insurance policies which pay for long-term care services (such as nursing home and home care) that are generally not covered by other health insurance.... Community Health

MANAGED CARE

Community Health

A health care delivery system which entails interventions to control the price, volume, delivery site and intensity of health services provided, the goal of which is to maximize the value of health benefits and the coordination of health care management for a covered population.... Community Health

MANAGED CARE PLAN

Community Health

A health plan that uses managed care arrangements and has a defined system of selected providers who contract with the plan. Those enrolled have a financial incentive to use participating providers who agree to furnish a broad range of services to them. Providers may be paid on a pre-negotiated basis.... Community Health

MANAGED HEALTH CARE

Medical Dictionary

This process aims to reduce the costs of health care while maintaining its quality. The concept originated in the United States but has attracted interest in the United Kingdom and Europe, where the spiralling costs of health care have been causing widespread concern. Managed care works through changing clinical practice, but it is not a discrete entity: the American I. J. Iglehart has de?ned it as ‘a variety of methods of ?nancing and organising the delivery of comprehensive health care in which an attempt is made to control costs by controlling the provision of services’. Managed care has three facets: health policy; how that policy is managed; and how individuals needing health care are dealt with. The process and its applications are still evolving and it is likely that di?erent health-care systems will adapt it to suit their own particular circumstances.... Medical Dictionary

MEDICARE

Medical Dictionary

A health insurance scheme in the United States, managed by the federal government, that provides cover for Americans over the age of 65 who have certain disabilities.... Medical Dictionary

NATIONAL CARE STANDARDS COMMISSION

Medical Dictionary

This was set up under the CARE STANDARDS ACT 2000 as an independent regulator in respect of homes for the elderly, the disabled and children in the state and private sectors in the UK.... Medical Dictionary

NEONATAL INTENSIVE CARE

Medical Dictionary

The provision of a dedicated unit with special facilities, including one-to-one nursing and appropriate technology, for caring for premature and seriously ill newborn babies. Paediatricians and neonatologists are involved in the running of such units. Not every maternity unit can provide intensive care: for example, the provision of arti?cial ventilation, other than as a holding procedure until a baby can be transferred to a better-equipped and better-serviced unit. Such hospitals tend to have special-care baby units, which are capable of looking after the needs of most, but not all, premature or ill babies.... Medical Dictionary

PALLIATIVE CARE

Community Health

The active total care offered to a person and that person’s family when it is recognized that the illness is no longer curable, in order to concentrate on the person’s quality of life and the alleviation of distressing symptoms. The focus of palliative care is neither to hasten nor postpone death. It provides relief from pain and other distressing symptoms and integrates the psychological and spiritual aspects of care. It offers a support system to help relatives and friends cope during an individual’s illness and with their bereavement.... Community Health

PALLIATIVE CARE

Medical Dictionary

This is de?ned as comprehensive care of patients and families facing terminal illness. The care focuses primarily on comfort and support. Such care includes:

careful control of symptoms, especially PAIN.

psychosocial and spiritual care.

a personalised management plan centred on the patient’s needs and wishes.

care that takes into account the family’s needs and that is carried into the bereavement period.

provision of coordinated services in the home, hospital, day-care centre and other facilities used by the patient. Palliative care should include: managing

chronic cancer pain with planned use of common ANALGESICS including opioids (see SYRINGE DRIVERS); planning ahead to preserve as far as possible the patient’s autonomy and choice as death approaches and the ability to make decisions may decline; and an understanding and use of arti?cial feeding and hydration. Palliative care seeks to improve the satisfaction of both patient and family, to identify their needs and, if possible, to reduce the overall cost because the patient can often be looked after at home or in a HOSPICE instead of in hospital.

A well-publicised question that may arise in the context of palliative care is physician-assisted suicide. This subject is referred to in the entry on ETHICS. A request by a patient for accelerated death may suggest that he or she is depressed – a treatable condition – or that the palliative care is inadequate and needs reviewing and, if possible, improving.... Medical Dictionary

PATIENT CARE PLANNING

Community Health

See “care plan”.... Community Health

PATIENT-CENTRED CARE

Community Health

An approach to care that consciously adopts a patient’s perspective. This perspective can be characterized around dimensions such as respect for patients’ values, preferences and expressed needs; coordination and integration of care; information, communication and education; physical comfort, emotional support and alleviation of fear and anxiety; involvement of family and friends; or transition and continuity.... Community Health

PERSONAL CARE

Community Health

Assistance with those functions and activities normally associated with body hygiene, nutrition, elimination, rest and ambulation, which enables an individual to live at home or in the community.... Community Health

PERSONAL CARE PLAN

Community Health

See “care plan”.... Community Health

PLAN OF CARE

Community Health

See “care plan”.... Community Health

POST

Medical Dictionary

A pre?x signifying after or behind.... Medical Dictionary

POST-ACUTE CARE

Community Health

See “transitional care”.... Community Health

POST-COITAL CONTRACEPTION

Medical Dictionary

Action taken to prevent CONCEPTION after sexual intercourse. The type of contraception may be hormonal, or it may be an intrauterine device (see below, and under CONTRACEPTION). Pregnancy after intercourse without contraception – or where contraception has failed as a result, for example, of a leaking condom – may be avoided with a course of ‘morning-after’ contraceptive pills. Such preparations usually contain an oestrogen (see OESTROGENS) and a PROGESTOGEN. Two doses should be taken within 72 hours of ‘unprotected’ intercourse. An alternative for the woman is to take a high dose of oestrogen on its own. The aim is to postpone OVULATION and to a?ect the lining of the UTERUS so that the egg is unable to implant itself.

Intrauterine contraceptive device (IUCD) This, in e?ect, is a form of post-coital contraception. The IUCD is a plastic shape up to 3 cm long around which copper wire is wound, carrying plastic thread from its tail. Colloquially known as a coil, it acts by inhibiting implantation and may also impair migration of sperm. Devices need changing every 3–5 years. Coils have generally replaced the larger, non-copper-bearing ‘inert’ types of IUCD, which caused more complications but did not need changing (so are sometimes still found in situ). They tend to be chosen as a method of contraception (6 per cent) by older, parous women in stable relationships, with a generally low problem rate.

Nevertheless, certain problems do occur with IUCDs, the following being the most common:

They tend to be expelled by the uterus in women who have never conceived, or by a uterus distorted by, say, ?broids.

ECTOPIC PREGNANCY is more likely.

They are associated with pelvic infection and INFERTILITY, following SEXUALLY TRANSMITTED DISEASES (STDS) – or possibly introduced during insertion.

They often produce heavy, painful periods (see MENSTRUATION), and women at high risk of these problems (e.g. women who are HIV positive [see AIDS/HIV], or with WILSON’S DISEASE or cardiac lesions) should generally be excluded – unless the IUCD is inserted under antibiotic cover.... Medical Dictionary

POST-COITAL TEST

Medical Dictionary

A test for INFERTILITY. A specimen of cervical mucus, taken up to 24 hours after coitus (during the post-ovulatory phase of the menstrual cycle), is examined microscopically to assess the motility of the sperms. If motility is above a certain level, then sperms and mucus are not interacting abnormally – thus eliminating one cause of sterility.... Medical Dictionary

POST-MORTEM EXAMINATION

Medical Dictionary

Also called an autopsy (and less commonly, necropsy), this is an examination of a body to discover the causes of death. Such an examination is sometimes required by law. An unnatural death; a death occurring in suspicious circumstances; or a death when a doctor feels unable to complete a certi?cate about the cause – all must be reported to the CORONER (in Scotland, to the procurator ?scal). He or she may order an autopsy to be carried out as part of the inquiry into cause of death. Sometimes doctors may request the permission of relatives to perform a post-mortem so that they may discover something of value for the improvement of medical care. Relatives may refuse consent. (See also DEATH, CAUSES OF.)... Medical Dictionary

POST-OPERATIVE

Medical Dictionary

The period after an operation, the patient’s condition after operation, or any investigations or treatment during this time.... Medical Dictionary

POST-PARTUM

Medical Dictionary

The term applied to anything happening immediately after childbirth: for example, postpartum haemorrhage. (See also PREGNANCY AND LABOUR.)... Medical Dictionary

POST-TRAUMATIC STRESS DISORDER (PTSD)

Medical Dictionary

A term introduced to PSYCHIATRY in 1980 after the Vietnam War. It is one of several psychiatric disorders that can develop in people exposed to severe trauma, such as a major physical injury, participation in warfare, assault or rape, or any event in which there is major loss of life or a threat of loss of life. Most people exposed to trauma do not develop psychiatric disorder; however, some develop immediate distress and, occasionally, the reaction can be delayed for many months. Someone with PTSD has regular recurrences of memories or images of the stressful event (‘?ashbacks’), especially when reminded of it. Insomnia, feelings of guilt and isolation, an inability to concentrate and irritability may result. DEPRESSION is very common. Support from friends and family is probably the best management, but those who do not recover quickly can be helped by antidepressants and psychological treatments such as COGNITIVE BEHAVIOUR THERAPY. Over the past few years, PTSD has featured increasingly in compensation litigation.... Medical Dictionary

POST-VIRAL FATIGUE SYNDROME

Medical Dictionary

See MYALGIC ENCEPHALOMYELITIS (ME).... Medical Dictionary

POSTPARTUM

Herbal Medical

After birthing.... Herbal Medical

POSTURAL DRAINAGE

Medical Dictionary

Facilitation of the drainage of secretions from dilated bronchi of the LUNGS. The patient lies on an inclined plane, head downwards, and is encouraged to cough up as much secretion from the lungs as possible. The precise position depends on which part of the lungs is a?ected. It may need to be carried out for up to three hours daily in divided periods. It is of particular value in BRONCHIECTASIS and lung abscess (see LUNGS, DISEASES OF).... Medical Dictionary

PREVENTIVE CARE

Community Health

Care that has the aim of preventing disease or its consequences. It includes health care programmes aimed at warding off illnesses, early detection of disease, and inhibiting further deterioration of the body.... Community Health

PRIMARY CARE

Community Health

Basic or general health care focused on the point at which a patient ideally first seeks assistance from the medical care system. It is the basis for referrals to secondary and tertiary level care.... Community Health

PRIMARY CARE

Community Health

See “care”.... Community Health

PRIMARY CARE TRUST

Medical Dictionary

See GENERAL PRACTITIONER (GP)... Medical Dictionary

PRIMARY HEALTH CARE

Medical Dictionary

Sometimes called primary medical care, this is the care provided by a GENERAL PRACTITIONER (GP) – traditionally entitled the family doctor – or other health professionals who have ?rst contact with a patient needing or wanting medical attention. In the NHS, the primary health-care services include those provided by the general, dental, ophthalmic and pharmaceutical services as well as the family doctor service. Community health services provided outside the hospitals also o?er some primary health care.... Medical Dictionary

PRIVATE HEALTH CARE

Medical Dictionary

The provision of medical and dental care to patients who pay for the care either directly, through private medical insurance, or through employer-funded private insurance. In the UK, most patients are treated and cared for by the community- or hospital-based NHS. Although not forbidden to do so, few NHS general practitioners see private patients. NHS consultants are – within certain prescribed circumstances – allowed to treat private patients and many, especially surgeons, do so; but consultations and treatment are usually done on private-health premises. Some NHS hospitals have private facilities attached, but most private care is carried out in separate, privately run clinics and hospitals.

Certain specialties – for example, orthopaedic and reconstructive/cosmetic surgery and mental health – attract more private patients than others, such as paediatrics or medicine for the elderly. The standards of clinical care are generally the same in the two systems, but private patients can see the specialist of their choice at a time convenient to them. Waiting times for consultations and treatment are short and, when in hospital, private patients usually have their own room, telephone, TV, open visiting hours, etc.

A substantial proportion of private medical-care services are those provided for elderly people requiring regular nursing care and some medical supervision. The distinction between residential care and nursing care for the elderly is often blurred, but the government policy of providing means-tested state funding only for people genuinely needing regular nursing care – a system operated by local-authority social-service departments in England and Wales – has necessitated clearer de?nitions of the facilities provided for the elderly by private organisations. The strict criteria for state support (especially in England), the budget-conscious approach of local authorities when negotiating fees with private nursing homes, and the fact that NHS hospital trusts also have to pay for some patients discharged to such homes (to free-up hospital beds for new admissions) have led to intense ?nancial pressures on private facilities for the elderly. This has caused the closure of many homes, which, in turn, is worsening the level of BED-BLOCKING by elderly patients who do not require hospital-intensity nursing but who lack family support in the community and cannot a?ord private care.... Medical Dictionary

QUALITY OF CARE

Community Health

The degree to which delivered health services meet established professional standards and are judged to be of value to the consumer. Quality may also be seen as the degree to which actions taken or not taken maximize the probability of beneficial health outcomes and minimize risk and other outcomes, given the existing state of medical science and art.... Community Health

RENAL FAILURE (ACUTE)

Dictionary of Tropical Medicine

Inefficient functioning of the kidney, leading to death unless acute medical attention is available. Envenomation (especially snake bite) is a common cause, as well as a range of medical conditions, including infection..... Dictionary of Tropical Medicine

RESIDENTIAL AGED CARE FACILITY

Community Health

See “residential care”; “assisted living facility”.... Community Health

RESIDENTIAL CARE

Community Health

Provides accommodation and other care, such as domestic services (laundry, cleaning), help with performing daily tasks (moving around, dressing, personal hygiene, eating) and medical care (various levels of nursing care and therapy services). Residential care is for older people with physical, medical, psychological or social care needs which cannot be met in the community.... Community Health

RESIDENTIAL CARE SERVICES

Community Health

Accommodation and support for people who can no longer live at home.... Community Health

RESPITE CARE

Community Health

Services provided in the home, at a day care centre or by temporary placement in a nursing home or residential home to functionally disabled or frail individuals to provide occasional or systematic relief to informal caregivers.... Community Health

RESTORATIVE CARE

Community Health

Services provided to older people on a short-term basis to restore their physical condition to a level which would allow them to return home with appropriate support. See “rehabilitation”.... Community Health

SECONDARY CARE

Community Health

Specialist care provided on an ambulatory or inpatient basis, usually following a referral from primary care.... Community Health

SECONDARY CARE

Community Health

See “care”.... Community Health

SELF CARE

Community Health

Health activities, including promotion, maintenance, treatment, care and health related decision-making, carried out by individuals and families.... Community Health

SHORT-TERM AGED CARE

Community Health

Involves care designed to improve the physical wellbeing and restore the health of older people to an optimum level following a serious illness.... Community Health

SKILLED CARE

Community Health

“Higher level” of care (such as injections, catheterization and dressing changes) provided by trained health professionals, including nurses, doctors and therapists.... Community Health

SKILLED NURSING CARE

Community Health

Daily nursing and rehabilitative care that can only be performed by, or under the supervision of, skilled nursing personnel.... Community Health

SOCIAL CARE SERVICE

Community Health

Assistance with the activities of daily life (personal care, domestic maintenance, self-direction) delivered by a personal care helper, home helper or social worker and aimed at supporting older people who experience disabilities in functioning.... Community Health

SOCIAL NETWORK CARE

Community Health

See “informal care”.... Community Health

SPECIAL CARE UNIT

Community Health

A long-term care facility unit with services specifically for persons with particular diseases, disorders or injuries.... Community Health

SPECIALIZED NURSING CARE NEEDS

Community Health

Nursing care needs that require the advanced and specialized clinical skills and knowledge of a registered nurse.... Community Health

STAKEHOLDERS (IN AGED CARE)

Community Health

People or groups who have an involvement or interest in the aged care system, including beneficiaries, providers and funders.... Community Health

STATE MEDICINE (HEALTH CARE SYSTEMS)

Community Health

Major government schemes to ensure adequate health services to substantial sectors of the community through direct provision of services.... Community Health

SUB-ACUTE CARE

Community Health

Sub-acute care is a bridge between acute care and home care. It is medical and skilled nursing services provided to persons who are not in the acute phase of an illness but who require a level of care higher than that provided in a long-term care setting.... Community Health

SUBACUTE

Medical Dictionary

Having characteristics of both acute and chronic. This is the state in a disease when most of the aches and pains have subsided and you are likely to overdo things and not completely recover. The chest cold that lingers for weeks as a stubborn cough is a subacute condition, as is the tendonitis that lingers because you won’t stop playing tennis long enough to completely heal.... Medical Dictionary

SUBACUTE

Herbal Medical

The description applied to a disease the duration of which lies between ACUTE and chronic (see CHRONIC DISORDER). An example is subacute ENDOCARDITIS, a disorder that may not be diagnosed for several weeks or months, during which time it can severely damage valves in the heart.... Herbal Medical

SUBACUTE COMBINED DEGENERATION OF THE CORD

Medical Dictionary

A degenerative condition of the SPINAL CORD which most commonly occurs as a complication of PERNICIOUS ANAEMIA. The motor and sensory nerves in the cord are damaged, causing spasticity of the limbs and an unsteady gait. Treatment is with vitamin B12 (see APPENDIX 5: VITAMINS).... Medical Dictionary

SUBACUTE SCLEROSING PANENCEPHALITIS

Medical Dictionary

A rare complication of MEASLES due to infection of the brain with the measles virus. It develops 2–18 years after the onset of the measles, and is characterised by mental deterioration leading on to CONVULSIONS, COMA and death. The annual incidence in Britain is about one per million of the childhood population. The risk of its developing is 5–25 times greater after measles than after measles vaccination (see MMR VACCINE; IMMUNISATION).... Medical Dictionary

TERMINAL CARE

Community Health

Medical and nursing care of persons in the terminal stage of an illness. See also “palliative care”.... Community Health

TERTIARY CARE

Community Health

The provision of highly specialized services in ambulatory and hospital settings.... Community Health

TERTIARY CARE

Community Health

See “care”.... Community Health

TRANSITIONAL CARE

Community Health

A type of short-term care provided by some long-term care facilities and hospitals, which may include rehabilitation services, specialized care for certain conditions (such as stroke and diabetes) and/or post-surgical care and other services associated with the transition between hospital and home.... Community Health