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While most of the time the urinary tract infection (UTI) is treated relatively easily with the antibiotics course, the presence of increased lethargy suggests the possibility of mental and behavioral disorders. UTI at this age is often accompanied by fatigue, confusion, agitation, and dementia (Chiang et al., 2015). Furthermore, the infection is often recurring among the elderly, which, coupled with its asymptomatic nature, presents additional dangers to the well-being of the patient. Finally, mental and behavioral disorders, such as the lethargy mentioned above, are likely the result of upper urinary tract infection, which is far more dangerous and can be lethal.
Based on the poor test results and mental performance, the following things had to be done to improve the discharge procedure. First, the assisted living facility had to be contacted to make sure they are aware of Mr. Jonson’s condition and are able to detect changes in his health. Second, the patient had to be informed about his condition as thoroughly as possible and in the most approachable manner. Third, the appointments had to be made for future visits to the laboratory and his MD. Finally, the need for additional care had to be determined and the appropriate personnel contacted if needed.
To make a better assessment, two additional evaluations are recommended: cognitive and physical. The latter is important to determine the exact nature of the infection: the upper tract variety is more dangerous, as it may lead to sepsis and, in many cases, death (Shaw et al., 2015). It also requires more complex treatment and closer attention by the assisted living facility staff. The cognitive evaluation is recommended because the patient is showing early signs of cognitive dysfunctions, such as being unable to remember his place of living. At the same time, his ability to timely self-diagnose the recurring UTI is important for successful treatment, so it is crucial to determine whether he is capable of evaluating his condition.
The recommended discharge plan is as follows:
- Assess the needs of the patient
- Involve family and caregivers in the discharge process
- Obtain instructions from the patient’s MD
- Prepare written instructions regarding medications and self-diagnosis for the patient
- Assess the assisted living facility in terms of the patient’s awareness and health monitoring capabilities
- Provide the facility with a set of written instructions regarding the actions in case of observing the patient’s declining conditions.
- Provide the additional community personnel if needed
In addition to the written instructions, the patient needs to be appropriately informed about his health condition both on and outside the acute setting. The information must include the following:
The medications: the UTI will most likely require the course of antibiotics. Additionally, the medications for reducing pain might be prescribed. Both must be taken strictly according to the instructions provided by the MD. The patient must not alter or stop taking the medications without consulting his healthcare provider.
Treatments: Several techniques and practices, such as maintaining personal hygiene, wearing appropriate clothes, and emptying the bladder timely, need to be explained to the patient before the discharge.
Health Knowledge: The disease must be explained in detail to the patient, but without overloading him with unnecessary detail. Understanding the main causes, symptoms, and health effects of UTI will increase the chances of successful prevention and treatment.
Diet: The patient needs to maintain a healthy diet and drink more liquids. The intake of vitamin C may be recommended by MD.
The cognitive processes of the elderly population have several alterations, so the learning must account for declining vision and hearing. Besides, the altered cognitive processes demand a long time to process information and inclusion of an overview of each topic (King, Fogel, Albouy, & Doyon, 2013).
References
Chiang, C. H., Wu, M. P., Ho, C. H., Weng, S. F., Huang, C. C., Hsieh, W. T., Hsu, Y. W., & Chen, P. J. (2015). Lower urinary tract symptoms are associated with increased risk of dementia among the elderly: a nationwide study.BioMed research international. Web.
King, B. R., Fogel, S. M., Albouy, G., & Doyon, J. (2013). Neural correlates of the age-related changes in motor sequence learning and motor adaptation in older adults. Frontiers in Human Neuroscience, 7(1), 7-15.
Shaw, E., Benito, N., Rodríguez-Baño, J., Padilla, B., Pintado, V., Calbo, E., & Horcajada, J. P. (2015). Risk factors for severe sepsis in community-onset bacteraemic urinary tract infection: impact of antimicrobial resistance in a large hospitalised cohort. Journal of Infection, 70(3), 247-254.
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