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Holistic Health Assessment

Holistic Health Assessment. Presenter’s name. Preparation 5 mins. Review key background information (1). Registration Details Disability Ethnicity Smoking Alcohol Flu vacc Next of kin Last A&E attendance Residential status Housing status continued….

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Holistic Health Assessment

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  1. Holistic Health Assessment Presenter’s name

  2. Preparation 5 mins Review key background information (1) • Registration Details • Disability • Ethnicity • Smoking • Alcohol • Flu vacc • Next of kin • Last A&E attendance • Residential status • Housing status continued… This is all uploaded onto the Template (Annex B, page 11, all in HHA template)

  3. Preparation Review key background information (2) • Med review • Lives alone • Social services status • DN attends • Is a ‘carer’ • HAS a ‘carer’ • Case managed • NHS HealthCheck • Canadian Study of Health and Aging (page 42) (This is where the background information ends) This is all uploaded onto the Template

  4. Preparation • Fracture risk (FRAX score) or after assessment • http://www.shef.ac.uk/FRAX/tool.jsp?country=1 • Blood results • Review medications • Check that med review done within 1 year

  5. Introduction 1min • Focus on maintaining your independence • Holistic approach to health issues • Designed for breadth not depth • Easy to complete • Read coded and linked to QOF • Can be tailored for each person

  6. Health observations 3 mins • Blood pressure • Pulse • Blood sugar (only if doesn’t have diabetes) • Breathlessness score

  7. Nutrition 1 min • BMI • Wt loss • Wt gain • Appetite increased/normal/reduced - PAYMENT for these codes

  8. Falls Risk 2 mins • Fallen in last 6 mths • Reason why • Falls status check - PAYMENT for these codes

  9. Dementia 1.5 min • Rationale • Forgetful • Has it effected day to day life • Dementia status check - PAYMENT for these codes

  10. Skin Condition 1.5 min • Rationale - dry cracked skin leads to infection • Observe patient • Pressure sores • Positioning of chair/bed for house bound

  11. Feet and Legs 2 min • Foot examination • Unilateral problem • Advice re foot care • Leg examination – oedema?

  12. Continence 1.5 min • Persistent UTI’s • Urinalysis only for housebound • Urine leakage • Offensive • Bowel continence/habit changes • Constipated - PAYMENT for these codes

  13. Vision & Hearing 1 min • Eye site deterioration • Both eyes • Hearing difficulty ? Wax

  14. Looking after yourself and your home2min • Able to look after yourself - PAYMENT for these codes • Dress • Bath • Cook etc by self • Getting frail, needs help

  15. Depression 1 min • In last month have you been feeling down, depressed or hopeless? • In last month have you been bothered by having little interest or pleasure in doing things?

  16. Pain 0.5mins • Does pain limit your daily activities or disturb sleep?

  17. Outcomes 2 mins • No action , advise review 6 mths • Refer GP/PN/NP/DN/CM etc • For complex people refer to Integrated Care Manager and possibly CMDT

  18. Overview of outcomes with patients • Referrals etc documented • Signposted • Advice to patient • Care plan agreed with patient

  19. Request passing on patients details for research purposes • Consent read coded • Clinical management plan: next steps • Assessment complete: PAYMENT for this code • Print out for patient if necessary • Need signature from housebound patients

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