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Teaching: Home Care

Activity and Exercise

Maintaining Musculoskeletal Function

Teach the systematic performance of passive or assistive ROM exercises to maintain joint mobility. As appropriate, demonstrate the proper way to perform isotonic, isometric, or isokinetic exercises to maintain muscle mass and tone (collaborate with the physical therapist about these). Incorporate ADLs into exercise program if appropriate. Provide a written schedule for the type, frequency, and duration of exercises; encourage the use of a progress graph or chart to facilitate adherence with the therapy. Offer an ambulation schedule. Instruct in the availability of assistive ambulatory devices and correct use of them. Discuss pain control measures required before exercise.

Teach the use of proper body mechanics. Teach ways to prevent postural hypotension.

Managing Energy to Prevent Fatigue

Preventing Injury

Discuss activity and rest patterns and develop a plan as indicated; intersperse rest periods with activity periods. Discuss ways to minimize fatigue such as performing activities more slowly and for shorter periods, resting more often, and using more assistance as required. Provide information about available resources to help with ADLs and home maintenance management. Teach ways to increase energy (e.g.,increasing intake of highenergy foods, ensuring adequate rest and sleep, controlling pain). Teach techniques to monitor activity tolerance as appropriate.

Teach safe transfer and ambulation techniques. Discuss safety measures to avoid falls (e.g., locking wheelchairs, wearing appropriate footwear, using rubber tips on crutches, keeping the environment safe, and using mechanical aids such as raised toilet seat, grab bars, urinal, and bedpan or commode to facilitate toileting).

Referrals

Provide appropriate information about accessing community resources: home care agencies, sources of equipment, and so on.