Ngengozi noma Ngenhlamba? Ukubika Ukulimala Kwemvelaphi Engaziwa
Esinye sezibonakaliso eziningi zokuxhashazwa ngokomzimba kubantu abadala asebekhulile. Ngezinye izikhathi, kubonakala ngokusobala ukuthi izivunguvungu zihlobene nokuhlukunyezwa. Kungenzeka zihambisane nezinye izimpawu zokuhlukunyezwa, noma umuntu angase abike ngokucacile ukuthi kwenzekani nokuthi ubani owabalimaza. Ngezinye izikhathi, akucaci kahle. Njengomsebenzi wezokwelapha, ubunzima buya lapho ukulimala kukhona futhi akekho owazi ukuthi kwenzeka kanjani lapho.
Ingabe ingozi, njengoba kunemivimbo eminingi, noma iyasolisa futhi kungenzeka yini ukuthi kukhona ukuhlukunyezwa?
Ukubika Okugunyaziwe Ukuhlukunyezwa
Odokotela, abasebenzi bezenhlalakahle, abahlengikazi, abasebenzi basezimo eziphuthumayo, kuhlanganise namaphoyisa kanye nabavukuzi bomlilo, abefundisi, odokotela bezempilo yengqondo kanye nabanye abasebenzi kudingeka babike ukuhlukumeza noma ukunganaki abantu abadala . Lokhu kubizwa ngokuthi kubikwa okugunyaziwe.
Uma lo muntu ehlala emphakathini, lo mbiko kufanele uthunyelwe eMnyangweni Wasevisi Wokuvikela Abadala. Imibiko ye-APS ivame ukukhiqizwa uma othile etshela isisebenzi sezempilo, ngokuzikhethela noma ekuphenduleni imibuzo, ukuthi bayalimala, kungakhathaliseki lokho ngenxa yokuhlukunyezwa ngokomzimba, ngokomzwelo, ngokomlomo, ngokocansi noma ngokwezimali.
Uma lo muntu ehlala ekhaya lokuhlengikaza , abasebenzi bakhona babenqunywe yizintatheli futhi kumele bafake lolo lwazi ku-ejensi yokucwaninga kahulumeni. Babhekana nemiphumela ephawulekayo uma bengabika isigameko, kuhlanganise nesicatshulwa sokungabika ukuthi kungenzeka ukuhlukumeza, isitatimende sokungahambisani nenqubomgomo edingekayo yokubika ukuhlukunyezwa, kanye nokucaphuna okungeziwe nokukhokha uma ukuhlukunyezwa kubonakala kwenzeka ngempela.
Imfuneko ye-CMS Yokubika Ukuhlukunyezwa Kwezikhalazo Nokulimala Kwemvelaphi Engaziwa
Izikhungo ze-Medicare neMediicaid Services zinemfuneko eminingi yokubamba iqhaza uma izikhungo zokunakekela abanekhono zifisa ukuthola imali yokukhokhela izakhamuzi zabo. Esinye isidingo esinjalo ukuthi isikhungo kumele sibike icala lokuhlukunyezwa noma ukulimala kwemvelaphi engaziwa ejensi yabo yombuso ngaphakathi kwamahora amabili okutholakala kwalo.
I-ejensi yombuso (eqondiswa yi-CMS) bese ikhetha ukuthi ingaphenya yini icala lokuhlukunyezwa noma ukuthi ukulimala okungaziwa emvelaphi ngokushesha, kungakapheli amasonto ambalwa noma izinyanga, noma ekuhloleni okungaziwa okungakaze kwavela .
Uma ohlalayo ebeka icala lokuhlukunyezwa, kungakhathaliseki ukuthi ikhono lokuhlala engqondweni yomhlalaphi, abasebenzi basekhaya labahlengikazi kumele babike insolo, baphenye ngokugcwele futhi bafake uphenyo ne-ejensi kahulumeni ezinsukwini ezingu-5 zesigameko. Nakuba kuphazamiseka izikhungo, kulula ukukwazi ukuthi lezi zinsolo zidinga ukubikwa.
Isinqumo esinzima ngokwengeziwe sokuphathwa kwezindlu ezihlengikazi sinquma ukuthi yiziphi izigameko okufanele zibhekwe njengezilimala ezingaveli engaziwa ngakho-ke zidinga ukubika. Ngokusho kwe-CMS, ukulimala kwemvelaphi engaziwa kuchazwa kanje:
- Ukulimala akuzange kubonwe ngumuntu noma ayikwazi ukuchazwa ngumhlali.
- Ukulimala kusolisayo ngenxa yendawo (endaweni engavame ukubhekene nengozi), ubukhulu bokulimala, inani lokulimala okwenzeka ngesikhathi esifanayo, noma inani lokulimala ngokuhamba kwesikhathi.
Umgomo we-CMS ngokudinga ukubikwa kokulimala kwemvelaphi engaziwa ukunciphisa nokuvimbela noma yikuphi ukuhlukunyezwa kwabantu abadala.
Kodwa-ke, ukusebenza ngale ncazelo kuba inselele uma kunezinguquko ezihlukile zalokho okubheka "okusolisayo," ikakhulukazi kokulimala okwenzeka kaningi, njengemivimbo.
Ukuhlaselwa kwabakhileyo ekhaya abahlengikazi sekuvame ukuhunyushwa njengengozi emvelweni, futhi kuyaqondakala ngakho ngenxa yokukhubazeka kwabantu abadala ukulimaza. Kodwa-ke, amanye ama-ejensi wombuso manje ahumusha ezinye ukulimaza njengokwemvelo emasimweni futhi akhuluma ngezikhungo zokungabika lokho okulimazayo ukuphenywa.
Inselele ye-CMS, i-ejensi yombuso, namakhaya asebehlengikazi ukuphuthelwa lezo zivunguvungu ezingabonisa ukuhlukunyezwa, kodwa azidingi noma zenze ukubikezelwa okuqhubekayo kwezivunguvungu, eziningi zazo zengozi emvelweni.
Ukubika ngokweqile, okufaka ukuphenya, ukubhala phansi nokubhala imibiko ende, kudinga ukusetshenziswa kwezinsiza ezibalulekile ukuthi esikhundleni sakho zingasetshenziswa ukuhlinzeka izinga eliphezulu lokunakekela izakhamuzi.
Ukusebenzisa Ucwaningo Ukusiza Ukunquma Lapho Ukudumaza Kusolisa
Ukungabikho kwemikhombandlela eqondile evela ku-CMS, ezinye izikhungo zisebenzisa ucwaningo lwesayensi ukuze kusize ngokucacile izici zemivimbo yabantu asebekhulile abangase basolise ngokwemvelo futhi ngaleyo ndlela bangadinga ukubika.
Ingozi Yokukhukhumeza Kubantu Abadala
Okokuqala, kudingeka siqaphele ukuthi ukulimala kuvame kakhulu kubantu abadala, lapho kunemivimbo eminingi eyenzeka ngaphandle kwesizathu esicacile. Kwesinye isifundo sokulimala ngengozi, abangu-72 kwabangu-101 abacwaningi abadala abacwaninga abadala babhekana okungenani ukulimaza okukodwa ngesikhathi sesonto eli-2.
Okwesibili, kunezici eziningana ezandisa amathuba okulimala kubantu asebekhulile. Zihlanganisa:
- Ukulimala ngengozi kubantu abadala asebekhulile kungenzeka ukuthi kwenzeke ngenxa yokunciphisa amafutha ngaphansi kwesikhumba, isikhumba esincane, nama-capillary ashaya amandla.
- Abantu abathola imithi ethile bangengozini enkulu yokulimala. Ucwaningo lubonisa ukulinganisa kwansuku zonke kwe-prednisone, i-Aspirin 325 mg, i-Warfarin ne-Plavix, kanye ne- corticosteroids ekhonjisiwe , ngokuphawulekayo okwandisa ingozi yokulimala. Ingozi encane kodwa isanda kunyuselwa kubantu abadala abathola i-aspirin 81 mg, i-NSAID s (izinsuku ezingaphezu kwezintathu ngesonto), kanye ne-ginkgo.
- Ukuphazamiseka kwamapulazi kanye ne- gait konke kwandisa amathuba okugunda.
- Izakhamuzi ezidinga usizo nge- ADL zingase zithole ukulimala.
- Ukusebenzisa idivayisi yokusiza (njengokuhamba, umhlanga, noma isitulo sabakhubazekile) kwandisa ithuba lokulimaza.
- I-fibrillation ye-atrial yisimo esivumelana nokulimala ngoba ngokuvamile kuvusa ukusetshenziswa kwamakhompiyutha kanye nemithi kadokotela okuthiwa i-anticoagulants eyanciphisa ukuguqulwa kwegazi .
I-Dementia, Ukuhlukunyezwa, nokukhumbula Ukulimala
Abantu abane- Alzheimer's disease noma ezinye izinhlobo zokudemeka komzimba basengozini enkulu yokuhlukunyezwa. Ukukhubazeka kwabo kwenkumbulo , ukwehla kwamakhono okuxhumana , nokwahlulela okungalungile kwenza kube lula kunabanye ukuqonda kwabo okungaqondile. Ukukhumbula kwabo noma ukusola ukuhlukunyezwa kungase kuhlwithwe ngenxa yememori yabo embi noma umlando we- paranoia noma ukucubungula . Ngakho-ke, kubalulekile ukuthi sizame ukuvikela laba bantu engozini yokuhlukunyezwa.
Ngokuthakazelisayo, uma omdala omdala engazi ukuthi ukulimala kwenzekani noma akakukhumbuli, kungenzeka kakhulu ukulimala ngengozi. Ukucwaninga ngokulimala ngengozi kwakuthola ukuthi amaphesenti angu-17 kuphela abantu abadala asekhulile bangakhumbula ukuthi ukulimala kwabo kwenzeka kanjani.
Ngokuphambene, amaphesenti angu-91 abahlanganyeli abahlukunyeziwe ocwaningweni oluhlukile angakhumbula imbangela yokulimaza kwabo, naphezu kwabaningi balabo bantu ababeka phansi ngaphansi kuka-24 kwi-MMSE. (Amaphesenti angu-19-24 akhombise isifo se-Alzheimer sokuqala.) Ukukhumbula ukuhlukunyezwa kwabo kwaqinisekiswa ngobunye ubufakazi ukuqinisekisa ukuchithwa. Abacwaningi balolu cwaningo bakhombise ukuthi ukuthambekela kwabantu abahlukumezekile ukukhumbula umsuka wokulimala noma ukuhlukumeza noma ngabe izinkinga zenkumbulo ziphinde zibonwe ehhovisi elidokotela labahlengikazi bevakashela iziguli zabo.
Lo mkhuba wokukhumbula izenzakalo ezithintekayo ngokomzwelo (njengokuhlukunyezwa) naphezu komqondo wokucubungula okuye kwacwaningwa futhi kwaboniswa izikhathi eziningi. Ukwengeza, imizwa yokudangala kwengqondo ijwayele ukuhlala isikhathi eside kunemikhumbuzo ethile, ngakho-ke ukuqaphela isimo somuntu ngokomzwelo kubalulekile.
Ngenxa yalokhu okungenzeka ukukhumbula izenzakalo ezihlukumezayo, abantu abadala kufanele bahlale bebuzwa ngobumnene ngemvelaphi yokulimaza kwabo, kungakhathaliseki ukuthi banekhono lokucabanga noma ukuhluleka.
Ukuguga kwe-Bruise
Ungase ujwayelane nomqondo wokuthi ukulimaza kushintsha umbala njengoba kudala. Ngenkathi izinguquko zemibala zivame ukwenzeka, ngokuvamile azikwenzi ngendlela elandelwayo. Isibonelo, ngokuphambene nokuthi "ukuqonda," ucwaningo luye lwabonisa ukuthi ngenxa nje yokuthi ukulimala kuphuzi, akusho ukuthi kudala kunesikhukhula esibubende. Lokhu kusho ukuthi ukuzama ukubona uma ukulimala kwenzeka okokuqala ngokuya kombala wokulimaza akuyona indlela enembile yokwenza ukulimala.
Izinhlamvu Zokuthungatha Ngengozi
- Imikhawulo (izingalo nemilenze) yabantu asebekhulile bayalinyazwa kalula ngokulimala okuncane. Kwesinye isifundo sokulimala ngengozi, amaphesenti angama-90 emivimbo ayekhona emaphethelweni.
- Iningi lezinkinga eziphuthumayo (ezichazwe njengezikhulu kunama-5 cm ngaphesheya kunoma iyiphi indlela) zikhona emaphethelweni.
- Abesifazane bavame ukulimaza kalula kusuka ekulimaweni okuncane kunamadoda, ikakhulukazi emathangeni, ezingeni eliphezulu nasezintweni.
Izinhlamvu ze-Bruising Abusive
- Izivunguvungu ezinkulu (ezichazwe njengama-5 cm ngaphesheya kunoma iyiphi indlela) ezingekho emaphethelweni cishe zihlobene nokuhlukunyezwa.
- Ukugquma kutholakala entanyeni, ezindlebeni, ekhanda, ebusweni, ngakwesokunene kwesandla sokunene, eceleni kwesandla, emuva, izintambo, izicathulo, nezinyawo ezinyaweni kungenzeka zihlobene nokuhlukunyezwa. Noma kunjalo, uhlangothi lwendwangu yesandla luyindawo evamile yokulimala ngengozi.
- Imivalo ephathekayo ekhombisa amamaki ngesandla noma amamaki amunwe kungenzeka ukuthi ahlobene nokuhlukunyezwa.
- Ezinye izinkomba zomzimba zokuhlukunyezwa zihlanganisa ukulimaza kwamabhomu, ukulimaza kwamathanga angaphakathi, "ukugoqa" izivunguvungu ezizungeze imilenze, izingalo noma i-torso, kanye nemivimbo eminingi ekhombisa ukuthi ukulimala okuningi kwatholakala ngokuhamba kwesikhathi.
- Qaphela ukuthi izindaba ezingavumelani, izincazelo ezishintshayo noma izinguquko zokuziphatha okungazelelwe zingase zibonise ukuhlukunyezwa.
- Izibhamu ezivela ekuhlukumezweni ngezinye izikhathi zihlangene nezinye ukulimala.
Ukuphenya Ngengozi Ngokwehlukumeza
Ngenkathi ukulimala ngezinye izikhathi kuhlatshwelwa uphawu njengendlela ebonakalayo yokuhlukunyezwa, ngeshwa ngucwaningo olulinganiselwe mayelana nokuthi unquma kanjani ukuthi ukulimala kungengozini noma kuhlobene nokuhlukunyezwa. Njengezisebenzi zokunakekelwa kwezempilo, kudingeka sisebenze ngokuzikhandla ngokuqinile ukuvikela abantu abasengozini, kodwa singasebenzisi imithombo ngokungenakuqondiswa "kokuzingela abathakathi" ngokulimala okusolisayo emphakathini ongakwazi ukulimala.
Ucwaningo oluhle luzosiza ekunqumeni izinyathelo zakho ezilandelayo uma kuziwa ukulimaza, izinyembezi zesikhumba, noma ezinye ukulimala kubantu abadala. Uphenyo lwakho kufanele lufake lokhu okulandelayo:
- Izingxoxo nomuntu, iqembu elinomthwalo wemfanelo, abanakekeli, nanoma yikuphi okunye okwenzekayo
- Ukubuyekezwa kwerekhodi yezokwelapha ukuthola ukuthi imithi noma izifo ezikhona zikhona yini ezandisa ingozi yokulimaza noma ukulimala
- Ukubuyekezwa kwanoma yikuphi ukuwa kwamanje okungenzeka kwabangele ukulimaza
- Ukubuyekezwa kwemvelo engokwemvelo ukuhlola ukuthi ngabe yini eyabangela ukulimaza noma ukulimala
Isinqumo sakho sokuthi ukuhlukanisa ukulimaza njengokusola noma kwengozi kuyoba lula ukuzivikela kubahloli bamazwe bakho uma uthatha isikweletu ngezinqubo zakho zomcabango ngokubhala imibono yakho kanye nezingxoxo zakho.
Izwi elivela
Kubalulekile ukuthi uqaphele ukuthi lezi ziphakamiso zokuhlola uma ukulimaza kubantu asebekhulile kusolisa kusekelwe ekucwaningweni okulinganiselwe. Ucwaningo olwengeziwe lungasisiza ukuba siqonde ngokunembile izingozi zokuhlukumeza, kanye nokusiqinisekisa ngokuphathelene nokulimala kwengozi nezinye ukulimala.
Inselele yokugcina izakhamuzi kanye neziguli ziphephile, kanye nokunamathela ezimisweni zokulawula zokubika ukuhlukumeza nokulimala kwemvelaphi engaziwa, kubalulekile. Ukujwayela ucwaningo olutholakalayo kusenza sonke senze izinqumo ezinolwazi futhi sisebenzise imikhuba emihle emsebenzini wethu wezokwelapha.
> Imithombo:
> Mosqueda, L, Burnight, K,, Liao, S. Isingeniso Esiphezulu Ukuqhuma kwabakwaGeriatric Population, NIJ Grant # 2001-IJ-CX-KO14. https://www.ncjrs.gov/pdffiles1/nij/grants/214649.pdf
> I-National Institute of Justice. Ukukhomba Ukuhlukumeza Abadala. Ngo-Meyi 6, 2013. https://www.nij.gov/topics/crime/elder-abuse/pages/identifying.aspx
> University of Michigan. Umuthi waseMichigan. Ukudumaza Negazi Ngezici Ngaphansi Kesikhumba. Mashi 20, 2017. http://www.uofmhealth.org/health-library/bruse
> Wiglesworth, A, Mosqueda, L. Abantu abane-Dementia njengoFakazi ezenzakalweni zemizwelo. https://www.ncjrs.gov/pdffiles1/nij/grants/234132.pdf
> Wiglesworth, A, Austin, R, Corona, M, Mosqueda, L. Bruising njengeMakethe we-Forensic of Elder Abuse Abuse. https://www.ncjrs.gov/pdffiles1/nij/grants/226457.pdf