District Nurses are especially involved with nursing services in the home following hospital discharge. This includes wound care, palliative care and intravenous therapy etc. Often if the care need continues after 8 weeks from discharge the assessment agency is requested to re-assess and find additional care services via a government contracted home care provider.
District Nurses can also assist with short-term loan of equipment such as bed cradles, toilet chairs, shower stools, bath seats, toilet seats, bed pans, urinals, beds and feeding pumps.
Home oxygen is provided to those people who have been referred by a Respiratory Physician.
Referrals to District Nursing Services can be made from the Hospital, Doctors and Allied Health Professionals.
Continence Care Services
The Continence Nurse provides advice, suggestions and support to people with incontinence problems. Incontinence is more common than most people think, often it can be cured, and almost always can be improved.
The Continence Nurse can advise on product safety and provide on incontinence issues.
Some incontinence products can be made available free of charge, depending on a assessment.
There is a Continence Nurse available in the Bay of Plenty. Referrals can be made through your Doctor or by self referral by contact the Continence Nurse at your local DHB.
Physiotherapy can be provided by the local DHB in two ways either via outpatients, where you would need to come in and attend a appointment at the hospital or via community physiotherapy which is where they come to you at home. A referral from your GP or other health professional may be required to access these services. Where the injury is the result of an accident, self referral is accepted.
Physiotherapists deal mainly with joint problems, chest conditions, and offer post-operative physiotherapy. Referral is usually by Doctors.
Occupational Therapy is an important service for older people at home in the community. Occupational Therapists help solve everyday difficulties, aiming to maintain or improve a person's level of Independence. Occupational Therapists provide advice and suggestions on a range of topics including:
- Dressing, showering or bathing, transferring on/off beds, toilets, chairs etc, going up/down stairs and paths, preparing meals, holding objects such as scissors, cutlery, taps etc, performing household tasks, leisure activities, driving and vehicle mobility.
- Occupational Therapists also assess people for home modifications and equipment. There can be funding available for essential home modifications. However assessments need to be made by Occupational Therapists before applications for funding can be made.
In general, if older people (or their relatives) notice that everyday tasks are becoming difficult or unsafe, the Occupational Therapy Service may be asked to make an assessment and advise on services that could be funded by the Ministry of Health. Referrals are usually made through your Doctor but there are also private Occupational Therapist's available in the community.
Community Dietician, Nutrition and Diabetic Services
These services provide nutrition counselling and assessment, and specialised advice for diabetics.
Dietitians also often provide nutrition information and education services to health professionals and the public by providing talks, seminars etc.
Referral can be made through your Doctor or through self-referral
Inpatient and Outpatient Assessment, Treatment and Rehabilitation Services
As the title implies, these services are comprehensive, multi disciplinary services which make thorough assessments of older people, treat them and rehabilitate either back into the community or into a residential facility (e.g. rest home or long stay hospital).
Specialists such as Geriatrics and Psychogeriatricians, Speech Language Therapists etc. run clinics. Generally Doctors and Health Professionals will arrange appointments for people to ensure comprehensive assessment and treatment.
Various services are provided on an inpatient or outpatient basis. Individuals are also assessed on a day patient basis or in the community (e.g. in their homes, residential homes etc.).
A comprehensive range of services is provided, these may include Medical and Nursing staff, Psychotherapists, Occupational Therapists and Social Workers. The team may also include a Clinical Psychologist, Speech Language Therapist, Dietitian or Pharmacist. One or two may visit and this could result in further assessment at your closest or regional hospital.
In general both inpatient and outpatient services are provided for older people who may have multiple and complicated age related health and support needs.
Referrals can be made from many sources e.g. GP's, Health Professionals, acute wards or the person themselves.
Those referred will generally have some of the following conditions:
- Frail elderly with multiple medical problems.
- Those unable to complete their normal activities of daily living.
- People who are unsafe to go home but who would improve with more input from the Rehabilitation team.
- Those who are medically unstable.
- Patients who require complex home assessments or whose family members require skills and confidence to care for them.
- People with poor mobility or low exercise tolerance.
- Elderly people who require referrals to rest homes or long term care.
- Any elderly patient that would benefit from advice from specialist elder care professionals.