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LEGAL ASPECTS IN TAKING CARE OF ELDERLY AND DISABLED PEOPLE: GUARDIANSHIP AND SECTION 47

admin — Wed, 22 Sep 2010 09:56:32 +0000

Guardianship

A guardianship order is issued by the local authority and is effectively a social services order. To receive guardianship the person must have mental disorder, as defined under the Mental Health Act 1983, which must be longstanding and mean that the person needs help and guidance to manage in the community.

The application for the order is very similar to that for a compulsory admission under the Mental Health Act, i.e. by a close relative or social worker on the recommendation of two doctors. The guardian has to be accepted by the social services (or indeed is the local authority) and they have the power to make the person live at a specified address, to attend for medical treatment (they cannot make them accept it), and make sure that other agencies have access to that person. A guardianship order lasts for six months but can be renewed. A guardian has no access to the person’s money or household goods.

The Guardianship Order (sections 7-10) of the Mental Health Act 1983 was used only 200 times in 1985, possibly due to the fact that most often it is local authorities themselves who become the guardians and there may be a distinct conflict of interests.

Section 47

Section 47 of the National Assistance Act 1948, amended 1951, allows for the compulsory removal of an adult from their home under certain circumstances. It states that adults not suffering from mental illness can be placed in an institution compulsorily to ‘secure the necessary care and attention’ if they:

• are suffering from grave chronic disease or being aged, infirm, or physically incapacitated, are living in unsanitary conditions, and

• are unable to devote to themselves and are not receiving from other persons proper care and attention.

The local community physician acting with the local authority applies to a magistrates’ court for an order committing the person to institutional care, usually either a local hospital or old people’s home. If the person is placed in hospital, however, there is nothing in the order that allows for treatment, and this can still be refused. Because of its obvious infringements on personal liberty the use of this Act is declining (approximately 200 cases a year are still carried out) and there are great regional variations, with some local authorities never using it at all.

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HOW TO SURVIVE YOUR DOCTOR: IRON DEFICIENCY ANAEMIA AND IRRITABLE BOWEL SYNDROME

admin — Wed, 22 Sep 2010 09:55:00 +0000

Iron Deficiency Anaemia

Iron deficiency leads to low levels of hemoglobin in the red blood cells and a reduction in the total red cell count. The finding of an iron deficiency anaemia is a sign of blood loss until proven otherwise. In women the cause may be heavy periods; but always the problem of blood loss from the gut must be confronted. Low hemoglobin could be the first and only sign of an intestinal malignancy. If confirmatory blood tests fail to show the cause of iron deficiency anaemia, the next step must always be endoscopy or X-ray studies of the bowel.

Home Remedies

Do not supplement with iron until the cause for an iron deficiency has been established. If the cause relates to dietary insufficiency or heavy periods add the following food stuffs to your daily diet: liver, oysters, wheat germ and apricots.

Irritable Bowel Syndrome

The Irritable Bowel Syndrome is a diagnostic rubbish bin for any collection of gastrointestinal symptoms from diarrhea to constipation that medical science can’t find an answer for. There is no single picture consistent with the Irritable Bowel Syndrome; there are multiple treatments and multiple therapeutic failures. It is the practice of doctors to keep trying different forms of chemical substances until such time as one or a combination of medicines is found that relieves most of the symptoms.

Home Remedies

The bowel is more sensitive than other bodily organs to emotions, anxiety and stress. It is not surprising that symptoms of the irritable Bowel Syndrome occur whenever these phenomenons appear in excess. In many instances the resolution of stress circumstances or the normalization of an emotional state relieves the Irritable Bowel Syndrome. Doctors have no training and little inclination to help when patients’ physical symptoms are intertwined with social and psychological variables Clinical psychologists, naturopaths, homoeopaths and nutritional therapists all have more to offer than the medical practitioner. A high fibre diet is the basis of any multi disciplinary attack of the Irritable Bowel Syndrome. High fibre produces a soft, bulky and regular motion in the face of either diarrhea or constipation.

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COMMON INFECTIONS OF CHILDHOOD: INHALED FOREIGN BODY

admin — Thu, 21 May 2009 07:11:15 +0000

Sometimes an inhaled foreign body will cause stridor in children. The child will develop a cough, stridor or will have difficulty breathing after playing with a toy that has small removable parts, or after eating nuts or a piece of carrot. The diagnosis is made, often after a long delay, by special X-rays. The child usually has to be hospitalised and the inhaled foreign body removed under general anaesthetic.

Young children tend to place everything in their mouths as part of their exploration, and small objects can then very easily be inhaled. Do not allow toddlers or young children to eat nuts, and make sure that the toys they play with do not have small removable parts that can be easily inhaled.

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BIRTH — COMMON PROBLEMS: RESUSCITATION IN THE DELIVERY ROOM

admin — Tue, 19 May 2009 06:29:42 +0000

If a baby is thought to be at any risk during delivery, a paediatric resuscitation team will be on hand with special equipment to aid the baby in his transition from life in the womb to the outside world. Dramatic physiological changes enabling him to breathe must be achieved by the newborn in the first few minutes after birth. Most babies will do this successfully themselves, but sometimes they require the skilled assistance of a resuscitation team. This is a major advantage of having your baby in hospital, because if anything does go wrong, skilled staff are on hand to ensure your baby’s well-being, as well as your own.

The aim of resuscitation when required is firstly to clear the newborn baby’s airway. This often involves sucking out mucus or meconium (the baby’s waste products) which block the windpipe. Your baby may require additional oxygen for a short period of time. This is provided through a special mask which allows maximal concentration of oxygen to reach his lungs.

Attention is then given to the baby’s heart and circulation and he is kept warm in order to reduce heat loss. Your baby is given a score out of 10 at 1 minute and 5 minutes after birth, called the Apgar score. This is a measure of five objective signs in the newborn — heart rate, respiratory effort, muscle tone, reflexes and colour. A score of 10 indicates a baby in a perfect condition, but this is quite unusual. Most babies reach a score of around 7, which means that they are in a satisfactory condition and do not require resuscitation.

Resuscitation procedures are only used when necessary, and every chance is given for your baby to make it into the world as much on his own steam as is possible. Gentle support is always available, and only becomes more vigorous if there is any imminent danger.

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YOUR MARITAL HEALTH/THE MOST OFTEN ASKED QUESTION: DO YOU THINK HE COULD BE A HOMOSEXUAL?

admin — Mon, 18 May 2009 12:58:35 +0000

“DO YOU THINK HE COULD BE A HOMOSEXUAL? HE DOESN’T WANT TO DO IT AS MUCH WITH ME ANYMORE.”

ANSWER: No. Absolutely not. If your feelings about this are based on sexual interest or desire, then the issue of gender is irrelevant. Male or female homosexuals have the same range of feelings and desires as anyone, may or may not want a lot or a little sexual relationship with the same or the opposite sex, and have as much healthy and unhealthy sex, as many problems and sexual joys, as anyone else. We must learn to stop labeling people or ourselves by what we do sexually. This is a basic super marital sex rule. The homosexual couples I have treated sometimes report the reverse concern, that diminishing interest on the part of one partner may mean that he or she is a “latent heterosexual.” It is one’s feelings, general hot or cold lifestyle, overall health, values, morals, fears, hopes, and relationship status that affects interest, desire, and arousal, not gender identity.

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HYSTERIA – CONCLUSION

admin — Fri, 15 May 2009 09:27:40 +0000

But there may be a Catch 22 to make us re-examine our lack of sympathy. Those who have to feign sickness, consciously or unconsciously, must indeed be sick to resort to such behavior.

It has been suggested that hysterical behavior is not a manifestation of disease, but a means of communication. It is part of our culture that sickness is not seen to be the fault of the sufferer and that when a person is ill he is entitled to our care and concern. He is excused from the normal demands of work and is not expected to accept the consequences of his actions until he has recovered.

Hysterical behavior may be a way for the person to communicate that he is unable to cope with the stresses of life and has a need for care and concern. It may be a way of avoiding the consequences of his actions or of escaping from an — to him — intolerable situation, such as war.

Most psychiatrists regard hysteria as notoriously difficult to treat. Perhaps if it is regarded not as an illness, but as an individual’s attempt to communicate, then we may react differently.

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ANAL FISSURE – DESCRIPTION

admin — Fri, 15 May 2009 07:44:11 +0000

An anal fissure is a split or tear in the skin and muscle layers around the anal opening, usually at the back.

The cause is unknown but is thought to be due to forceful stretching of the opening by passage of a large, hard stool. This certainly seems to be the cause in infants and children.

The condition is extremely painful, usually only on emptying the bowel. This pain in small children may cause them to hold on to the motion and become increasingly constipated.

It may be recognised in the infant too young to complain by the fact that he screams when passing a bowel motion and the stool maybe streaked with blood.

Treatment is successful. Mild cases may be managed by the topical application of local anaesthetic and then stretching the anus with a special dilator.

A short-acting but deep general anaesthetic and then forcibly stretching the anal margins by inserting eight fingers will be followed by rapid relief of symptoms and cure within days.

Chronic fissures with the development of thickened scar tissue may require operation.

In children, local anaesthetic and an agent to soften the stool may be sufficient.

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WHOOPING COUGH

admin — Wed, 29 Apr 2009 10:03:35 +0000

Whooping cough, or pertussis, is one of the most serious childhood illnesses. A highly contagious bacterial infection, it is spread by droplets of water sneezed or coughed by the sufferer.

The bacteria attack the mucous membranes lining the airways, and after an incubation period of one to two weeks, a cough, runny nose, mild fever and loss of appetite develop. Conjunctivitis, where the eyes become pink, sore and runny, is sometimes another symptom. In about another week coughing becomes paroxysmal, particularly at night. Spasms of coughing end with a characteristic ‘whooping’, a noisy indrawing of breath. Vomiting may follow a paroxysm of coughing, ridding the body of mucus congesting the respiratory tract so as to make breathing easier. The illness may last up to four months, but the sufferer is contagious for only a month from the onset of symptoms.

Complications from whooping cough include bronchopneumonia, encephalitis, brain and lung damage and dehydration as a result of vomiting. Death can result from complications. Babies are especially at risk of dying.

Vaccination against whooping cough is highly recommended, despite the possible side effects which are considered to be less dangerous than the disease itself.

A doctor should be called immediately if whooping cough develops. Natural remedies can also be used in conjunction with medical advice. Homoeopathies, Vitamin C and herbal expectorants and relaxants may be recommended. Keeping up the supply of liquids, particularly if the child is vomiting, and avoiding mucus-forming foods such as dairy products, is also advised.

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PREMENSTRUAL TENSION SYNDROME (PMS): COFFEE AND PMS

admin — Tue, 28 Apr 2009 11:28:26 +0000

Confirmation of the link between coffee drinking and PMS comes from a study published in the American Journal of Public Health (75#11:1335). Drinking coffee aggravates the symptoms to such an extent that a woman for whom PMS is a problem should be very careful about her intake, especially just before the onset of her period.

The symptoms of this troublesome but not dangerous condition include tiredness, irritability, anxiety, depression, headaches, tender and swollen breasts, constipation, acne, and a craving for salty or sweet food. Many women also have backache, swelling of the abdomen, fingers and ankles, and a decreased tolerance for alcohol.

One or more of these symptoms occur with every menstrual cycle for a few days before the flow and then cease. Though more study is needed, and coffee is certainly not the only offender, women who are bothered by PMS to could try to reduce their coffee drinking during this time of the month.

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ABOUT INNOCENT HEART MURMURS IN CHILDREN

admin — Tue, 28 Apr 2009 09:34:14 +0000

Signs and symptoms

When a child is born, and also at periodic checkups, a doctor will listen to the child’s heartbeat with a stethoscope. The doctor is listening to see if the heartbeat is regular and strong, and also to detect heart murmurs. Ordinarily, the doctor will hear the noise made by the lower chambers of the heart, which are called the ventricles, as the heart muscle contracts. Also, the valves that regulate the flow of blood through the heart can be heard as they shut. Most other unexpected sounds that the heart makes are called “murmurs” and the doctor can usually identify the innocent murmurs. If any murmur is found, however, the doctor may recommend a complete examination of the child’s heart, to make sure that the heart and circulation are normal and healthy. This will involve taking a detailed medical history, making a complete physical examination, and possibly giving the child a series of tests including an electrocardiogram, a chest X ray, and an echocardiogram, in which sound waves bounce off the heart and form a visual image of it.

Home care

An innocent murmur is completely normal and does not require any treatment or extra care. Treat the child as the normal, healthy child that he or she is.

Precautions

• No precautions are needed. Sometimes parents are frightened by the idea of a heart murmur and overprotect a child whose heart is quite normal. This is not good for the child’s health or well-being.

• If your doctor diagnoses an innocent murmur, do not be alarmed by the complicated names for innocent murmurs or by the tests your child may have.

Medical treatment

No medical treatment is necessary for an innocent murmur. The doctor may listen for the murmur at routine checkups to see if the sound can still be heard, but it really doesn’t matter whether the murmur continues or not.

Occasionally, an innocent murmur will sound somewhat like another type of murmur. If this happens, the doctor may wish to check the child’s heart again after a few years to be sure the original diagnosis was correct.

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