Community Mental Health Nursing (RCMN)
HOME VISIT TO A CLIENT WITH EPILEPSY
It is a purposeful visit by the RCPN to the home of a client diagnosed with epilepsy. The nurse renders care with respect to the client's/family identified health needs.
Purpose
- Meet the specific health needs of the client and family in their home environment
- Monitor the progress of treatment, recovery and the coping strategies of client and family
- Prevent or minimize the frequency of epileptic attacks
- Maintain continuity of care
- Assess and identify stressors in the environment
- Maximise client, family and societal level of independence of health or wellbeing
- Ensure compliance
- Build confidence of the client and family
Indications
- Home visits to a client diagnosed with epilepsy.
- Monitoring treatment, recovery and coping strategies of the client and family.
- Preventing or minimising the frequency of epileptic attacks.
Equipment
- A Well-Equipped Home Visit Bag including specific items and equipment needed for the care of client diagnosed with epilepsy e.g. epileptic chart and medications
- Community Map and or GhanaPost Global Positions System (GPS)
- Area Register
- Means of Transportation
Preparation
- Carry items needed for the care of a client with epilepsy, such as an epileptic chart and medications.
- Read the community map or GPS and identify the home of the client.
Procedure steps
- Read map of the community and identify the home of the client
- Announce your presence, enter on response, greet and introduce yourself to client, family and significant others
- Establish rapport and enquire about the general health of client
- Observe the client's environment for cleanliness and safety
- Approach client in a calm and respectful manner to gain his trust
- Enquire and counsel on the following:
- Health of client and family
- Occupation/schooling
- Disease condition to family/and significant others (if necessary)
- Personal and environmental hygiene
- Nutritional needs
- Enquire of last attack, nature, time, duration, frequency and what was done for the client
- Observe for signs of possible injuries client might have sustained during previous epileptic attacks
- Encourage family on the need to maintain safe environment to prevent injuries
- Educate client to always sleep on a low bed to minimized the impact of falls during attacks
- Educate and encourage client to avoid exposure to open fires and swimming without supervision
- Educate client to avoid professions that requires operating machineries, driving, climbing heights or should be done under strict supervision
- Teach family/caregivers management of seizures and the need to keep a seizure chat
- Encourage the client to perform tolerable activities of daily living
- Educate client and family on the importance of adherence and the consequences of non-adherence to medication regiments
- Educate client and family on the therapeutic effect, possible side/adverse effects of his medication and the need to report to the clinic for review
- Support client and family and encourage them to share their fears and anxieties
- Teach client and family on effective coping mechanisms of overcoming stigma
- Remind client and family on regular reviews and visits
- Give hope to the client and family that the condition may be cured depending on the cause and proper management
- Refer problem beyond scope to other appropriate facility
- Leave your contact with client/caregiver and encourage them to call in case of emergency
- Inform client family of your next visit
- Document the care and findings in the report book
- Express appreciation and depart
Precautions
- Approach the client in a calm and respectful manner to gain trust.
- Keep the home environment safe to prevent injuries during attacks.
- Teach the family management of seizures and the need to keep a seizure chart.
- Educate the client to avoid high-risk activities such as operating machinery without supervision.
Aftercare
- Remind the client and family about regular reviews and visits.
- Leave contact details with the client or caregiver for emergencies.
Nursing considerations
- Support the client and family to share fears and anxieties and use effective coping mechanisms.
- Give hope where appropriate while teaching realistic management and adherence.
Patient education
- Educate the client to sleep on a low bed to reduce the impact of falls during attacks.
- Teach the family management of seizures and the importance of keeping a seizure chart.
- Educate on the therapeutic and side effects of medication and the consequences of non-adherence.
Documentation
- Document the care and findings in the report book.
References and further reading
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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