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Josephine by Mind Map: Josephine

1. What can cause pain in a replaced knee?

1.1. 20% of patients who undergo a total knee replacement will experience chronic pain. (1)

1.1.1. One of the leading risk factors to predicting chronic knee pain after replacement is the patients mental health status. Depression Anxiety

1.1.2. Hard to pinpoint the exact cause of the chronic knee pain. Could be from biological problems. Longterm osteoarthritis Hip pain Patellofemoral pain Allergy-related problem Inflammatory process Could be from surgical problems. Infection Nerve injury Prosthetic loosening Malalignment Malrotation Incorrect sizing Stiffness

2. What is the criteria for removal of license in elderly in CT?

2.1. CT has no specific testing requirements or restrictions for people over the age of 65. (2)

2.1.1. However, they can only renew their license for 2 years, rather than the standard 6 years.

2.1.2. Under law, physicians and health care workers can report patients to the DMV If they have a chronic health problem which will "significantly affect the driver's ability to drive safely." If they have "recurrent period of unconsciousness uncontrolled by medical treatment."

3. What are the services available to help the elderly with home healthcare?​ (3)

3.1. It is estimated that the number of home health and care aids will be at 1.3 million by 2020.

3.1.1. RNs

3.1.2. LPNs

3.1.3. Physical Therapists

3.1.4. Home Care Aids Assistance with Activities of Daily Living (ADLs) Bathing Dressing Toileting Grooming Housekeeping Meal Prep Laundry Transportation

3.1.5. Occupational Therapists

3.1.6. Social Workers

3.2. Assisted living facility

3.2.1. Average of $3,450/month or ~$111/day

3.3. Hospital stay

3.3.1. Average of $6,200/day

4. What are the criteria to qualify for Medicare home healthcare? (3)

4.1. Must meet all requirements.

4.1.1. "Must be under the care of a doctor and getting services under a plan of care established and reviewed regularly by your doctor."

4.1.2. "A doctor must certify that you are homebound, i.e. your condition keeps you from leaving home without help (wheelchair, walker, help from another person), leaving home takes a 'considerable and taxing effort'"

4.1.3. "Your doctor must certify that you need one or more of the following: skilled nursing care, physical therapy, speech-language pathology, and/or occupational therapy."

4.1.4. "The home health agency must be Medicare-certified"

4.2. Can only have a part-time skilled nurse.

4.2.1. "Providing care on less than 7 days/week or less than 8 hours each day over a period of 21 days or less."

4.3. What Medicare covers

4.3.1. RN or LPN Shots Tube Feeding IV Drugs Changing Dressings Prescription Drugs

4.3.2. Physical Therapy, Occupation Therapy, and Speech-Language Services

4.3.3. Medical social services Counseling

4.3.4. Medical supplies

4.4. What Medicare doesn't cover

4.4.1. Personal care Home health aides Bathing Dressing ADLs

4.4.2. Homemaker services Cleaning Laundry Shopping Meal Prep

4.4.3. 24-hour-a-day care

4.4.4. Medical alert system

5. What are the interactions between all the medications she is currently taking? (4)

5.1. Nyquil and Tramadol

5.1.1. [D] - Consider Therapy Modification

5.2. Lasix and Tramadol

5.2.1. [C] - Monitor Therapy

5.3. Lasix and Pepto-Bismol

5.3.1. [C] - Monitor Therapy

5.4. Nyquil and Tylenol

5.4.1. [C] - Monitor Therapy

5.5. Tramadol and Tylenol

5.5.1. [B] - No Action Needed

6. Bibliography

6.1. 1. Petersen, K. K. (2014). Chronic Pain after Total Knee Replacement. Chronic Pain after Total Knee Replacement, 1–61. doi: 10.13052/rp-9788793237476


6.3. 3. Help Paying for Senior Home Care: Elderly Home Care Costs & Pricing. (2019, July 2). Retrieved from

6.4. 4. Lexicomp