Mitchell* is a 65-year-old former hockey player who recently had hip replacement surgery. After Mitchell returned home from the hospital, he worked with a whole team of health professionals as he recovered and adjusted to life after surgery.
After surgery, Mitchell's doctor checked his progress regularly to make sure his recovery was going smoothly and to watch for signs of complications such as infection. The doctor also advised Mitchell when it was safe to return to his regular activities, such as climbing stairs, engaging in sexual activity, and driving. When Mitchell developed an infection, his doctor recommended antibiotic treatment and coordinated directly with Mitchell's home care nurse to make sure the wound was treated.
Mitchell left the hospital with prescriptions to prevent complications from his surgery. When he visited his local pharmacy, the pharmacist taught him about his new medications. She showed Mitchell what the medications were for, how to use them, when to expect them to start working, and possible side effects. She also checked them against another prescription Mitchell used occasionally that showed up in the pharmacy's electronic database, to ensure there were no conflicts between the drugs.
The home care nurse, personal care worker, and toll-free nursing line:
After Mitchell returned home, he and his wife Diane had a few problems coping with his care. Since Diane is much smaller and lighter than Mitchell, she was worried about what would happen if he fell while she was helping him with his daily activities. Meanwhile, Mitchell was having trouble getting around the house and keeping his incision clean.
Shortly after he returned home, Mitchell noticed that his incision was red, swollen, and itchy. He and his wife Diane were concerned and called a toll-free health information line staffed by nurses. The nurse told them that Mitchell's incision might be infected, and advised them to see his doctor. She also helped them find a home care nurse who could come to Mitchell's house to help him care for the infected wound once Mitchell had seen his doctor.
The home care nurse helped Mitchell treat his wound and keep it clean. She also worked with the couple to arrange for a personal care worker to come into their home a few times each week to help Mitchell shower and dress, and take him for a walk. Diane appreciated the extra help and felt less worried about Mitchell. Mitchell's recovery went more smoothly and he found it easier to care for himself and to focus on regaining his mobility.
The physiotherapist and occupational therapist:
Mitchell's physiotherapist and occupational therapist worked together to help him get back on his feet and to provide him with strategies for coping with his limited mobility during recovery. Mitchell's physiotherapist taught him exercises to help strengthen his hip and improve his mobility. She also showed him the proper way to use his walker and cane, and demonstrated the safest ways to sit, sleep, and get around the house. Regular appointments with his physiotherapist helped keep Mitchell on track with his exercises.
The occupational therapist suggested equipment and home modifications to help Mitchell with his daily activities. For example, she showed him how to use a long-handled reacher to pick up objects from the floor so that he wouldn't have to twist or bend at the hip. She also helped him find a transfer chair to help him get into the shower, and a raised toilet seat to make it easier for him to go to the bathroom. And she taught Mitchell's wife Diane how to make the house safer for Mitchell by removing throw rugs and other obstacles, setting up a "recovery centre" (a comfortable chair where Mitchell could reach a telephone, a glass of water, his medications, the TV remote control, and books to read), putting frequently used items at arm level, and moving sharp objects and furniture out of the way.
All of the professionals on Mitchell's primary health care team shared information using his electronic health record. Mitchell, as an important member of the team, was also involved in the decision-making process. Thanks to his team, Mitchell is now on the road to recovery after his hip replacement.
* Note: The stories of Mitchell, Diane, and Alex are hypothetical stories based on the goals and vision of primary health care.
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