Module 4: SELF-CARE Module 4: SELF-CARE

Leprosy puts the patient’s eyes, hands and feet at risk of developing impairments and disabilities. These may lead to serious repercussions not just on the physical but also the psychological and socio- economic aspects of a patient’s life.

Prevention of impairments and disabilities (POID) is a shared responsibility that requires active participation and collaboration of the patient, his family, and community along with the health care worker. The patient must be able to continue performing his activities of daily living (ADL) and participate in family and community activities.

Why is Self-Care Important? Impairments and disabilities in leprosy are caused by damage to the peripheral nerves of the eyes, hands and feet. Loss of these nerves’ functions places the patient at a lifelong risk of developing secondary impairments such as skin cracks, injuries and joint stiffness.

Why is Self-Care Important? Involvement of the eye may even lead to blindness. These impairments can limit activities of daily living (ADL) and restrict social participation.

Teaching self-care means empowering the patients to enable them to take care of themselves through effective transfer of technology and provision of opportunities to practice what they learn in preventing disabilities. Why is Self-Care Important?

Neglect of insensitive hands and feet, may be due to: What are the Reasons for the Occurrence of Ulcers and Injuries? limited knowledge; poor attitude; and/or inadequate performance of self-care by the patient and his family.

This neglect can result in complications such as ulcers and injuries that may become infected, furthering the patient’s impairments and deformities and limiting his activities and social participation. What are the Reasons for the Occurrence of Ulcers and Injuries?

Not resting the injured part; Why Don’t Wounds Heal: Not using proper footwear; Not using adaptation devices; Using inappropriate ointments; and Low self-esteem – poor social support leading to self-neglect. Not using proper footwear; Not using adaptation devices; Using inappropriate ointments; and Low self-esteem – poor social support leading to self-neglect.

How to Care for Wounds, Ulcers and Skin Cracks: How to Care for Wounds, Ulcers and Skin Cracks: The most important task is to prevent infection from occurring.

How to Care for Wounds, Ulcers and Skin Cracks: How to Care for Wounds, Ulcers and Skin Cracks: If there are no signs of infection, the area should be: cleaned; dressed; rested. If there are signs of infection, treat with systemic antibiotics.

Wound Types: Clean Clear serous discharge Superficial Deep Exudes pus Foul smelling Area around wound is hot, red & swollen Lymph nodes are tender and swollen

Give assurance. Rest. Elevate. Cover wound with clean cloth. Clean daily with clean water and cover again with clean cloth. Wound Types: Clean Clear serous discharge Superficial

12 Days Later: Wound surface area is smaller. Less discharge. New skin is growing around the edges. Congratulate patient and encourage him to continue until wound heals completely.

12 Days Later: Wound has not improved or has deteriorated. Discuss problem with patient. If patient has not been able to follow instructions: Investigate reasons, try & solve problems with the patient If wound is not infected, encourage home care again. If infected, treat with systemic antibiotics. However, if

Surgical debridement Antibiotics Casting (PoP) If patient has followed instructions faithfully 12 Days Later: Wound has not improved or has deteriorated. Discuss problem with patient.

Unna Boot If patient has followed instructions faithfully 12 Days Later: Wound has not improved or has deteriorated. Discuss problem with patient.

Surgical debridement Amputation If patient has followed instructions faithfully 12 Days Later: Wound has not improved or has deteriorated. Discuss problem with patient.

Deep Exudes pus Foul smelling Area around wound is hot, red & swollen Lymph nodes are tender and swollen Surgical debridement Antibiotics Casting (PoP) Wound Types:

Deep Exudes pus Foul smelling Area around wound is hot, red & swollen Lymph nodes are tender and swollen Unna Boot Wound Types:

Deep Exudes pus Foul smelling Area around wound is hot, red & swollen Lymph nodes are tender and swollen Surgical debridement Amputation Wound Types: