Caring for a child with Cerebral Palsy will include parental involvement and a health care team to help the child deal with their medical condition and everyday life. Nurses who are trained in helping Cerebral Palsy patients are especially important to ensure that the child is well cared for. A home care nurse will perform an assessment of your child and create a care plan that has desired goals based on individual needs. This will help maintain continuity of care at home.
When a home nursing care plan is created for your child, be sure that the following points have been taken into consideration:
- Self-Care activities: Due to lack of muscle control and coordination, the child with Cerebral Palsy may be unable to perform basic tasks such as hygiene care, bathing, oral care, toileting, grooming or changing clothes. A caregiver will assist the child with these tasks and where possible help them learn adapted self-care measures to perform these daily activities. The use of assistive devices such as bathroom chairs, toothbrushes with straps and adaptive clothing may be recommended. Learning to perform self-care skills themselves will enable the child to gain self confidence in accomplishing them.
- Nutritional needs: A nurse will ensure that the child receives adequate balanced nutrition based on their condition. Children with Cerebral Palsy require high calorie and high fiber in their diets. Those with Cerebral Palsy may face feeding difficulties due to poor muscle control over their mouth or tongue. A nurse can monitor the child’s chewing and mouth control to make eating easier and safe. They will also look at the way the food is cooked to make it easier to swallow and will assess the proper positioning of the child while eating in order to avoid Aspiration pneumonia. If tube feeding is required, the nurse will administer feeding as prescribed and teach the family how to maintain the child’s eating techniques.
- Communication: For those children who are unable to communicate verbally, the nurse will work with the child to develop their communication skills by using alternative methods such as sign language, flash cards, communication board, computer, or non-verbal cues such as facial expressions or gestures. A nurse will coordinate with an early speech therapist to help the child speak slowly and coordinate their lips and mouth to form speech sounds.
- Physical mobility: With the help of a physiotherapist, the nurse will assist the child with performing daily living activities and range of motion exercises to promote mobility, improve fine and gross motor skills and to prevent deformity. A nurse will allow the child to perform activities at their own pace and rest between activities that are tiring in order to maintain energy. In order to help build stability, the nurse will educate the family with the proper use of an orthotic device and will assist the child in putting it on if required. They will also administer prescribed medication to treat tremors, muscle stiffness, spasms and even seizures.
- Safe Environment: A primary reason why a parent needs a nurse for their child is for safety. A nurse ensures that the child’s environment is safe and will educate the family on possible safety precautions. A nurse will oversee feeding techniques, positioning, safe furniture, toys and safety in the vehicle. They will also constantly inspect the floor for any clutter and for anything that can cause falls. They make sure the child uses safety equipment such as helmets, knee caps, seat belts, secured mobility devices and will make sure the child’s bed is safe by raising padded bed rails.
- Education for the family: A nurse will educate the family on how to manage the child’s care and routine. They encourage the parents and siblings to express their concerns and find ways support and guide them with care for the child’s physical and emotional needs. They encourage parents to seek appropriate rehabilitation, functional, vocational and adaptive training and will also recommend enrollment for the child in a school program consistent with the child’s intellectual abilities.
- Promote self-esteem, growth and development: A nurse will encourage age related play and choose appropriate toys and devices to strengthen gross and fine motor development, sensory and cognitive development. They would set realistic development goals and praise the child’s accomplishments. By learning how to perform activities themselves, the child improves the feeling of self-worth. A nurse will also improve a child’s conscious and unconscious perception towards their body image and provide reassurance, acceptance and encouragement in times of stress.
- Skin Care: Children with Cerebral Palsy are at risk for developing skin conditions which can be infectious and non-infectious. A home care nurse will regularly monitor the skin and take necessary prevention steps to minimize pressure to body parts which can lead to pressure ulcers.
The child’s home health care team will comprise of several heath care workers including the home care nurses who will provide health care services for the child at their own home. The relationship with the people on the home care team and confidence in their care for your child is of utmost importance.
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