DREAM-HOPE Acute care nurse coordination includes as pain management of a normal, predicted physiological response to an adverse. Chemical, thermal, or mechanical stimulus and associated with surgery, trauma, and acute illness. It is generally limited and responds to treatment in less than six months.

DREAM-HOPE Chronic nurse care coordination includes as persistent pain management that exists beyond an expected time for healing usually lasts more than six months. It requires comprehensive assessment and treatment care plan past and present physiological condition, sensory, affective, cognitive, behavioral and sociocultural components.

DREAM-HOPE Convalescent care a safe and an efficient transition for sub-acute and post-acute transition starting with discharge planner and home care nurse coordinator begin with the baseline client/patient information. These includes current medical, psychological, mental, health status, family and community support systems, payer sources, financial status, decision-making capacity, religious preference and legal issues. DREAM-HOPE Home health nurse will coordinate the treatment order with the physician to make the patient transition smooth and effective.

Convalescent care divided into two parts, One is convalescent Sub-acute care is for patients who have received acute care (defined as short-term medical care. Especially for serious disease or trauma that has a sudden onset, sharp, and short course and continue to require complex medical and/or rehabilitative care. Examples care following a stroke or a broken hip. Typically, short-term sub-acute care helps patients transition to lower levels of care or return from home to communities.

Convalescent Post-acute care consists of services to help patients of transition from the hospital back to their homes and communities. Some patient enters post-acute care following sub-acute care. Post-acute care settings for the convalescent client might be in community apartment or own homes. The patient recovers from a surgical procedure and needed to recover in their own homes.

DREAM-HOPE respite care coordination applies to family needed temporary relief from caring a member of a family with the health problem, and need assistant with ADL, shopping, help laundry, and companionship. Respite care provides family members to have rest from taking care of a client, raising children, being a working parent. A client with Alzheimer also benefit being in the safe environment, will have planned activities, and help them with their memories. Respite care providers in client’s home, adult day care, and residential facilities, and may be for 24 hours overnight care or days and weekends. Skilled care services including meds will be coordinated by the Registered nurse.

Long-term supportive nurse care coordination includes all client’s activities in home care environment due to disability or chronic illness. The nurse will assess client’s health and functional ability to regain strength as long as possible and prevent an actual and potential problem in self-care activities to promote safety and control infection. Client goal is to maintain as much function and dependency as possible in everyday life while ensuring safety, comfort, and wellbeing. Client participates in health promotion program includes weight management, proper nutrition, safety management, prevention of infection to modify lifestyle.

DREAM-HOPE Comprehensive care coordination focus on all aspect of client’s home health care needs as a whole. Client care coordination starts at the time of discharge and continues on home health care nurse assessment admission process. We work with interdisciplinary nurse team and the Multidisciplinary team of Physician, Nurse practitioner, Dentist or/and another practitioner. Our complete nursing assessment includes health history and physical exams.

DREAM-HOPE Client-family nurse care coordination provides understanding and meaningful participation in home health care of a client. Client-family participation focuses on communication pattern, decision-making, problem-solving, role pattern, values, coping, socialization, effective, and healthcare practice.

DREAM-HOPE Mother-infant care nurse coordination includes providing safe and effective perinatal and infant care. The maternal care part antepartum, intrapartum, and postpartum. Infant care includes preterm and full term condition. Postpartum assessment care, nutrition, breastfeeding, counseling, prevention of postpartum depression, postpartum family planning, newborn assessment care as management of the common newborn problem.

Developmental nurse care coordination includes normal to abnormal changes that occur in all age throughout the lifespan process whereby client adapt their own environment. This includes clients with short or long memory loss and mental disabilities. We have direct care or personal care staff who support the client to be involved in the activity of daily living and accompany them to participate in the community. Our nurse team coordinate client care to achieve a personal goal in schooling, jobs, to support living arrangement.

DREAM-HOPE nurse will coordinate the rehabilitation care with a physician or Nurse Practitioner and multidisciplinary team as physical, speech, or occupational therapy. Registered Nurse (RN0 work closely to client’s health management and health restoration process on skills and knowledge that is lost in the result of illness, accident or injury. DREAM-HOPE nurse uses assessment of client’s functional health on cognitive -perception pattern with the adequacy of sensory pain perception, pain management, cognitive functional ability, and activity of daily; living (ADL).

DREAM-HOPE Palliative care nurse coordination includes tertiary prevention and relieve suffering, and to support the best possible quality of life for client/patient and their families, regarding of the stage of the disease or the need for other therapies. DREAM-HOPE will support patients’ and families’ goals for the future; including their hopes for the care of life-prolonging, as well as their hopes for peace and dignity throughout the course of the illness, the dying process, and death.

DREAM-HOPE Hospice care nurse coordination focuses on quality of life instead of on continuing with treatment to prolong client’s life. A client with terminal illness stays in their home while getting 24 hours personal care, or medical Hospice care. Nurse team provides medical services that focus on pain and symptom management, medical supplies and equipment, counseling and social support, and guidance with family decision making.

DREAM-HOPE end of life spiritual care helps the patient savor the remaining period of life and identifies the meaning of impending death. Recognize that facing death and dealing with separation are developmental tasks for all humans. DREAM-HOPE healthcare teams acknowledge a stage of development and validate its importance nondisease-related interventions.  Nurse and health care team help redirect coping efforts toward positive life closure. Promote focus on growth and learning rather than on disease or injury, and arrange spiritual care as needed per family requests.