HOME VISIT REPORT

Compiled by:Deby Ariandiny NIM: 108103000024Disca Ariella Rucita NIM: 108103000042Farida Nur Aini NIM: 108103000053Leliana Saleh NIM: 108103000008Muhammad Ihsan Sasraningrat NIM: 108103000019

CLINICAL WORK ADDICTION HOSPITAL DRUG DEPENDENCE (RSKO)

MEDICAL EDUCATION STUDY PROGRAM FACULTY OF MEDICINE AND HEALTH SCIENCES

SYARIF HIDAYATULLAH STATE ISLAMIC UNIVERSITY JAKARTA

2014

I. BACKGROUND• To perform optimally in the treatment of addicts (recovering

addict), need cooperation between health workers / medical personnel and family members of clients who received treatment. For those reasons, the family should be included in the client's treatment and recovery programs for clients heal and clients can stop (clean) from drug dependence consciously (sober). It is very important that the client, who is experiencing a mental disorder due to the influence of psychoactive substances (drugs), does not always have to be hospitalized at detoxification and drug rehabilitation of hospital drug dependency.

• In this case, the role of the family is required to optimize the client to independent, increase the fulfillment of daily living, provide information, communication, education to clients and families, empowering families in caring for patients at home. For those, we can do home visit.

II. IMPLEMENTATION

a. Time, day, date, year : At 11:00, Monday, February 3, 2014.

b. Responsible Person : Mr. Abidin. c. Address : Cibubur IV RT. 005/002, Cibubur,

East Jakarta.

III. CLIENT IDENTITY

a. Name: Mr. Junaedi. b. Medical Record Numbers: C.257 / No. PTRM

028 318 c. Age: 31 Years. d. Sex: Male. e. Religion: Islam. f. Room: Participant of PTRM. g. Date of entry: Methadone Treatment since

2011 to 2014.

IV. PURPOSE OF PATIENT’S HOME VISIT

• To determine biopsychosocial of patients and their families.

• In addition, for health education on family and validation of data.

V. GENOGRAM

VI. INTERVENTION

• Provide health education to families about home care of client during treatment and recovery in order to achieve the level of clean and sober. Health education includes:

a. Do activities in accordance with the patient's ability and pray in accordance with the patient’s faith. With these, patient is expected to have positive activities so that they can build patient’s confidence and keep patient from negative events (reuse drugs) because there are no activities and patient’s memories (flash back).

VI. INTERVENTION

b. Involve client in every state in his family and environment (such as social events, religion etc.).

c. Provide information about the importance of regular outpatient (in this case, the treatment of PTRM), report to the doctor/ medical officer at the hospital when the patient returns to have suggest (a desire to use drugs again) and withdrawal symptoms, and monitor patient to consume Methadone correctly if the patient is taking THD (Take Home Dose).

VII. EVALUATION

a. Acceptance of family: the family is very cooperative (the patient's mother) and can cooperate with the officer of home visit.

b. The results of family health education: familiy can understand the importance of regular PTRM medication and family has a good spirit and desire to maintain and care for the patient (as a recovering addict) that patient can recover and achieve clean and sober.

FIRST ATTACHMENT – HOUSE PLAN

SECOND ATTACHMENT – HOME VISIT PHOTOS

THIRD ATTACHMENT – FORM HOME VISIT

A. 1. Patient Identity / Rehabilitant:Medical Record Numbers : C257 / 028 318 Name : Mr. Junaedi Age : 31 Years Education : High School Address : Cibubur No. IV. 97 RT 005/002 Cibubur, East Jakarta Have Been Treated : - Last Treated : Treatment Metadone (2011 s / d 2014) Out of Treatment : - Occupation : Retail Trader (Pedagang Eceran) Ethnicity : Betawi Religion : Islam Diagnosis : Opioid Dependent Status in The Family : Children Bladder Marital Status : Single

A. 2. The identity of the head of family:Name : Mr. Abidin Education : SMP Address of the head of family : Cibubur IV. 005/002, Cibubur, East Jakarta Occupation : Construction workerMarital status : Married Relationship Status of the head of family : Father The composition of family in the house : 1. Father : Mr. Abidin, 57 years old2. Mother : Mrs. Jumimah, 51 years old 3. Child 1 : Tn. Junaedi, 31 years old 4. Child 2 : Ny. Maisaroh, 26 years old (not at home) 5. Child 3 : Ms. Titin, 21 years old 6. Child 4 : Ms. Ade, 12 years old

B. Purpose of Home VisitKnowing biopsychosocial of patient and Family

C. The State of Social and Economic of Family1. Status residence : own property 2. Separate room for patient : yes3. Condition of the house : moderate 4. Home hygiene : moderate5. Neatness of the house : poor 6. Atmosphere of residential area :

a. Occupancy : medium b. Cleanliness : moderate c. Serenity : Quiet

7. Economic condition of the family / patient : enough 8. Living costs are borne by : father 9. Number of dependents : 4 people 10. Breadwinner in the family : father 11. Attitude of patient towards family : obedient12. Attitude of family towards patient : accept 13. The difficulty of family in the care of patient at home: no 14. Attitude of patient towards neighbors : good15. Attitude of neighbors towards patient : indifferent

D. 1. Physical and appearance changes :FatNet FriendlyAgile

D. 2. Family’s complaints about the behavior of patient:a. Suicide attempt : nob. Self-isolation : noc. Insomnia : nod. Hostile : no e. Suspicious : no f. Threatening : no g. Glum : no h. Agrasi : no

E. Disability Conditions of patient:1. Behaviors related to the needs of daily living (ADL)

1. Wake up : independent 2. Defecate : independent 3. Urination : independent 4. Bath time : independent

5. Change clothes : independent 6. Eating and drinking : independent7. Maintaining personal hygiene : independent 8. Keeping the safety of self : independent9. Go to sleep : independent

2. Social Behaviors:10. Relationship to child / husband / significant others : good 11. Social contacts of the officers : good 12. Eye contact when talking/speaking : good 13. Associating : good 14. Obeying the order : good 15. Manners : good

3. Occupational Behaviors:16. Interested in the activities / work : agree17. Want to do activities : agree 18. Active / diligent to do activity / work : agree 19. Productive in doing work / activity : agree 20. Skilled in do activities : agree 21. Appreciating the work results : agree 22. Want to receive command / criticism : agree

F. Conclusion:1. Psychosocial stressors : not married yet, not having a permanent job 2. Adaptation function of one last year: no symptoms, maximum functioning, no problems are not insurmountable 3. Family’s response to the home visit officer : open and friendly 4. Family’s motivation to take medication for patient : patient recovers and has a permanent job

Family,Signature

Mrs. Tamimah (Patient’s Mother)