long-term care - Legislative Reference Bureau

More documents

Recommendations

Info

SINGLE ENTRY POINT FOR LONG-TERM CARE SERVICES (2) Congregate Housing and Services Model: Housing is supplemented with congregate services, e.g. 24-hour security, transport, recreation, and meals. Life care communities are a modification of this model where large initial payments are made, supplemented with monthly fees which cover housing and medical care. Group or boarding homes do not provide health care but allow residents to share house duties. Foster adult care is a variation. (3) Home Care Model: Individuals are homebound (about 5% of the elderly population); individuals may also be bedbound. Services include those of physicians, nurses, social workers, and attendants offering various therapies, personal care, homemaking, transport, and home modifications. Examples of this model include various states' "nursing home without walls" (such as New York's St. Vincent's Hospital and Medical Center). St. Vincent's began as one of the first pilots in New York's Medicaid-funded nursing home without walls program in 1979. It provided a " ... broad array of in-home services, including not only the physician-nurse-social worker team but also various therapies, paraprofessional care, and medical equipment and supplies, nutritional counseling, heavy chore services and personal emergency response systems. Only persons entitled to Medicaid are eligible, with few exceptions, and the patient's rights to remain eligible are held to rigid norms of cost and service. "25 The aim is to replicate the supportive services usually provided in institutions or congregate housing for those living at home. (4) Institutional Care Model: Hospitals and nursing homes provide care in this category. Nursing homes provide skilled, intermediate, and personal care. Care can be either for short-term post-hospital or rehabilitation services or for chronic long-term care. "Skilled care is defined by Medicare and Medicaid as that provided in a state-licensed institution (or a distinct part of an institution) that is primarily engaged in giving skilled nursing care and related services to patients who require medical, nursing, or rehabilitation services for an extended period of time but do not require hospitalization .... Intermediate care is that provided in an institution licensed by a state to provide health-related care to individuals who do not require the degree of care provided by a hospital or a skilled nursing facility but do require care or services available only through an institutional facility. These facilities are sometimes called supportive nursing care or health-related facilities .... Personal care is assistance with such activities of daily living as bathing, toileting, eating, transferring, and ambulating provided to an individual in an institutional setting. Customarily, three or more of these services are routinely provided to each client in order to qualify an institution as a personal-care facility. "26 Broken down in terms of home- and community-based services and not in terms of models or categories of long-term care: 27 1. Rehabilitation: restores or maintains wellness and physical, mental, and social functioning after accident, injury, surgery, or illness. Usually includes various therapies (occupational, physical, speech, hearing, etc.). 2. Counseling: often offered at senior centers, nutrition sites, congregate housing, and nursing homes. 3. Senior center services: education, information and referral, counseling, health, employment, recreation, volunteer, and special services including therapy and transport. 4. Transportation: from housing to senior centers and for physician visits, church, etc. 5. Nutrition program: includes delivered meals. 36
LONG-TERM CARE SERVICES 6. Home health services: licensed home health care authorized by physician to restore/maintain health and minimize effects of illness or disability which may include nursing, various therapies, physician services, social work, and counseling. May be supplemented by personal care and homemaker services or be substituted for by the latter two. 7. Homemaker services: (also known as chore services) are non-medical. Unlike personal care services, they are limited to services to enhance the physical environment and not the person. 8. Personal care services: non-medical help with ADLs and affects the person, not the environment. 9. Adult day health services: provided in daytime congregate settings to. those not needing institutionalization which include health care, physical and vocational rehabilitation, meals, personal care, and recreational and educational activities. 10. Spiritual supports: on-site or via transport to a religious site. 11. The arts: local artists perform for the home-bound. 12. Respite care: infrequent and temporary substitute care, or supervision of a disabled person in the absence of the normal caregiver or to provide that caregiver with relief. Can be provided through in-patient facilities, home health agencies, adult day carelhealth centers, and adult night care. 13. Hospice care. From yet another perspective, Figure 3-1 lists an ideal set of services in a continuum of care for the elderly based on options available in Indiana in 1990. 28 TyPe of Service Housing Social! Recreational Mental Health Community -Own home or apt. -Low income housing -Retirement community -Accessory apts. -Senior centers -I ntergenerational activites -Senior community and church groups -Volunteer opportunities -Senior centers -Mutual support and Figure 3-1 37 Supported Living -Own home -Residential facility -Group home -Adult foster care -Home repair -Weatherization -Friendly visitor -Telephone reassurance -Social model Adult day care -In-home counseling -Outreach Institutional -Nursing home -Hospital -Sub acute units -Alzheimer's units -Activity programs -On-site child care -Volunteer involvement -In facility counsleing
Page 1 and 2: LONG-TERM CARE: A SINGLE ENTRY POIN
Page 3 and 4: TABLE OF CONTENTS Page FOREWORD....
Page 5: Community Long-Term Care Branch (CL
Page 8 and 9: SINGLE ENTRY POINT FOR LONG-TERM CA
Page 10 and 11: Chapter 2 CONCEPT OF A SINGLE ENTRY
Page 12 and 13: CONCEPT OF A SINGLE ENTRY POINT .Ex
Page 14: CONCEPT OF A SINGLE ENTRY POINT •
Page 26 and 27: CONCEPT OF A SINGLE ENTRY POINT Usi
Page 28 and 29: CONCEPT OF A SINGLE ENTRY POINT ser
Page 35 and 36: .42. Koff, pp. 167-168. 43. AARP fa
Page 37: Chapter 3 LONG-TERM CARE SERVICES O
Page 46: FIGURE 3-2 40
Page 49 and 50: LONG-TERM CARE SERVICES Categorizin
Page 51: LQNG-TERM CARE SERVICES ADCCs do no
Page 56: SINGLE ENTRY POINT FOR LONG-TERM CA
Page 59 and 60: LONG-TERM CARE SERVICES • Some pe
Page 61 and 62: LONG-TERM CARE SERVICES (1) Suffer
Page 68 and 69: Traditional Developmental Services
Page 72 and 73: 77. Ibid., pp. 18-19. SINGLE ENTRY
Page 84: SINGLE ENTRY POINT FOR LONG-TERM CA
Page 87 and 88: OTHER STATES purchased with state a
Page 89: OTHER STATES The main impetus for t
Page 92 and 93:
SINGLE ENTRY POINT FOR LONG-TERM CA
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102:
Page 105:
OTHER STATES long-term care, includ
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
34. Ibid., pp. 5-6. 35. Ibid., p. 6
Page 114 and 115:
79. Ibid. SINGLE ENTRY POINT FOR LO
Page 116 and 117:
Page 118 and 119:
Chapter 5 HAWAII Organization: Part
Page 120 and 121:
HAWAII (2) Case Management: Continu
Page 122 and 123:
HAWAII (5) A geriatric psychiatry t
Page 124 and 125:
HAWAII As mentioned above, there is
Page 126 and 127:
HAWAII • Home maintenance • Nut
Page 128 and 129:
HAWAII the time of its closing, Pro
Page 130:
HAWAII (2) Conducting public affair
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
50. Ibid., p. 13. 51. Ibid. 52. Ibi
Page 141 and 142:
85. Seely memo, p. 2. SINGLE ENTRY
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
SINGLE ENTRY POINT FOR LONG·TERM C
Page 151 and 152:
SINGLE ENTRY POINT FOR LONG·TERM C
Page 153 and 154:
Page 155 and 156:
THE SENATE EIGHTEENTH LEGISLATURE,
Page 157 and 158:
Appendix B Model Long Term Care Ass
Page 160:
ASSESSMENT FACE SHEET The assessmen
Page 163 and 164:
PHYSICAL HEALTH r------------------
Page 166:
MedicationsfTreatments/Services/Sup
Page 171 and 172:
Physical Health (con't) Note any di
Page 173 and 174:
ACTIVITIES OF DAILY LIVING Completi
Page 175:
INSTRUMENTAL ACTIVITIES OF DAILY LI
Page 178 and 179:
SOCIAL HISTORYIRESOURCES Please tel
Page 181 and 182:
Social HistorylResources (con't) Wh
Page 183 and 184:
PHYSICAL ENVIRONMENT How long have
Page 186 and 187:
EMOTIONAL FUNCTIONING This section
Page 189 and 190:
COGNITIVE FUNCTIONING This section
Page 191 and 192:
FAMILY SCREEN To what extent has th
Page 193:
ALCOHOL AND DRUG ASSESSMENT TOOL AL
Page 196 and 197:
GERIATRIC DEPRESSION SCALE 1. Are y
Page 198:
INSTRUCTIONS FOR HOME SAFETY CHECK-
show all

long-term care - Legislative Reference Bureau

Create successful ePaper yourself

Delete template?

Save as template?