long-term care - Legislative Reference Bureau

More documents

Recommendations

Info

A. System Needs SINGLE ENTRY POINT FOR LONG-TERM CARE SERVICES Figure 3-3 1. Information and referral 2_ Preadmission screening 3. Case management 4. Simple coordinated access B. Inpatient health care facilities C. Inpatient long-term care facilities D. PreventionlEarly Intervention Services E. Community-based services 1. Medical Care a) practitioners offices b) outpatient clinics c) home health services 2. Residential services a) assisted housing b) home renovation, repair, subsidy 3. Day Care 4. Transportation 5. Personal Care 6. Homemaker Chore 7. Nutritional assistance a) home-delivered meals b) congregate meals 8. Medication management 9. Caregiver supports a) respite b) training and education c) supportive counseling d) financial assistance 10. Habilitation and Rehabilitation 11. Employment related services a) prevocation and vocational services b) supported employment 12. Ongoing socialization 13. Protection and Advocacy 14. Income Maintenance 15. Volunteer services Utilizing a continuum of care builds in a measure of flexibility when responding to changes in an individual's long-term care needs. However, coordination of any changes in services, especially funding sources, is necessary in order to minimize disruption in care. Inconsistent Terminology: Confusion may arise from the differing use among states of terminology for community- and home-based long-term care services. 30 42
LONG-TERM CARE SERVICES Categorizing state service options first requires some common definition of terms. Each state used different names to describe essentially identical in-home services (such as personal care, supportive home care, homemaker, in-home aides), ... These services are typically defined to encompass a wide range of activities from heavy to light housekeeping and from minimal to substantial assistance with bathing, dressing, eating and other activities of daily living. For example, in the six-state study by Justice, et aI., similar services are delivered under the rubric of "home care services" in Arkansas, Illinois, Maryland, Maine, Oregon, and Wisconsin. They are: "personal care," "housekeeping/chore homemaker," "personal care inhome aides," "personal care assistance," "home care," and "supportive home care," respectively.31 These are not identical. Personal care addresses impairments with ADLs such as eating, bathing, dressing, and toileting. Chore services, on the other hand, help individuals who have difficulty with Instrumental ADLs (IADLs) such as shopping and meal preparation. With companion sitter services, a trained live-in person (sometimes another elderly person) ensures that medications are taken and does the housekeeping, shopping, and cooking. 32 On the other hand, in the completely different area of long-term care living arrangements, different services address that same need. These are "board and care"; "congregate housing services"; "adult foster care"; "residential care facilities"; "adult family homes"; and "community-based residential facilities. "33 Another listing of alternative living arrangements (for the elderly) include: 34 • Living in original home • ECHO housing ("Elder Cottage Housing Opportunity" housing: temporary, detached, usually pre-fabricated units sited near a caregiver's home) • Shared housing (many elders living in one house) • Boarding homes • Retirement centers • Congregate housing • Efficiency apartments which include special modifications for the functionally impaired, such as safe appliances, low shelves, emergency call buttons, bath railings, limited entry for security, etc. • Residential housing • Living with family members Home Care -- Informal Support by Family Caregivers: The terminology of long-term care services may cause confusion that is distracting. But it must be noted that home care, as provided by usually unpaid informal caregivers such as family or friends, accounts for about 75 percent of home- and community-based long-term care. Of the 12.7 million individuals with long-term care needs, about 80 percent (10.2 million) live either at home or in community settings.35 In 1991, 5.3 million persons aged 65 and over who needed help with an ADL or IADL were not institutionalized. Many of these persons do not receive formal home- and community-based long-term care services. They rely instead on informal support given by family and friends. 36 Thus, informal care constitutes a large, if not dominant, portion of long-term care. The point is that informal care is usually unpaid and forms the basis upon which publicly-funded packages of long-term care services are authorized. Although a significant part of the continuum of long-term care, informal care is not a "service" that can be authorized and provided by any program. Most states do not penalize a potential 43
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 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 98 and 99:
SINGLE ENTRY POINT FOR LONG-TERM CA
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?