3 - Levels of Residential Care Flashcards
3 Chronic Care Models of Care
Comprehensive Care Model – IP team, family physician, community
- made up of an interprofessional team that engages with an informed, activated client to arrive at appropriate clinical outcomes marked by client satisfaction
Chronic Care Model – primary care based, supporting complex needs of clients living with >1 chronic conditions
- Informed, activated clients working with proactive h.c. team
○ Includes self-management support, decision support, delivery system design, clinical information systems, health care organization, and community resources
○ Best comprehensive model for addressing chronic care needs
Expanded Chronic Care Model – acknowledges association b/w h.c. and communities e.g. family supports
- broadens the clinical focus of the CCM to include population health promotion with the aim to improve prevention of illness and enhance community participation
What is the LTC Continuum?
- Encompasses a variety of services for those who cant manage independently
- long-term care services are also provided in the community
- Includes:
1) living at home requiring minimal support
2) 24 hr assistance in an institutional facility - Transition of care is dependent on age and progression of the chronic condition resulting in increased dependence and reliance on others
What is the largest component of community-based LTC?
Home care
What is involved in community-based LTC?
- meal prep
- personal support
- palliative care
- respite/day programs
- provision of necessary medical equipment and supplies
Why is there a need for skilled care in LTC?
- a significant portion of older adults have complex and multifaceted care needs that necessitate long-term care (LTC) facilities
- there is an increasing demand for specialized care due to the prevalence of multiple medical conditions, high medication requirements, cognitive issues, and behavioral challenges among new residents
Examples of Complex Nursing Care
- Administration of medications(!)
- Identifying changes in client status
- Managing multiple co-morbidities
- Communication with client and families
- Interdisciplinary communication
- Multitasking
What is Palliative Care
- approach to care focused on improving quality of life for both the patient with a life-threatening illness and their family.
- Includes hospice and end-of life care across settings (including homes)
- Focus is on pain and distress management respecting clients’ and families’ needs, culture and values.
What are the types of LTC Facilities?
- Independent Living
- Retirement Living
- Long-term care (nursing home)
What are the challenges in LTC?
- rapidly changing demographic profile of a “super-aged” nation
- legacy of government underfunding of LTC services
- financial burden of out-of-pocket LTC expenses
- chronic and problematic practice providing care for older people in institutionalized settings
What is the result of challenges in LTC?
- Expanding waitlists
- Staffing shortages due to long-standing recruitment & retention
- Overreliance on unpaid caregivers
- Growing quality inconsistencies
What is the Resident Bill of Rights?
- The requirements in the LTCHA ensure that residents receive safe, consistent, and high-quality resident-centered care in settings where residents feel at home, are treated with respect, and have the supports and services they need for their health and well-being.
What are the “Rights” in the Bill of Rights
- Courtesy & respect
- Safety
- Shelter, food, privacy
- Abuse
- Neglect
- Shelter, food, privacy
- Independence, QOL
- Restraints
- Family present 24 hrs/day with illness/death
What is Ontarios Action Plan for Seniors?
- the government is committed to increasing staffing levels in LTC to ensure a provincial average of four care hrs/resident
What is involved in fixing the LTC Act
Resident safety and well-being
- Stronger infection prevention and control requirements
- More focus on continuous quality improvement in residents’ quality of life and quality of care
- Tools to ensure homes comply with the rules
- Screen staff and visitors and members of home’s governing structure for criminal wrong doing or professional misconduct
Staffing
Emergency planning
Accountability and quality
RNAO’s Recommendations for Nursing Staffing
- Home Basic Care Guarantee - RNAO’s ongoing call for the implementation of standards for care in LTC
- recommendations include mandating and funding all Ontario LTC homes to provide a guaranteed minimum of four worked hours of direct nursing and personal care per LTC resident per day
