ALC Flashcards
What is the definition of “ALC”?
is a system classification used in Canada that is applied when there is a mismatch between the intensity of care needs in relationship to the intensity of services/resources in that setting.”
This is a term used in hospital settings to describe patients who are currently in hospital, but do not require the level of care or resources provided by the hospital service.
While these patients no longer require the level of care/services provided by the hospital, they become “stuck” in hospital- there is nowhere else for them to go.
When do people become ALC?
Their care goals have been met;
Their progress in hospital has reached a plateau;
They have reached their potential within that program/level of care, or;
Their admission occurs for a supportive care reason because services were not available in the community (e.g. a social admission)
Who determines ALC?
ALC status should be determined by a physician or physician delegate. It may be determined in collaboration with the interdisciplinary team. The discharge destination does not need to be known before an ALC status is designated
Who is most likely to have ALC status in hospital?
- People who are eventually discharged home are more likely to have ALC status if:
People who have a higher degree of health care needs
When an informal caregiver is experiencing distress or burnout
People who have bowel or bladder incontinence
People who do not have a spouse (CIHI, 2012)
- People who are eventually discharged to long-term care are more likely to have ALC status if:
People who have dementia
People who have complex responsive behaviours
People who have communication difficulties
People who are more medically stable (*perhaps suggesting that people who are more medically unstable receive priority beds or are served within specialized settings)
People who take more than nine prescription medications
People who take one or more psychotropic medication(s)
How does being deemed “ALC” impact older adults?
When seniors wait in hospital, they face risk factors, including:
Hospital-acquired infections
Delirium
Atrophy
Falls
General functional decline
How does being deemed “ALC” impact families?
Families reported distress related to ALC status, including believing that:
The quality of care dropped after their family member because ALC, as their family member was no longer acutely ill
There was an expectation that family members begin to offer the care in hospital, since the patient “no longer needed the staff”
Feeling uncertainty and confusion over the process
Preferring long-term care to hospital services, and feeling “stuck
How does being deemed “ALC” impact the system?
ALC days are very costly to the system. The average cost for a hospital bed is $843/day (Home Care Ontario, n.d.). This cost may increase depending on the patient complexities;
ALC days interrupt hospital flow. They may hold up services needed for acutely ill people who need the bed, while patients who do not need the bed continue to use it. Thus, patients who are requiring an acute-level bed may have to wait in the Emergency Department for days, waiting for a bed, while the folks who are in the existing acute-level beds do not require them (OHA, 2018).
What is Implied Consent?
Implied consent allows sharing health info within the Circle of Care, which includes certain health agencies.
Who can we speak with without expressed consent from our patient?
Registered Health Care Providers
Long-term Care Homes
Retirement Homes (*but only registered health care staff members within retirement homes)
Local Health Integration Networks
Hospitals
Laboratories
Some community-based provider
is a program in the SouthWest LHIN that offers support for individuals with responsive behaviors.
Behavioural Supports Ontario (BSO)
