Exam 3 - Lecture 2 (Retirement, Legal & Ethical Issues) Flashcards
what are the types of economic assistance that older adults are entitled to?
- SS
- Medicare
what is retirement?
the expectation that older adults will cease full-time work
which group of older adults plan to work past 65 yrs old or have no intentions to retire?
Baby Boomers
retirement planning is largely aimed at these group of people
- highly educated
- those with high occupational status
- government employees
- employees in companies with pensions
why do women retire earlier than men?
- gender bias
- family responsibilities
- more variability in work due to interrupted careers
- sporadic work history
what are the nursing responsibilities regarding retirement?
- discuss it with clients in primary care
- discuss transition to retired status
- address health issues affecting retirement
- provide resources for planning & support
what is the full retirement age for SS?
65-67 years old
what was the purpose of the “Age-entitlement Program” (SS) under FDR?
provide monetary support at a certain age regardless of personal financial resources
how is the “benefit amount” calculated for SS?
get the avg salary during 35 working years
what are the different insurance plans provided by the US government?
- Medicare
- Railroad Medicare
- Medicaid
- TRICARE
- VA
which insurance plan is designed for adults age 65, people who are blind or totally disabled and those with ESRD?
Medicare
what do supplemental insurance plans (Medigap) help with?
- Medicare co-pays
- deductibles
- a portion of coinsurance amounts
what does Supplemental Security Income provide?
minimum level of economic support to people older than 65 regardless of earning power in early working life
what is Medicaid?
a health insurance program funded by the federal and state with tax dollars
Medicaid provides health services to which group of people?
- low-income children
- pregnant women
- permanently disabled
- adults 65 and older
this type of insurance is designed to cover expenses for LTC that are not included in health insurance or Medicare
LTC insurance
what are some things that LTC insurance offer?
- wide range of benefits
- wide range of costs
- some offer a maximum time for coverage (5 years)
how are costs for LTC paid for?
- Medicaid
- Medicare
- private LTC insurance
- out-of-pocket
most older adults prefer to stay at home
true
what are the 3 residence options for older adults?
- shared housing with family members
- community care
- skilled-nursing facilities
what are the 4 types of community care?
- PACE (care for older adults living in communities)
- adult day services
- assisted living facilities
- continuing care retirement communities
what are the 2 types of skilled nursing facilities?
- sub-acute
- chronic care (LTC)
who are typical residents of an LTC facility?
- women older than 80
- widowed
what is fictive kin?
people unrelated to an individual who are close to them
who is considered fictive kin?
- CNA
- RN
- caregivers
- case managers
who is most likely to inflict abuse on an older adult?
their own children
nurses are mandated to report elder abuse
true
documented elder abuse occurs with which population?
Caucasians
most elderly abuse occurs in the home by spouses and children
true
types of abuse
- physical
- sexual
- emotional
- medical
- financial
- discrmination
- abandonment / neglect
what is the most common type of elder abuse?
neglect
what are 2 common bruising patterns in abused older adults
- wrap-around
- linear
where are linear bruising patterns most commonly seen?
- back
- thighs
- arms
- buttocks
what causes linear bruising?
striking with an object
what are the nursing interventions for elder abuse?
- observe for obvious bruises
- ask about medications (medical abuse)
- photograph injuries
- note body odor, dirty clothing
- other signs of neglect
- look for signs of restraints
which agency are nurses required to report elderly abuse to?
Adult Protective Services
according to SS, what does one “credit” equal to?
$1,300
how many credits can a working adult earn in one year?
4
how can one receive the minimal monthly income from SS?
earn 40 credits
how much does does the Supplemental Security Income (SSI) provide?
maximum benefit of $750 per month
how are beneficiaries determined for SSI?
consideration of total income plus the value of “gifts” such as housing
this type of Medicare is designed to partially cover costs of acute hospitalization (semiprivate rooms), short-term rehabilitation, hospice care, and any necessary medical services and supplies
Medicare part A
this type of Medicare is designed to cover costs associated with outpatient or ambulatory services
outpt: clinics, outpt surgery, imaging, dialysis, chemotherapy, etc
Medicare part B
under Medicare part B, diabetic supplies require deductibles & copays
true
what other name is Medicare part C referred to as?
Medicare Advantage Plans
what does Medicare part C entail?
- use of prospective payment system (reimbursement based on fixed amount)
- inclusion of health maintenance organizations (HMOs)
Medicare part C requires what special rule in order to provide full coverage?
providing proof of referral to the assigned PCP
what does Medicare part D help cover?
cost of prescription drugs
assisted living facilities
annual cost
$45,000
nursing home care
national median daily rate (semiprivate room)
$235
nursing home care
national median monthly rate
$7,148
nursing home care
annual cost
$85,783
assisted living facility
national median monthly rate
$3,750
what are the factors to consider when selecting a nursing home?
Box 32.13
- central focus are the residents & families
- positive interactions between staff
- calm & friendly milieu
- clean & well-maintained environment
- individualized care
- well-trained staff
- involved RNs
- safety
nursing home culture change competencies for nurses
- effective communication skills
- accommodation of resident preferences
- views self as part of the team
- addresses barriers to person-directed care
- views the environment as the resident’s home
- consistency
- shared problem solving
