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Special Populations > Healthcare Systems > Flashcards

Healthcare Systems Flashcards

1
Q

what is the purpose of the Patient Self-Determination Act of 1990?

A

inform patients of their rights regarding decisions toward their own medical care, and ensure that these rights are communicated by the health care provider

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2
Q

list several laws that pertain to employment issues

A
  1. ADA
  2. FMLA → Family and Medical Leave Act
  3. Age Discrimination in Employment Act
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3
Q

what is the ADA?

A

a law that prohibits discrimination on the basis of disability in employment, state and local government, public accommodations, commercial facilities, transportation, and telecommunication

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4
Q

what is the purpose of the FMLA?

A

entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons

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5
Q

what is the purpose of the Age Discrimination Act?

A

forbids age discrimination against people who are age 40 or older

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6
Q

what is the purpose of power of attorney?

A

it is a legal document that gives one person (“the agent”) power to take actions on behalf of another person (“the principal”)

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7
Q

what is the difference between power of attorney and durable power of attorney?

A

durable POA continues after principal becomes incapacitated

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8
Q

what is springing POA?

A

gives the agent power only when the principal becomes incapacitated

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9
Q

list the types of elder abuse

A
  1. Caregiver and self-neglect
  2. Emotional and psychological abuse
    1. deception
    2. intimidation
    3. threats
  3. Fiduciary/financial exploitation
    1. typically includes psychological abuse
  4. Physical abuse
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10
Q

who typically carries out elder abuse?

A
  1. family members
  2. paid caregivers
  3. nursing homes
  4. scam artists
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11
Q

List S/S of abuse

A
  1. In the patient
    1. unexplained or untreated injuries
    2. poor hygiene
    3. malnutrition and dehydration
    4. dirty or inappropriate dress
  2. In the abuser
    1. aggression toward or verbal abuse of the pt
    2. speaking for the pt during an exam or trx
    3. disagreeable to instructions or suggestions in pt’s best interest
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12
Q

list screening tests for elder abuse

A
  1. elder assessment instrument
  2. indicators of abuse screen
  3. brief abuse screen for the elderly
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13
Q

T/F: geriatric rehab pros have a legal duty to act reasonably to ID elder abuse or neglect involving their pts

A

TRUE

as well as take appropriate action to prevent further abuse

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14
Q

what does NC Gen Stat 108A-102(a) - (b)(a) state

A

any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such info to the director of Adult Protective Services

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15
Q

who should you contact when you suspect elder abuse

A
  1. for a community-dwelling older adult
    1. local adult protective services agency
  2. for an older adult in a long-term care facility
    1. local long-term care ombudsman
  3. Other group
    1. citizen advocacy groups
    2. office of aging
    3. protective and advocacy system
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16
Q

what are restraints?

A

devices (physical) or substances (chemical) that restrict freedom of movement

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17
Q

T/F: evidence shows that restraints often increase the incidence of falls

A

TRUE

18
Q

law relating to restraints

A

pt has the right to be free from any physical or chemical restraints imposed for purposes of disciplines or convenience, and not required to treat the resident’s medical symptoms

19
Q

T/F: you do not need an MD order to restrain a pt

A

FALSE

  1. requires MD order
  2. must be discontinued after 24 hrs unless well documented for necessity
  3. additionally, elaborate process to show failure of “less restrictive devices” prior to restraint implementation
20
Q

describe parameters for the use of restraints

A
  1. prohibited in prone positions
  2. may be used if necessary to prevent imminent danger or injury
  3. may not be used as a discipline or for convenience
  4. must be ended at the earliest possible time
  5. may only be used when less restrictive interventions have been determined to be ineffective
  6. must be ordered by a physician or other authorized, licensed practitioner
21
Q

list types of restraints

A
  1. chair or bed alarm
  2. bed rail
  3. lap buddy, lap tray
  4. seat belt
  5. reclining WC or gerichair
  6. wedge cushion
  7. hand mitts
  8. extremity tie-on-devices
  9. waist and pelvic ties
  10. posey vests
22
Q

list benefits to restriants

A
  1. prevent falls and injuries (in theory)
  2. allow medical procedure w/o pt interference
  3. maintenance of body alignment (in theory)
  4. protects others from physical harm by the individual
23
Q

list risks to restraints

A
  1. injury from falls
  2. strangulation
  3. skin abrasions and breakdown
  4. immobilization sequelae
  5. decline in ADLs
  6. social/emotional isolation
24
Q

what is included in the basic coverage of Medicare A?

A
  1. IP hospital
  2. SNF
  3. Hospice
  4. HH
25
Q

what are the premium costs for Medicare A?

A

usually no premiums

  1. IP/SNF depends on days of coverage
  2. HH and Hospice no additional costs
26
Q

what is included in the basic coverage in Medicare B?

A
  1. OP care
  2. MD visits
  3. Preventive services
  4. labs
  5. DME
  6. kidney supplies
  7. wellness visits
27
Q

what are the premium costs for Medicare B?

A

monthly premium, sliding scale for income

after deductible met, pay 80% of cost

28
Q

what is included in the basic coverage for Medicare C?

A

All Part A (except hospice) and B, usually D

  • benefits vary widely
  • some include eye, dental, hearing
29
Q

what are the premium costs for Medicare C?

A

administered by private health insurance plan

monthly premiums vary by plan

30
Q

what is included in the basic coverage for Medicare D?

A
  1. OP Rx drug benefit offered through private plans
  2. limits applied annually
31
Q

What are the premium costs for Medicare D?

A

Monthly premium along with cost-sharing for brand and generic drugs

“donut hole” coverage for costly drugs

32
Q

which Medicare programs can student DPTs treat?

A

A and C

33
Q

what is the Payment Driven Payment Model (PDPM)?

A

model that uses clinically relevant factors instead of volume-based services for determining payment

ultimately reduces total therapy minutes → reduced therapy staffing

34
Q

list the social determinants of health

A
  1. availability of resources to meet daily needs
  2. access to educational, economic, and job opportunities
  3. access to healthcare services
  4. transportation options
  5. social support
  6. public safety
  7. social norms (discrimination, racism, etc.)
35
Q

what influences the health of a population?

A
  1. access and quality of healthcare
  2. Patients behaviors
  3. Socioeconomic conditions
36
Q

what are the 5 determinant areas that reflect critical components and influence health outcomes?

A
  1. Neighborhood and the built environment
  2. Economic stability
  3. Health and healthcare
  4. Education
  5. Social and community context
37
Q

how do we help people with unmet SDOH needs?

A
  1. Screening
    1. health leads social needs screening toolkit
    2. PRAPARE TOOLKIT
    3. HealthBegins Upstream Risks Screening Tool
  2. Tools to address SDOH needs
    1. Findhelp.org
    2. the neighborhood navigator
38
Q

Give some advocacy examples

A
  1. Falls prevention
  2. Medicare policy
  3. Access to reimbursable treatments
39
Q

what is the purpose of palliative care?

A

provides comfort measures for individuals/families with life-threatening conditions that may or may not be terminal

40
Q

what is the purpose of hospice care?

A

provides comfort measures for individuals/families with terminal conditions and >6 months of life

focus → physical, emotions, spiritual care

41
Q

what is a “good death”?

A

defined as one that is free from avoidable distress and suffering for the pts, families, and caregivers

in general accord with the pt’s and families wishes and reasonably consistent with clinical, cultural and ethical standards

Special Populations (26 decks)

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