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MEDS 577 PC FINAL > Lecture 11&12: Home/Community Based Services > Flashcards

Lecture 11&12: Home/Community Based Services Flashcards

1
Q

For Continuum of Care what must providers do?

A

Providers work together to develop a coordinated plan addressing physical, emotional, social, spiritual, caregiving, nutritional, safety and other needs

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2
Q

T/F

In some communities 1 or 2 agencies work together to offer a range of services, while in others multiple organizations work together to meet needs

A

T

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3
Q

What is the common thread is that all models should feature regarding continuum of care?

A

all models feature conversations about when and how to infuse palliative care throughout the disease trajectory

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4
Q

What is the order of continuum of care?

A
  1. “Diagnosis”
  2. Therapies to modify disease
  3. Therapies to relieve suffering and improve quality of life
  4. “6 months” before death start “Life Closure”
  5. “Actively dying” before “death”
  6. “Bereavement Care
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5
Q

What are the 2 categories of Home & Community-Based Services (HCBS)

A

Health ServicesandHuman Services

Programs may offer a combination of both types

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6
Q

T/F

Home & Community-Based Services (HCBS) offers cariety of health & human services providedand address people with limitations who need assistance with everyday activities

A

T

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7
Q

T/F

Home & Community-Based Services (HCBS) is often designed to enable people to stay in their homes, rather than moving to a facility

A

True

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8
Q

List Advantages of Home & Community-Based Services (HCBS)

A
  1. Cost-effectiveness (Often lower (50%) hospitalization rates and costs)
  2. More Control of Personal Schedule (LTC facilities structure activities aroundstaff rotations rather than patients’ schedules. Patients spend more time lying in bed alone rather than interacting with others or receiving care. Easier to coordinate visiting with family, events, etc.)
  3. Better Care (Cost of institutional care has NEVER been proportional to the quality of care. In community care, more patients improve. In LTC, most patients flatline or decline)
  4. Culturally responsive (Spiritual and cultural activities and support available)
  5. Familiarity (Patient enjoys comfort of own home or small residential facility in community)
  6. Counseling or clergy assist with bereavement
  7. Family members may be paid as caregivers
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9
Q

List Challenges of Home & Community-Based Services (HCBS)

A
  1. Home health care (Skilled home nursing care, OT/Speech Therapy/PT, Dietician)
  2. Pharmacy
  3. Durable medical equipment
  4. Case management
  5. Personal care (more later)
  6. Caregiver and client training
  7. Health promotion and disease prevention
  8. Hospice care (Comfort care for dying patients)
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10
Q

List some Human Services (Daily Living) for Home & Community-Based Services (HCBS)

A
  • Senior centers
  • Adult daycares
  • Congregate meal sites
  • Home-delivery meal program
  • Personal care
  • Transportation and access
  • Home repairs and modifications
  • Home safety assessments
  • Homemaker and chore services
  • Information and referral services
  • Financial services
  • Legal services, such as help preparing a will
  • Telephone reassurance
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11
Q

List some Personal Care (Usually in Home) for Home & Community-Based Services (HCBS)

A
  • Socialization
  • Supervision
  • Showering
  • Tub Bathing
  • Hair Care
  • Skin Care
  • Foot Care
  • Shaving and Grooming
  • Oral Hygiene
  • Medication Reminders
  • Ambulation Assistance (via Standby, Walker, Wheelchair, or Cane)
  • Positioning and Range of Motion Activities
  • Transferring and Mobility Assistance
  • Toileting, Catheter and Ostomy Assistance
  • Housekeeping
  • Laundry
  • Grocery Shopping and Errands
  • Meal Preparation and Eating Assistance
  • Limiting or Encouraging of Fluid Intake
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12
Q

List some Community Based (Non-Medical Services) for Home & Community-Based Services (HCBS)

A
  • Behavior Shaping and Management
  • Communication
  • Community Experiences
  • Daily Living Skills
  • Decision Making
  • Health Maintenance
  • Mobility
  • Money Management
  • Reinforcement of Therapeutic Services
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13
Q

Describe policy making for continuum of care assessment?

A
  1. What services/programs do we offer?
  2. What do hospice competitors offer?
  3. What services are available in the community?
  4. What strengths do we have?
  5. Where do the gaps & strengths align?
  6. What do we know about our community?
  7. Which service/program has the best ROI?
  8. IMPLEMENT
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14
Q

What are some example questions of Needs assessment for Home & Community-Based Services (HCBS)

A
  1. What is the total population?
  2. What is the population by age?
3. What is the disease mix?
Cancer vs. Non-Cancer
Cardiac
Alzheimer/dementia
Respiratory
4. What are the sites of care?
Home
Nursing Home
Hospital
Assisted Living
  1. What is the death rate?
    By age
    By demographic
    By ethnicity
  2. What are disease trends?
    Increase vs. decrease of death
  3. Where do people die?
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15
Q

Who quoted this?

“Only those who attempt the absurd will achieve the impossible. I think it’s in my basement… let me go upstairs and check”

A

M.C. Escher

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16
Q

Global Access to Pain Relief Initiative (GAPRI) is a joint intiative with _________________

A

Joint initiative with the WHO and partners addressing target 8 of the World Cancer Declaration

By 2025: ‘Effective pain control and distress management services will be universally available’

17
Q

Global Access to Pain Relief Initiative (GAPRI) works to: (4)

A
  1. Raise profile of the urgent need to make pain relief medications and palliative care services globally available
  2. Support governments to take the lead in expanding access to pain relief medications and palliative care services
  3. Integrate pain management and PC services into national cancer control planning and health system responses
  4. Mainstream access to pain meds and PC services in the global health, development and drug control agendas
18
Q

Global Access to Pain Relief Initiative (GAPRI) works to ensure access to ___________ is prioritized within global political, policy and program developments of key agencies

A

pain relief and palliative care

19
Q

Global Access to Pain Relief Initiative (GAPRI) lead a response to ____________

A
  • Lead a coordinated worldwide response of states to improve the management, policies and procedures related to access to controlled drugs, particularly pain medication, for medical purposes
  • Build capacity at the global, state and local level to address the challenges of developing practices and policies that promote appropriate access to controlled drugs for medical purposes;
  • Develop recommendations and standard practice for implementing national control systems allowing for access to controlled drugs for medical purposes
  • Initiate and give momentum to a health systems model of palliative care, ensuring access to controlled drugs for medical purposes and the provision of pain relief services in pilot countries. (Work has commenced in the first pilot country, Ghana, including a health system survey on perceived barriers and challenges, a stakeholder meeting and development of strategic plans, and training on standardizing approaches to implementing palliative care interventions)
20
Q

What is Hospice Palliative Care Association (HPCA)-South Africa

A

1987: Membership organization for S.A. hospices
7 regional association members from each province

National and provincial PC development structures aimed at support and capacity building of member hospices & partner organizations

21
Q

Hospice Palliative Care Association (HPCA)-South Africa

A
  1. Butterfly Box - Pop-up shop stocked with designer clothing and consumer goods to raise funds and awareness
  2. Lace Up For Cancer - Fundraising & Awareness-raising foot races
  3. Fives for Hospice (Football) - Tournament to raise awareness & funds
22
Q

End-of-Life Nursing Education Consortium (ELNEC) does what

A

Core curriculum to educate nurses and healthcare professionals on end of life care to improve attention to dying patients’ unique needs

23
Q

Who developed the End-of-Life Nursing Education Consortium (ELNEC)

A

City of Hope Medical Center and the American Association of Colleges of Nursing (AACN)

24
Q

T/F

200,000+ health professionals have attended ELNEC train-the-trainer courses

A

F

20,000+ health professionals have attended ELNEC train-the-trainer courses

25
Q

T/F

2006: ELNEC launches international curriculum
Trainers have come from 85 countries world-wide, and the curriculum has been translated into eight languages

A

T

26
Q

Who was Cicely Saunders

A

British nurse (1918-2005)
Founded the modern hospice movement
Emphasized need for PC in modern medicine

27
Q

“Total Pain” Concept come from who?

A

Cicely Saunders

Physical, emotional, social, spiritual distress

28
Q

St. Christopher’s Hospice was established by who and for what?

A

Cicely Saunders in 1967

  1. Combine teaching and clinical research
  2. Expert pain/symptom relief
  3. Social & psychological needs
  4. Spiritual needs
29
Q

Cicely Saunders Intl.

A

Founded in 2002

Research & PC training
PC public awareness
Partnerships with other groups

30
Q

International Network for Cancer Treatment and Research (INCTR) was established to …

A

Established to address increasing burden of cancer in developing countries. Build capacity for prevention, treatment (including PC) and research, and improved access to care

31
Q

International Network for Cancer Treatment and Research (INCTR) focuses on ….

A
  • Building capacity in countries with limited resources (Long-term collaborative projects coupled to training and educational programs)
  • Promote international collaboration between technologically advanced countries and those with limited resources
  • Development of networks and partnerships with corporate, professional, academic, governmental and non-governmental organizations
  • “To take advantage of unique opportunities for cancer research in developing countries”
32
Q

International Network for Cancer Treatment and Research (INCTR) Initiative in Kerala, India

A

70 million people & a large tribal/rural population

Public-private partnership with the government

Blend of clinical service, education and advocacy

33
Q

International Network for Cancer Treatment and Research (INCTR) Initiative in Kerala, India has what promising progress

A
  • 11,000 PC consultations in 2011
  • 1-month PC courses for doctors & nurses
  • Government of Andra Pradesh has established a PC policy and increasingly supports materially
34
Q

International Network for Cancer Treatment and Research (INCTR) Initiative in Kerala, India “Integrated Urban & Rural Community-based Interventions: Early Detection, Treatment & PC of Cancer” does what

A
  1. Urban AND Rural Patients
    (Inpatient & outpatient PC services, Support urban home care, Supports village pilot projects, Advocates for PC in medical training, Advocates for PC state policy)
  2. Cancer Prevention, Early Diagnosis and Treatment
  3. Development of Cancer Registration in Rajasthan
  4. Palliative Care

MEDS 577 PC FINAL (6 decks)

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