NOT ON STUDY GUIDE FOR EXAM 3 - Week 12: Long Term Care Flashcards
Long Term Care
describes a variety of services, including medical and nonmedical care, provided on an ongoing basis to people of all ages who have a chronic illness of physical, cognitive, or developmental disability.
Costs of LTC: Medicaid
- Primary payer for LTC services.
- Large differences across states.
Costs of LTC: Medicare
Would not cover unless there was some skilled need
Costs of LTC: Private LTC insurance
-Relatively few people have purchase this insurance
Costs of LTC: Out-of-pocket spending
Accounts for 22% of national spending for LTC
Program for All-Inclusive Care for the Elderly (PACE)
- Provide community services to people 55 or older who would otherwise need a nursing home level of care.
- Participants must meet the criteria for nursing home admission, prefer to remain in the community and be eligible for Medicare and Medicaid.
Adult Day Services
- Community-based group programs designed to provide social and some health services to adults who need supervised care in a safe setting during the day.
- They offer caregivers respite from the responsibilities of caregiving, and most provide educational programs, support groups, and individual counseling for caregivers.
Continuing Care Retirement Communities
- Provide full range of residential options, from single family homes to skilled nursing facilities (SNFs) all in one location.
- Allows community members to make the transition between levels without disrupting moves.
- The average monthly cost for living at a CCRC is $2672.
Residential Care/Assisted Living
- Provides housing and services for close to 1 million older adults in the United States.
- Almost one half of older adults would move to an assisted living community if they could no longer care for themselves.
- RC/AL is viewed as more cost effective than nursing homes while providing more privacy and a homelike environment.
SNF’s (Nursing Homes)
Delivery of around-the-clock for those needing specialized care
Characteristics of Nursing Homes
Includes up to two levels of care: skilled nursing care (subacute) and chronic care (long term, custodial)
Characteristics of Nursing Homes: Subacute Care
- Short term
- More intensive and more costly
- Most frequent site of post-acute care
- Length of stay usually no more than 1-3 months
Characteristics of Nursing Homes: Chronic Care
- Long term
- May not need intensive care but still need ongoing 24 hour care.
- Residents are predominately women, >80 y/o, widowed and dependents in ADL’s and instrumental ADL’s.
More RN direct-care time per resident in nursing facilities is associated with
- Fewer pressure ulcers
- Fewer hospitalizations
- Fewer UTI’s
- Less weight loss
- Fewer catheterizations
- Less deterioration in the ability to perform ADLs
Nursing Assistants
-Provide the majority of direct care in nursing homes and significantly contribute to the quality of life for residents
Resident Bill of Rights
- Residents have rights under both federal and state law
- LTC Ombudsman Program is a nationwide effort to support the rights of both the residents and the facilities
- Each facility is required to post the name and contact information of the ombudsman assigned to the facility
Quality of Care in SNF’s
- Nursing homes are one of the most highly regulated industries in the US.
- Advanced practice nurses are linked to improved quality of care in nursing homes.
Interventions to Reduce Acute Care Transfers (INTERACT)
An exemplary program for reducing frequency of transfers to the acute hospital from nursing homes.
The culture change movement
To improve the lives of residents and staff by centering facilities’ philosophies, organizational structures, environmental designs, and care around practices that support residents’ needs and preferences.
Nurses and LTC
- Play a key role in improving quality of care in nursing homes through EBP and leadership in quality improvement initiatives.
- The need for expert nursing is the most essential service provided.
