Week 5 Flashcards
What kind of clients will you see at Assisted Living?
- Most only require min A with basic ADLs and medication management
- Can still have independence in some areas
- They do NOT need skilled medical care
What kind of clients will you work with at a SNF?
- Clients are getting more intensive rehab (sub-acute rehab, bridges the gap between hospital and home)
- Lots of joint replacements
- Usually require some skilled nursing intervention like TPN, intravenous medication, wound care
What kind of clients will you work with at an Extended Care Facility?
- Those who cannot be home for medical reasons or don’t have outside support or place to stay
- Require 24 hour of care for unknown period of time
- May transfer from hospital, nursing home, or home
- Long term stay, you live there
- Person needs assistance with self-care
- “Functional recovery” may not be possible; lack financial resources or support at home
OTs role in Assisted Living
- Foster and enhance habits and routines, personal care skills and simple home care, leisure, activities with environmental supports (assistive tech)
- Can be consultative; assist with modifications and adaptations, programming and promoting safety throughout facility
- Can educate direct service staff regarding issues on aging, occupation, health promotion
- Direct services include safety, ADL assessments, IADL assessments and interventions, social activity
Housing and personalized support for those needing help with ADLs
Assited Living (AL)
- Allows for privacy
- Services available: linen service, meals, social activities, local transportation, laundry, housekeeping
How are Assisted Living places regulated?
-Regulated and licensed at a state level
How is Assisted Living funded?
- Private pay, state assistance, medicaid voucher
- Cost depends on number of services provided and type of living arrangement (2 bedrooms, suite, etc)
Require special, 24-hour care for either a short or extended time period
Skilled Nursing Facility (SNF). “Bridges the gap” with another level of care. Can be a unit in a hospital or in a free-standing nursing home
Where do clients come from and where do they go to after stay at SNF?
- Admitted from hospital
- Maybe sent for 2 weeks before able to tolerate lots of rehab
- After stay, can be sent home or back to acute rehab if need more/can tolerate more intensive and comprehensive therapy
OTs role in SNF:
- Similar to IRF but less intensive (less than 3 hours per day)
- ADL/IADL; teach approach, etc
How long will a patient stay at a SNF?
Short term stay: up to 100 days
Long term stay: as long as needed
OT role in Extended Care Facility (ECF) or Long-Term Care (LTC)
- Direct or consultative in nature
- Consultative: staff/nurse education, positioning
- Usually won’t hire full time
T/F: Cost at Extended Care Facility (ECF) or Long-Term Care (LTC) varies
True
Facility closest to classic “Nursing Home”
Extended Care Facility (ECF) or Long-Term Care (LTC)
How have nursing homes changed in the last couple decades?
- Publications in 80’s and 90’s have exposed the inefficiencies of nursing homes
- Nursing homes are now responsible for adhering to national and state guidelines
- Shifted from bare minimum to restoring function
- Before, nurses and docs spend little time with residents, used restraints, lack of meaningful occupation, dissatisfaction of care
- Federal and State regulations focus on residents rights, quality of care/life
- Implementation of Minimum Data Sat (MDS)-screens residents for potential problems, abilities, preferences
T/F: nursing homes have remained relatively static in their care implementation
False. Nursing homes have been constantly changing since 1965
Instrument that provides a comprehensive assessment of each resident’s functional capabilities and helps nursing home staff identify health problems
Minimum Data Set. Screens residents for potential problems, abilities, preferences
This legislative measure focussed on wellness and redefined the concept of long-term care
OBRA. OBRA-87 enhanced the regulation of nursing homes and included new requirements on quality of care, resident assessment, care planning, and the use of neuroleptic drugs and physical restraints. Lack of adherence to regulations created sanctions, such as fines.
What is the funding source for many residents of long term care and how does this affect standards of care at LTC facilities?
Madicare and Medicaid funds many residents, so must adhere to legislated standards of care to stay certified.
What are the 3 main categories of nursing home care?
- Skilled (ventilator care, high-level medicare care after a hospitalization)
- Rehabilitative (improvements expected with discharge to “less restrictive environment”). Stay from several weeks to several months
- True long term care
- Also residential alternatives e.g., adult day programs for less restrictive care