week 5 Flashcards
summer foundation
- The Summer Foundation’s mission is to resolve the issue of young people living in nursing homes.
- We support the disability, health and aged care systems to work more effectively with younger people in nursing homes.
- We have prototyped effective alternatives to aged care for younger people with disability.
- We support people with disability and their families to share their stories and empower others to avoid or leave aged care.
The NDIS eligibility
- Must be under the age of 65 years. The four younger residents are aged from 25-40 therefore are eligible.
- Must be an Australian Citizen or hold a permanent visa. It is assumed that the residents are Australian Citizens
- The disability will not go away include intellectual cognitive, neurological, sensory, physical impairments or mental health conditions. Severe acquired brain injury is a life time limiting disability.
- The person is less able to do things such as communication, learning, mobility, social interaction, self care and self management and need support. The scenario highlights that the clietns are high in ADL, behaviour and complex health needs when assessed though the aged care funding instrument category HHH.
whats a funding plan in NDIS
A funding plan will be based on what the National Disability Insurance Agency (NDIA) considers to be reasonable and necessary. Reasonable means something that is fair and necessary means something that you must have.
There are three categories of funding. For assistive technology capital support budget focuses on this.
whats a local area coordinator NDIS
- the role of the Local Area Coordinator (LAC) is to assist people to navigate the NDIS.
- provide planning and coordination for people with disability to maximise the choice and control over the services they use.
- This includes supporting people with disability to navigate mainstream services and increase their capability to be an active part of their community.
The Aged Care Funding Instrument (ACFI)
classified the patients as category HHH, which means they required complex health care needs. So, complex health care needs refer to persons whose conditions necessitate complex continuous management frequently require care from different health professionals in multiple settings
Needs are classified under the 3 funding domains of:
• activities of daily living (ADL)
• behaviour (BEH)
• complex health care (CHC)
The 4 levels of funding for each domain are:
• nil
• low
• medium
• high
You must then conduct an ACFI appraisal:
• at least 7 days after the resident enters your care
• before the resident has been with you for 2 months
Residential Classification Scale (RCS):
- is a funding tool used to calculate the subsidy paid by the Commonwealth Department of Health and Aged Care to residential aged care facilities.
- The RCS is an assessment and funding tool used to determine the level of subsidies that are provided for each resident. The appraisal used for the RCS does not consider all of a resident’s care needs. It considers factors that have been identified as contributing the most to differences in the total cost of care.
The assessment covers all of the care needs of the resident. These include:
• maintaining continence or managing incontinence
• maintaining, restoring and preventing skin damage
• specialised nursing procedures provided by or under the supervision of a registered nurse
• managing episodes of physical aggression or verbal disruption
• frequency of staff managing behavioural concerns
• assisting with vision, hearing, speech and comprehension
• support required with mobility, toileting, washing, dressing, eating and therapy.
- Describe the potential impact of a residential aged care environment on occupational choice
Occupational choice:
Potential impact:
- Very limited opportunity to make choices in their daily life (eg. Access to time alone, eating and sleeping times, bodily functions
- The ability to make choices every day and in their life is important can directly impact the person’s dignity and self-determination
- The two main areas that young people in nursing homes desired in greater choice were the timing and frequency of personal care routines (eg. Showering Mealtimes); choice regarding meaningful occupation undertaken within the nursing home and in the community
Suggestion
- Providing education for staff to increase recognition of individual needs and choice
- . Providing formal support to ensure people have maximum opportunities for choice making
- People with difficulty communicating their everyday needs – Ensure that the staff have the knowledge on effective communication strategies with the client (visual cues, keeping things short and simple)
- Describe the potential impact of a residential aged care environment on occupational participation
Occupational participation
Potential impact:
- Younger people living in RAC tend to be uninvolved in the “older generation sort of activities” offered in the RAC
- They were also often excluded from participation in the community as additional support and equipment might be required to access to the community
- Limited financial resources can be a barrier of participation
Suggestion
- Recreation support and adaptive recreation equipment is required to assist people to develop and pursue interests both at home and in their local community
- During accommodation planning, consideration of geographical location and proximity of local accessible community services is an important component
- Have appropriate funding in-place for support workers and to participate in occupation of their choice.
- NDIS to support the need for younger people with disability living in nursing homes, or at risk of entering one, to have effective NDIS plans, which include the funding they need to live as independently as possible in the community.
Describe the potential impact of a residential aged care environment on occupational performance
Potential impact
- The lack of availability of rehabilitation and other support services for YPIRAC
- Further deterioration of occupational performance issues caused by their disability
- No opportunities to participate in daily activities such as cooking that can help to promote their independence can also lead to further deterioration in their performance
Suggestion
- Systemic changes were needed so timely rehabilitation was available, and skilled support coordination was accessible.
- An effective review process to ensure that young people placed in aged care receive the ongoing rehabilitation and support required.
Describe the potential impact of complex care needs on a person’s ability to engage in meaningful occupation.
How it impacts individual’s ability to engage in meaningful occupations
• May be unable to participate in some occupations
• May require grading/assistance/supervision
• Lack of independence
• Complex care 🡪 usually requires supervision from caregiver 🡪 caregiver may not have the time to do the occupation the individual would like
• Lack of control over their time table
Especially for scenario
• Lack of flexibility in schedule
• Lack of amount of staff to help do occupations when they want
• Lack of independence 🡪 if they want to go watch TV in common room, will have to be hoisted out of the bed
intervention areas for ABI
- Fatigue management
- Memory strategies
- Routine planning
- Community access
- Volunteer work, depending on function
- Social activities
- Hobbies
- Travel training
- Sleeping hygiene
- Motivation
- Anger & behaviour management
adaptive technologies
- standing frames to assist with contractures
- adaptive switches
- ROHO cushion
- communication board
important of social inclusionfor ABI
• As young people, they would like them being a part of the community
• To be welcomed to opportunities
• Being free to go and do what they want to do rather than being stuck inside the residential aged care.
- Being valued: The biggest factor contributing to YPIRAC exclusion is a lack of value they receive from members of the general community. Their barriers to social inclusion are accessibility and acceptance by society.
Drawing on your knowledge of occupational science discuss the occupational issues for young people in residential aged care?
Socialisation
Community access
lesiure activities
- Select and justify two assessments that you might use to inform your consultation with staff of the residential aged care facility.
Quality of life profile
- The quality of life profile is a self-report measure which assesses the importance, satisfaction, levels of perceived control and opportunity the individual feels as though they have in key areas of wellbeing, occupation and community belonging.
- The three main categories being items- physical, psychological and spiritual wellbeing, belonging- physical, social and community belonging, becoming- practical, leisure and growth becoming (Janssen, 2004).
- Leisure becoming involves activities carried out for enjoyment that promote relaxation and stress reduction. Growth becoming activities promote the maintenance or improvement of knowledge and skills and adapting to change.
- The scores are then added to determine the individual’s quality of life. This can enable us to understand the interrelationships between engagement life satisfaction, social support, and perceived goals/occupational opportunities (Raphael, Rukholm, Brown, Hill-Bailey & Donato, 1996).
Canadian occupational performance measure (COPM):
find out their top priorities and favorite activities, as well as how
satisfied they are with it.
Make sure to consider which area they would prioritize as well (Self care, leisure,
productivity)
