Continuum of Care, Long-Term Care, Transitions, and Family Caregiving (Lecture Review)

A practical set of Q&A flashcards covering the continuum of care, acute and long-term care, transitions, regulation, culture change, caregiver burden, and elder care topics from the lecture.

What are the three types of care in the continuum as defined by Eliopoulos for chapter 1?

1) Supportive and preventive services (community). 2) Partial and intermittent services (community and institutions). 3) Complete and continuous care (institutions).

What does acute care mean in the context of this course?

Acute care refers to hospitalization.

What does long-term care refer to in the notes?

Long-term care refers to settings like nursing homes where ongoing assistance is provided.

What percentage of older adults in the United States live outside of institutions?

About 97.5% of older adults live in the community, not in institutions.

Which federal website is recommended for finding community services for older adults, and how is it used?

Eldercare.acl.gov; enter a ZIP code to pull up community services (housing, legal, transportation, etc.).

What does SNAP stand for and what is its purpose?

SNAP stands for the Supplemental Nutrition Assistance Program; it provides food assistance to eligible individuals, formerly known as food stamps.

What is the asset limit for SNAP for households with a member who is older?

Households with an older member cannot have assets greater than $4,500.

What is the product Tom Selleck promotes related to aging at home?

Reverse annuity mortgage, a loan against home equity where the homeowner receives payments from the bank.

How do regulations differ between assisted living and nursing homes?

Assisted living is regulated by state authorities and is less strictly regulated than nursing homes, which are heavily regulated at the federal level (including MDS and staffing requirements).

What does MDS stand for and what is its purpose in nursing homes?

MDS stands for Minimum Data Set; it is a standardized assessment for all residents used for quality monitoring and regulatory compliance.

What is care transitions?

Care transitions are the points where a client moves from one care setting to another, often across facilities or levels of care, and are high-risk for information loss and adverse events.

Name two common hospital-acquired infections mentioned for older adults.

Catheter-associated UTIs (CAUTIs) and central line-associated bloodstream infections (CLABSIs).

List six major risks older adults face in the hospital.

Delirium, falls, pressure injuries, dehydration, incontinence, constipation.

Name three nursing actions to prevent hospital-associated decline in older adults.

Careful baseline assessment and monitoring; promoting independence; monitoring medications; minimizing unnecessary catheter use; encouraging movement, coughing, and deep breathing; early discharge planning.

What is the difference between care management and case management?

Care management is a long-term relationship across multiple episodes; case management is focused on a single episode or problem.

What is PACE and who is it for?

PACE stands for Program of All-Inclusive Care for the Elderly; it provides coordinated care by a team of professionals and is typically available to Medicaid-eligible seniors.

What does OBRA 1987 refer to in the context of long-term care?

Omnibus Budget Reconciliation Act; federal regulations to improve nursing home quality, including staffing, resident rights, and oversight.

What are key elements of the culture change movement in long-term care?

Creating a home-like environment, consistent staff assignments, nurturing relationships, resident empowerment; examples include Eden Alternative and Pioneer Network; greenhouse/ cottage models.

What is caregiver burden?

The stress and negative consequences associated with providing care, a multidimensional biopsychosocial reaction to imbalanced care demands and resources.

Name the five burden domains measured by the Caregiver Burden Inventory.

Time dependence, Developmental burden, Physical burden, Social burden, Emotional burden.

What does the Family and Medical Leave Act (FMLA) provide?

FMLA allows eligible employees to take up to 12 weeks of unpaid leave for family caregiving while protected from losing their job.

What is long-distance caregiving and how common is it?

Caregiving for an older adult who lives more than an hour away; about 15% of caregivers fall into this category.

What forms can elder abuse take and how should it be addressed?

Neglect, physical abuse, financial exploitation/theft, sexual abuse, verbal/emotional abuse; assess risk, document, and report to Adult Protective Services as required.

What is the Nursing Home Ombudsman?

A state employee who protects resident rights; rights and ombudsman contact information must be posted in nursing homes.

What is the role of MDS in nursing homes?

A comprehensive assessment process used at admission and with any change in condition to guide care and regulatory compliance.