hde 100c chapter 12

long-term care

services and supports designed to meet a person’s health or personal care needs when they can no longer perform everyday activities on their own

institutional facility

group of residential setting in which staff provide individuals under their care with medical or psychiatric treatment

nursing home

medical institution that provides a room, meals, skilled nursing and rehabilitative care, medical services, and protective supervision

skilled nursing facility

designed to provide short term care to residents who receive medically necessary services such as wound care or intravenous injections long 24-hour supervision, intensive nursing care, meals, and assistance with daily activities

rehabilitation unit

nursing home provides residents with intensive treatment to restore previous levels of functioning following an injury or hospitalization

• treatments include occupational and physical therapy in addition to medical care

custodial care

non-medical care that can include a range of services such as help with daily activities (for residents who do not qualify for skilled nursing)

residential care facility; board and care home or group home

small privately owned facility that provides 24-hour supportive care services and supervision to individuals who do not require skilled nursing or health-related care

assisted living facilities

apartment-style housing complexes in which older persons live independently in their own units

• professionally managed and licensed

• some may include “memory care” units for individuals with neurocognitive disorders

Veterans Health Administration (VHA)

• largest healthcare network in the US

• provides longterm care in three types of settings

three types of Veterans Health Administration (VHA

• Community Living Centers (CLCs)

• Community nursing homes

• “soldiers homes”

Community Living Centers (CLCs)

• VA-owned and operated and provide both short- and long-term care

Community nursing homes

VA-contracted non-VA facilities

soldiers home

• operated by the states 

  • Operated by the state government to take care of veterans using money from the veterans administration 

home health care

includes a range of services in which individuals in need of treatment can remain in their own places of residence

• informal caregiving (family members or others close to an individual help with personal care tasks, housekeeping, medication management, and local transportation)

• formal caregiving: those who are hired to provide these services

geriatric partial hospital

provides older adults living in the community who needs psychiatric care with range of mental health services

adult day services

older adults who need assistance or supervision during the day receive a range of services in a setting that is either attached to another facility such as a nursing home or standalone agency

• services provided can include medication management, physical therapy, meals, medical care, counseling, etc.

respite care

provides family caregivers with a break while allowing the older adult to receive needed support services

government assisted housing

provided for individuals with low to moderate income who need affordable housing or rental assistance

• typically live in apartment complexes and have access to help with routine tasks such as housekeeping, shopping, laundry

accessory dwelling unit

second living space in the home that allows older adult to have independent living quarters, cooking space, and a bathroom

continuing care retirement community (CCRC)

housing community that provides various level of care adjusted to residents’ needs

• may be individual homes or apartments in which residents can live independently, an assisted living facility, and a nursing home

  • option 1: provides unlimited nursing care for slight increase in monthly payments

  • option 2: predetermined amount of long-term nursing care (resident responsible for additional payments)

  • option 3: resident pays fee for services; daily rates for all long-term nursing care

Centers for Medicare and Medicaid Services (CMS)

federal agency that oversees these two federal programs

• responsible for formulation of policy and guidelines, oversight and operation of contracts, maintenance and review of records, and general financing

“Medicare Advantage (MA)” Part C

insurance that individuals purchaser separately through a private company is administered on non-goverment websites

Medicare Part A (Hospital Insurance)

benefits cover necessary services and supplies provided during a patient’s stay in the hospital in a semi-private room and subsequent rehabilitation in an approved facility

• meals, nursing services, operating and recovery costs, intensive care, etc.

Medicare Part B

provides benefits or a range of medical services available to people who receive Medicare Part A

• services include preventive treatments including glaucoma and diabetes screenings, bone scans, mammograms, and colonoscopies, etc.

• one time wellness examination

Medicare Part D

prescription drug benefit plan that provides coverage for a portion of the enrollee’s costs

Medicaid spend down

they lower their income enough to meet eligibility criteria

• can do this by paying some of their monthly income directly into medical expenses

1998 Nursing Home Initiative

measure intended to increase the number of inspections, ensure that workers passed background checks and establish a national registry of nursing home aides

2002 National Nursing Home Quality Initiative

set forth procedures to provides resources for consumers in selecting nursing homes

community-based care settings

• assisted living facilities

• home health care

• geriatric partial hospital

• adult day services

• respite care

• government-assisted housing

• accessory dwelling unit

• continuing care retirement community

competence-press model

predicts an optimal level of adjustment that institutionalized persons will experience when their levels of competence match the demands or “press” of the institutional environment

Culture Change Movement

advocates promotion of person-centered care

• advocate for resident participating in their treatment and making their own choices

• empower staff

Green House model

offers an alternative to the traditional nursing homes by offering older adults individual homes within a small community

aging in place

refers to the principle that with appropriate services, older adults can remain in their own homes, or at least in their own communities

• reduce fire hazards,

• move items to easy reach

• put grab bars on shower

• improve lighting

• lower water heater temperature

• open space between rooms

• removed tripping hazards

• staying connected