Term
| Long term care includes a wide range of ________, __________, and ________ care services designed to assist individuals to live as independently as possible by maximizing their level of physical and psychological functioning. |
|
Definition
| medical, social and personal |
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Term
| Five groups with increased risk of long term care |
|
Definition
Those over 75
Those with Alzheimer’s
Those without a caregiver (spouse, family)
Elders who cannot perform ADLs
Frail elders |
|
|
Term
| Frail elders are at increased risk of long term care because of what four things |
|
Definition
Low appetite
Poor nutrition/physical strength/endurance
Slowed cognitive processes
Low “reserves” |
|
|
Term
| Long term care goal is to |
|
Definition
| assist people who cannot take care of themselves either temporarily or indefinitely. |
|
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Term
|
Definition
| activities of daily living; eating, bathing, dressing, bathroom, mobility, etc. |
|
|
Term
| Ethnic elders are ___ likely to use LTC |
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Definition
|
|
Term
|
Definition
|
|
Term
| ________ life expectancy of baby boomers |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Elders have moved away from _______-care to ______ care |
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Definition
|
|
Term
| More older people living alone now |
|
Definition
|
|
Term
| _____ women in workforce = _____ able to provide informal long-term care |
|
Definition
|
|
Term
| Children _______ _____ from parents |
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Definition
|
|
Term
|
Definition
|
|
Term
| People having ___/______ children |
|
Definition
|
|
Term
| Five reasons elders have moved from family to formal care |
|
Definition
More older people living alone now (30%)
More women in workforce = less able to provide informal long-term care
Children moving away from parents
Higher divorce rates
People having no/fewer children |
|
|
Term
|
Definition
| very limited for long term care |
|
|
Term
| The largest public funding source for LTC |
|
Definition
|
|
Term
| By law, Medicaid must provide |
|
Definition
| skilled nursing home services and home health for people eligible for skilled nursing services |
|
|
Term
|
Definition
| Medigap or long-term care insurance |
|
|
Term
| Three other sources of funding |
|
Definition
| SS, community support, Veterans Affairs |
|
|
Term
| Name six sources of funding for LTC |
|
Definition
| medicaid, medicare, private insurance, SS, community support, veterans affairs |
|
|
Term
| Expenses range from ___ to ___ per day for nursing home care |
|
Definition
|
|
Term
| Medicare’s main goal is to get |
|
Definition
| people out of hospital/nursing homes and back home. It also limits the use of home health aides |
|
|
Term
| Medcaid is the largest funding for long term care but you have to be ____ enough to qualify. |
|
Definition
|
|
Term
| The single-most-important consideration to determine if a frail elder can |
|
Definition
|
|
Term
| More women/men? are caregivers? |
|
Definition
|
|
Term
| Women handle ____, Men handle |
|
Definition
| ADLs, finances/managing care |
|
|
Term
|
Definition
|
|
Term
| Many family caregivers are still |
|
Definition
|
|
Term
| Caregivers working ___ hrs/week out-of-home, ___ hrs/week if living together |
|
Definition
|
|
Term
| ________ values in family care |
|
Definition
|
|
Term
| Family care can be what three kinds of taxing |
|
Definition
| Physically, emotionally and financially |
|
|
Term
| _______ family members provide majority of home care to frail elders. |
|
Definition
|
|
Term
| Ethic elders are ____ likely to be cared for at home because of stronger ____ and _____ |
|
Definition
| more, intergenerational family networks and cultural values. |
|
|
Term
| Home caregiver effectiveness depends on what five things |
|
Definition
Elder’s degree of disability
Caregiver’s health/mobility
Availability of emotional support
Caregiver’s other responsibilities
Caregiver respite |
|
|
Term
| Six ways caregivers are supported |
|
Definition
education
support groups
financial
legal
case management
respite |
|
|
Term
|
Definition
| increase skills and feelings of confidence |
|
|
Term
|
Definition
| for emotional and practical support |
|
|
Term
|
Definition
| Medicaid MAY be provided to family to care for disabled relative for up to 24 hrs a week. |
|
|
Term
|
Definition
| who makes the decisions? Access to resources? Power of attorney? |
|
|
Term
|
Definition
| certified professional who coordinates financial, legal and medical needs for the elder |
|
|
Term
|
Definition
| relieve stress, gives alone time |
|
|
Term
| Domestic elder abuse includes what four things? |
|
Definition
| physical, psychological or sexual abuse, financial exploitation and neglect |
|
|
Term
| It is very difficult to _____ and _____ data on domestic elder abuse |
|
Definition
|
|
Term
| What percent of elders are domestically abused |
|
Definition
|
|
Term
| Most abuse happens to ______ and ___+, and ____ of abusers are family members |
|
Definition
|
|
Term
| what five things are lost when elders are domestically abused |
|
Definition
| Loss of independence, money, health, dignity, safety |
|
|
Term
| Abuse happens because of _________ habits |
|
Definition
|
|
Term
|
Definition
| when an elder suffers harm or loss from one or more behaviors. |
|
|
Term
| Five habits and behaviors of an abusive caretaker |
|
Definition
| personality problems, history of using abusive methods to solve problems, mental illness, alcohol abuse, cycle of violence |
|
|
Term
|
Definition
| bruises, malnutrition, fractures, etc |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| six reasons why domestic elder abuse goes unreported |
|
Definition
Signs can be attributed to aging
Don’t want to be institutionalized
Behavior is seen as family “norm”
Confusion/Shame
Blame themselves
Loyalty or fear of retaliation |
|
|
Term
|
Definition
Failure to take care of health, meds, trash, pets
Hoarding
Malnourishment
Lack of or spoiled food
Poor hygiene
Unsuitable clothing
Confusion
Dehydration |
|
|
Term
|
Definition
| refusing to provide themselves with adequate food, water, clothing, shelter, safety, personal hygiene and needed medications. |
|
|
Term
| If those who self neglect are rational then it is best handled by |
|
Definition
| medical teams, family, law enforcement and mental health professionals |
|
|
Term
| _______ are appointed by court to make decision on behalf of individual who is self neglecting. It is a removal of all rights. |
|
Definition
|
|
Term
Self neglect
Elders’ right to _____ ___ ____ _____
vs.
Society’s obligation to _____ _______ |
|
Definition
| live as they please, ensure safety |
|
|
Term
| If elders are _______, there is little to be done about self-neglect |
|
Definition
|
|
Term
| A _______ can be assigned if the elder cannot manage his or her own affairs – it is difficult and serious to do this |
|
Definition
|
|
Term
|
Definition
| skilled and rehab services and personal care services |
|
|
Term
| ________ encourages home health services |
|
Definition
|
|
Term
| In home services are usually seen after |
|
Definition
| hospitalization, for chronic or acute illnesses, help with ADL, or dying |
|
|
Term
| There are ____ quality or training standards for home care |
|
Definition
|
|
Term
| Three barriers to home care |
|
Definition
Don’t want to be a burden = institutionalization
Lack a caregiver
Can’t coordinate or find services |
|
|
Term
| In home care Can be ____ expensive IF round the clock care is NOT needed |
|
Definition
|
|
Term
| Medicaid helps with some home health but NOT |
|
Definition
|
|
Term
| most common and most important home care to enable individual to stay as independent and comfortable as possible. |
|
Definition
|
|
Term
|
Definition
Light housekeeping, shopping, meal prep
Not reimbursed by Medicare |
|
|
Term
|
Definition
| Help with personal care such as bathing and meds |
|
|
Term
|
Definition
| Nurses come to the home to provide direct patient care, monitor treatment, refer the patient to other resources and give education and home care techniques |
|
|
Term
|
Definition
Doctors rarely make house calls anymore
A PA or NP can make home visits to treat the patient under the supervision of a doctor |
|
|
Term
| Physical, speech and occupational therapists |
|
Definition
The therapist develops a plan, teaches the patient and caregiver and then monitors with home visits
Mostly for hip fractures and stroke victims |
|
|
Term
| Therapists coming to the home actually have been found to see _____ results and _____ patient satisfaction! |
|
Definition
|
|
Term
| Emergency response services include |
|
Definition
electronic response
personal response
GPS, webcams, motion sensors are new options |
|
|
Term
|
Definition
| The elder has a button they can use for emergencies |
|
|
Term
|
Definition
| A friend calls at a prearranged time each day to check on the elder |
|
|
Term
| Telephone and visiting programs |
|
Definition
Help with isolation issues of homebound elders
The visitors are trained to notice health problems or environmental dangers |
|
|
Term
| How much does Philips lifeline cost |
|
Definition
|
|
Term
|
Definition
| 20 sec response and furthest range in home. They have an auto alert that helps tell of a fall without the elder pushing the button. |
|
|
Term
| Home delivered meals like |
|
Definition
|
|
Term
|
Definition
Can be provided in hospitals, but usually are in the home
Team of medical and social service personnel and trained volunteers that coordinate physical and psychological care to the dying person and family. |
|
|
Term
| Hospice care must be diagnosed with ___ or less months to live to qualify |
|
Definition
|
|
Term
| ______ will reimburse for hospice services |
|
Definition
|
|
Term
|
Definition
| Home health services (home maker aides, home health aides), nursing services, physician services, Physical, speech and occupational therapists, emergency response services, Telephone and visiting programs, home delivered meals, Hospice care |
|
|
Term
| 7 community based services |
|
Definition
congregate meal services, Adult day care centers and adult day health centers, multi purpose senior centers, Transportation service, case management services,
Comprehensive community-based care,
Community-based sheltered living |
|
|
Term
| Funding for congregate meal services comes from |
|
Definition
|
|
Term
|
Definition
Allows elders a social meal and includes transportation
Can be prepared with special dietary needs |
|
|
Term
| Many adult day care centers include specialized programs for |
|
Definition
|
|
Term
| Adult day care centers can be paid for through |
|
Definition
|
|
Term
| Many communities do not have |
|
Definition
|
|
Term
|
Definition
| services available in the community that support elders’ desire to live in their own homes with assistance. |
|
|
Term
| Adult day care helps with |
|
Definition
| social, recreational and health related activities. Some many adjust pricing according to income. |
|
|
Term
| What percentage of elders use multipurpose senior centers |
|
Definition
|
|
Term
| Two parts of multipurpose senior centers |
|
Definition
| recreation/education and service |
|
|
Term
| service of multipurpose senior centers include |
|
Definition
|
|
Term
|
Definition
Necessary for many elders to attend social and cultural events
Public transportation does not always serve wheelchairs or frail elders
Can be part of other community-based programs |
|
|
Term
| Case managment servicat es is also known as |
|
Definition
|
|
Term
| case management services helps negotiate |
|
Definition
| the services offered to assist elders with long-term care |
|
|
Term
| case management services can keep elders out of nursing homes by using |
|
Definition
|
|
Term
| ______ and ____ _______ offer case management services |
|
Definition
| hospitals, private companies |
|
|
Term
| Case management services are common with |
|
Definition
|
|
Term
| Comprehensive community based care includes what program |
|
Definition
| Program of All-Inclusive Care of the Elderly (PACE |
|
|
Term
| PACE helps elders who have |
|
Definition
| have been certified as eligible for nursing home admission to enter a long-term care program and remain at home |
|
|
Term
| Must be __________ seniors (Medi-Medi)for Pace |
|
Definition
|
|
Term
| Comprehensive community based care |
|
Definition
helps seniors with chronic care needs and their families to be served in the community.
Offers: medical care, medications, home care, adult day health center, social and transportation services. |
|
|
Term
| PACE – 2009 there were ___ programs in 30 states. In 2011, ___ in 29 states |
|
Definition
|
|
Term
| With PACE only __% are actually in nursing homes |
|
Definition
|
|
Term
|
Definition
Helps elders who need assistance, but not 24-hour nursing care
Levels of care, licensing and costs vary
Boarding houses
Adult foster care
Assisted living |
|
|
Term
|
Definition
| room, board with some supervision; independent but need protection (mentally ill) |
|
|
Term
|
Definition
| sub family provides care and protection (again mentally ill) |
|
|
Term
|
Definition
| independent but staff available to assist as needed. |
|
|
Term
|
Definition
24-hour care, short-term or long-term
Similar to hospitals
Offer activities, assistance, therapy
Each facility varies in price, care, size, etc. |
|
|
Term
|
Definition
| Nursing assistants are the majority of staff, LPNs and RNs assist with medical care and contact doctors when needed |
|
|
Term
| Less than ___% of nation’s elders are in NH |
|
Definition
|
|
Term
| __ people in nursing homes are women, most are ________ |
|
Definition
|
|
Term
| Average length of stay in a nursing home |
|
Definition
|
|
Term
| Generally people in nursing homes are |
|
Definition
| Cannot perform the tasks of daily living and have no help (family) to take care of them |
|
|
Term
| _______ ______ are underrepresented in nursing homes |
|
Definition
|
|
Term
| Average cost of nursing home per year |
|
Definition
|
|
Term
| Many elders enter nursing homes with ________ as their primary funding, then pay ____ when no longer eligible; then move to _________ when their assets are depleted |
|
Definition
|
|
Term
| Medicaid pays ____ per day than the costs, so facilities with Medicaid patients ____ $ |
|
Definition
|
|
Term
| ___% of Nursing homes residents rely on Medicaid. |
|
Definition
|
|
Term
|
Definition
| Physical, medical and psychological well-being of the residents |
|
|
Term
| Nursing homes Cannot receive payment from Medicare or Medicaid without |
|
Definition
|
|
Term
| Who also makes regulations for nursing homes? |
|
Definition
|
|
Term
| Nursing home deficiency reports are available to |
|
Definition
|
|
Term
| what kind of rating system does the nursing home have |
|
Definition
|
|
Term
| What kind of regulations do nursing homes have |
|
Definition
|
|
Term
|
Definition
| Omnibus Budget Reconciliation Act environmental, staffing, dosage |
|
|
Term
|
Definition
| assessments of each resident submitted to the federal government and completed by staff who works closely with the patient |
|
|
Term
| Minimum data sets help determine |
|
Definition
| the Medicare reimbursement rate |
|
|
Term
| minimum data sets include information on |
|
Definition
health, well-being, function, risk factors, care plan, etc. They are extensive reports.
demographics, likes, dislikes, treatments, amount of assistance, medications |
|
|
Term
| Minimum data sets are assessed on what days of admission |
|
Definition
| 5th, 14th, 30th, 60, and 90th |
|
|
Term
| Minimum data set information is transmitted to |
|
Definition
| Centers of Medicare/Medicaid Services where it is compiled and reviews and sent a “problem” report back as needed. |
|
|
Term
| Nursing homes have individual |
|
Definition
|
|
Term
| Data from _____ _____ _____ determines I care plans |
|
Definition
|
|
Term
| I care plan takes info from |
|
Definition
| info from the team, resident, and resident’s family |
|
|
Term
| Four selected areas of concern with nursing homes |
|
Definition
| physical restraints, chemical restraints, pressure ulcers, institutional elder abuse |
|
|
Term
| What is the most common reason for law suits against nursing homes? |
|
Definition
|
|
Term
| What percent of people in nursing homes have pressure ulcers? |
|
Definition
|
|
Term
| Two solutions to the threat of pressure ulcers |
|
Definition
There are lots of regulations for treatment and prevention
Those at risk need to have it in their care plan |
|
|
Term
| Three ways to prevent institutional elder abuse |
|
Definition
Healthcare providers must report any suspected elder abuse
Careful screening of employees can help eliminate elder abuse (criminal background)
Nursing homes should have many visitors |
|
|
Term
| Five benefits of nursing homes |
|
Definition
24-hour medical supervision
Centralized, coordinated care
Social interaction
Federally regulated
Safe, secure place for frail elders |
|
|
Term
| Five limitations of nursing homes |
|
Definition
Keeping qualified staff – especially nurse’s aides
Atmosphere may feel like a hospital instead of a home – impersonal
Too much care
Loss of individuality
Privacy and personal choice are rare |
|
|
Term
| Two new directions of nursing homes |
|
Definition
Person-directed care – making the institution fit the elder
Focus on relationships |
|
|
Term
|
Definition
living spaces that promote human growth. Plants, animals, gardening, children into daily lives of residents, etc.
Focus on relationships rather than tasks |
|
|
Term
|
Definition
Knowing the rights of patients
Having an Ombudsman investigating and responding to complaints. |
|
|
Term
| Nursing Home Reform Act of 1987 |
|
Definition
| mandates certain rights to those who use Medicare and Medicaid |
|
|
Term
| Each Area Agency on Aging has an _____ program |
|
Definition
|
|
Term
| Five ways to plan for long term care |
|
Definition
Must look at options including financing before the need arises
A reverse mortgage can help with financing
Visit all potential nursing homes in the area
Visit during a meal and talk to the residents
Visit websites for comparison information |
|
|
Term
|
Definition
| bank pays owner money and in return bank gets home at death |
|
|
