Posts Tagged "assessment"

Long Term Care Terminology

Posted by on Mar 1, 2011 in Health Care Team and System, Living Arrangements | 0 comments

Long-term care refers to care homes, as well as to a variety of services for people who experience prolonged physical illness, disability or severe cognitive problems. These care homes and services help people maintain a level of functioning rather than correct or cure medical problems. Most commonly, they include help with Activities of Daily Living (ADL) and professional care. They may be delivered as in-home services; or the person needing care may travel to a community services such as adult day programs and respite.  Or this person may need to live full-time in a care home in order to receive the services.  Care homes may provide supportive housing and personal care, such as Assisted Living and Designated Assisted Living. Care homes provide 24-hour nursing and professional care. Depending on your province, they may be called Nursing Homes, Residential Care Facilities (RCF), Homes for the Aged, Extended Care, or Long Term Care Centres (LTCC).  To receive any services provided by government-funded programs, you must undergo assessment and meet eligibility criteria. Here are more detailed explanations for the highlighted terms: Activities of Daily Living (ADL) are everyday activities that most adults do independently including bathing, continence, dressing, eating, toileting, and transferring or mobility (arising from bed and moving around the home environment). Services that support ADLs are called “personal care services” and provided by workers such as Home Health Aides, Nursing Assistants and Personal Care Aides. Adult Day Programs help adults with physical and mental disabilities through group programs that may include personal care services, therapeutic recreation, social activities and meals. Assessment usually precedes government-funded programs, and is completed by a professional (e.g., nurse or social worker) to determine eligibility for the variety of home, community and care home services. Cognitive problems arise from the inability to think, reason, remember or perceive. Alzheimer Disease, for example, is a major cause of cognitive impairment. Eligibility for government-funded programs is determined through a professional assessment and may include criteria such as age, medical status, residence requirements (e.g. living in the province for 1 year) and other criteria unique to each program. In privately funded programs, the client and/or the provider determine eligibility. Care Homes provide nursing and professional care, 24 hours/day, to support individuals with physical and cognitive problems. Each province determines the name commonly used for facilitis offering long-term care. In-Home Services are professional and personal care services are provided to individuals living in private homes, apartments, seniors’ lodges and other congregate dwellings. Professional Care refers to assessment and therapeutic interventions delivered by professionals, such as registered nurses, social workers, and therapists. Professional care may be delivered in-home or in community settings, and is always available in care homes. Respite is designed for family and friends who require rest from the physical and emotional demands of caregiving. Respite services might be brought to the home, or the individual may attend a community program or be admitted temporarily to a care home. Some of these services are provided without charge through government-funded programs, others require a fee. The amount charged varies between programs and between provinces.   Vol.2, No.21; © ElderWise Inc. 2006-2011. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Inc., Canada’s go-to place for “age-smart” planning.  Visit us at http://elderwise.memwebs.com and subscribe to our FREE e-newsletter.                     ...

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A Surprise Call From The Hospital

Posted by on Feb 23, 2011 in Health Care Team and System, Health Emergencies, Powers of Attorney | 0 comments

John’s aging parent,  Mary, 90, lives in another province. One day, he gets the call he has long dreaded: his mother has fallen, broken her wrist, and has been taken by ambulance to the hospital.  She has had surgery and her arm is in a cast. Is she ready to go home? Not so fast.  John is told that his mother is showing signs of mild cognitive impairment and that the discharge planner wants an assessment. John must call the doctor for more information. John manages to talk to the doctor later that day. He learns that Mary is doing very well physically, but the doctor is concerned about the possibility of dementia and has referred her to the Geriatric Team.  John asks if he should take time off work and come. The doctor advises him to wait a few days until the outcome of the assessment. During the next few days, John calls the hospital for updates. He talks to: the Registered Nurse on the unit; the Head Nurse on the unit; the Relief Nurse on shift; and the Discharge Planner. John is confused. Some of these professionals believe that Mary has signs of dementia while others are not sure. The discharge planner is concerned that Mary may not be safe to return home; John worries, because Mom has refused previous attempts to talk about moving to assisted living. Later, John hears from the Geriatric Case Manager that, for now, they have not confirmed dementia. His mother had delirium because of the injury, pain, unfamiliar environment and anxiety. Mary is moved to a transition unit.  Soon after, Mary calls John to tell him that she is discharged and will get home care. John wonders if she will accept strangers coming into her house because she has refused previous offers of household help. John takes a week’s vacation time and goes to help his mother. During his time there, he meets: the community care (home care) coordinator; the home care nurse; a home health aide; the transition coordinator; the geriatric case manager; and an occupational therapist. Collectively, they offer the following advice: Arrange for Meals on Wheels Make changes for safety at home: get a bathroom grab bar; remove scatter rugs; add a night light; get Mary an emergency response system Mary should accept home care services for help with bathing John should get Power of Attorney to look after Mary’s finances Mary should write a Personal Health Care Directive John is told that they will follow-up to monitor his mother’s safety at home. If she is not safe, the team will encourage her to move into assisted living.  John returns home and stays in daily phone contact with his mother. Contacting the health care professionals is difficult, given time zone differences and work schedules. They encourage him to talk to his mother so she can keep him up to date. But John senses that Mary is avoiding detailed questions. He assumes that she wants to appear to be doing well so that she can stay at home instead of living in a care home. Who am I supposed to talk to? How do I reconcile different opinions from the various professionals? Why is the medical team so guarded about what to tell me? When should I go help my mother – right away or when she is discharged? Will I have enough warning to arrange vacation time and travel? Why is Mom moving to another unit in the hospital? What is her diagnosis? What will she need from now on? On the medical team, who is responsible for what? Why are so many people involved? John finds out...

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Be “Stroke-Wise!”

Posted by on Sep 8, 2010 in Health Emergencies, Health Signals | 0 comments

Every 10 minutes, a Canadian will suffer a stroke, meaning strokes affect more than 50,000 Canadians every year. The good news is that recognizing early warning signs and getting prompt treatment has improved the chance of surviving a stroke. A stroke is a medical emergency caused by decreased blood flow to the brain. Blood flow is interrupted by a blood clot (blockage) or rupture of a blood vessel.  Without oxygen, brain cells die. Depending on the size and location of the stroke, the individual loses some function. You can reduce your risk for stroke by making these choices in your daily life Treat high blood pressure Stop smoking Reduce salt and sodium in your diet Have an active lifestyle To find out your unique risks, take the assessment offered by the Heart and Stroke Foundation. http://heartandstroke.ca/hs_risk.asp?media=risk Those who survive a stroke may experience a range of physical and emotional problems. These include: Physical impairments Personality and behaviour changes Communication problems Cognitive changes  Knowing the risks, making wise lifestyle choices, and recognizing the early signs can dramatically reduce your chances of being a victim of stroke. Vol. 4, No. 4 © ElderWise Publishing 2008. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at www.elderwise.ca and subscribe to our FREE...

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Home Care for Canada’s Elderly

Posted by on Sep 8, 2010 in Caregiving, Health Care Team and System | 0 comments

What is Home Care? Home care helps elderly people remain in their own homes, helps reduce hospital admissions, and may allow earlier discharge from hospitals. Home care is appropriate if you need help from registered nurses, physiotherapists, occupational therapists, and social workers, or if you need personal care provided by home health aides.   Who provides Home Care? Both public and private sectors offer home and community care services.  Public services are funded and managed by the local health authority. Eligibility depends on a professional’s assessment of your specific needs, your existing supports, and local community resources. Many people are surprised when they learn that public funding for home care is available for limited hours and only for very specific types of support.  That’s where private home care providers can help, with a variety of services, from personal care to visiting and companionship, from housekeeping to help with transportation.  Some are non-profit organizations; others are businesses. Expect variety in types of services offered, staff qualifications, and costs.  Seniors who want to stay in their home often mix different types of services, both public and private. When home care is no longer a viable option, you need to understand higher levels of care available for the elderly. Care homes, including assisted living and long term care, exist to serve different levels of care. Further reading: Long Term Care Planning Long Term Care Terminology  Understanding “Assisted Living” Vol.3, No.11 © ElderWise Inc. 2007-2011. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise Publishing, a division of ElderWise Inc. We provide clear, concise and practical direction to Canadians with aging parents. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE e-newsletter.      ...

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Action for Common Aging Concerns

Posted by on Sep 7, 2010 in Caregiving, Health Signals, Planning | 0 comments

In previous newsletters, we showed how you can approach sensitive topics during holiday visits with aging parents. During the visit you may have noticed new areas of concern, or old problems that are calling for action. Now, you may feel anxiety or uncertainty about what to do next. Taking that first step, no matter how small, creates momentum towards positive change. Here are some first steps for common concerns: 1. Health Changes in physical or mental health are usually at the root of all other challenges facing your aging parents.  Many factors combine to keep seniors healthy. Among the most important are good medical care, proper exercise and nutrition, and a sense of purpose and belonging. A good first step is to become more informed about your parent’s health. Educate yourself about normal aging, and learn more about their chronic health conditions. With your parents’ permission, talk with their family doctor about your concerns. 2. Hygiene Personal care may slip when a senior’s eyesight, physical energy, or state of mind are affected. First, gently point out some physical evidence (e.g., stained clothing) and share your concern. Encourage your parent to get a physical check-up and/or an eye exam.  3. Housekeeping Loss of strength or mobility can make household chores more difficult. Start a conversation about getting more help – either from other family members, or by hiring someone. Some seniors are reluctant to ask for help or to invite “strangers” into their homes. Suggest that help with household duties may mean that your parents stay in their own home a little longer. 4. Hazards Safety hazards at home increase when health and strength start to fail. Here are some simple adaptations that make life safer: rearrange cupboards to easily reach things, install grab bars in the bathroom, remove loose scatter rugs, and add brighter lighting, especially over stairways. You can also look into personal emergency response systems. Worn on the wrist or as a pendant, they enable your parent to call for emergency help when they cannot reach a telephone. Initiating some of these changes may require a “community” effort. That can mean recruiting help from other family members, friends, neighbours and/or getting outside help – private or public. In larger towns and cities, families can call on their local seniors’ resource centre for more information on support programs. In rural areas, churches and other members of the community traditionally step up to help neighbours. Concerned families can also ask for an assessment of the senior by their local health authority, to see whether their family member (who must consent to the assessment) qualifies for public assistance. Vol. 5, No. 1 © ElderWise Publishing 2009. You have permission to reprint this or any other ElderWise INFO article, provided you reproduce it in its entirety, acknowledge our copyright, and include the following statement: Originally published by ElderWise, Canada’s go-to place for “age-smart” planning. Visit us at http://elderwise.memwebs.com/ and subscribe to our FREE...

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