Long Term Care Administration Midterm

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Four Pillars of Retirement Income

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The idea that post retirement employment provides additional income when the three traditional sources - social security, pensions, and savings - are insufficient.

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Encore Career

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Employment in the second half of life, often in positions of greater meaning and social impact in not for profit or public interest fields.

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Continuum of Care

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A holistic system comprising services and mechanisms that assist individuals over time through a wide range of physical health, mental health and social services needs, across all levels of care intensity.

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Activities of Daily Living

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Routine daily activities; the basic ADLs are eating, bathing, dressing, toileting, and walking. A person's ability to perform ADLs is a determining factor in the level of long term care needs.

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Residential Care Settings

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Independent living settings, Assisted living settings, Skilled nursing settings, Continuing care communities.

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Independent Living Setting

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A category of housing options for individuals who are able to live without assistance, including adult communities and congregate housing arrangements. These residences often impose age restrictions and offer social activities, supportive services, and increased security.

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Assisted Living Setting

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Facilities in which staff help residents with the ADLs, coordinate services from outside providers, and monitor activities to help ensure residents' health, well being, and safety.

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Skilled Nursing Setting

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Facilities that provide medical, nursing, or rehabilitative services on an inpatient basis.

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Continuing Care Communities

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Residential complexes for seniors that offer comprehensive nursing care and housing options to residents as they age and their needs change.

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Planned virtual retirement community

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A community in which the elderly live in their own homes, but receive information and services to help them remain independent.

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History of Assisted Living Facility

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Introduced in the 1970s as an alternate to nursing homes. In 2001, the Assisted Living Workgroup developed 110 consensus recommendations to improve quality of ALFs. 1) create new kind of service where the physical plant, service delivery model, and approach to staffing support the ideas of privacy, dignity, and consumer choice 2) more private rooms, residential living environments, greater choice of services (especially for those with disabilities), and staffing models that enhance the role of direct care workers

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Greenhouse

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A deinstitutionalization movement for long term care in which individuals who require care live in small homes and have access to clinical and personal care services on the level of those provided in high quality nursing homes.

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Older Americans Act

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Legislation passed by the US congress in 1965 that established the Administration on Aging and state agencies on aging to address the social services needs of older adults.

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Senior Centers

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Places where older adults come together for services and activities that reflect their experience and skills, respond to their diverse needs and interests, enhance their dignity, support their independence, and encourage their involvement in and within the center and the community.

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Adult Day Services

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Community based facilities for individuals who need supervised care during the daytime, but who otherwise remain in their homes.

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Home Care

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Healthcare or supportive services for individuals with a chronic disability or illness who live in the community.

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Telehealth

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The delivery of health related services and information via telecommunications technology.

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Telemedicine

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The practice of using technology, such as a telephone or computer, to monitor the medical condition of a patient from a long distance of consult with colleagues in different locations.

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Electronic Medical Record

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A digital healthcare file composed of various individual data elements that are typically a historical view of one individual's healthcare information.

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Dementia vs. Alzheimer's

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Alzheimer's accounts for up to 75% of all dementia. Alzheimer's destroys brain cells and dementia is an acquired persistent impairment.

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Symptoms of Alzheimer's

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Stage 1) forgetfulness, word finding issues, difficulty learning new information
Stage 2) restlessness, irritability, pacing, poor comprehension, delusions, agitation, difficulty getting dressed, memory problems, increased confusion Stage 3) require care for all functions, incapable communicating, recognizing themselves and family members

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Activity Therapy

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Prevents excess disability from developing.

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Wandering

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The act by a person with dementia of walking, riding, of driving off unsupervised, leading to a potentially dangerous situation.

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Sundowning

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A symptom exhibited by some people with Alzheimer's or other dementias characterized by confusion, anxiety, and agitation in the early evening or into the night.

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How to Deal With Alzheimer's as an Administrator

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The administrator needs to be mindful of the mild to extreme difficulty experienced in communicating with those who have Alzheimer's disease.
1) Face the person and remain calm
2) Attempt to identify the feelings rather than the words to understand what the person is attempting to communicate
3) Check for hearing or vision problems that might hinder communication
4) Use the person's full name with title
5) Speak slowly, use simple words and omit conjunctions
6) Ask one question at a time, and allow ample time for response
7) Include the person in the conversation if he is in the room, and refrain from talking about him as if he is not there
8) Be patient
9) Use gestures and pictures of objects or actions

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Differences Between Palliative Care and Hospice

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Palliative care extends the principles of hospice but begins at an earlier point in the disease process, and accepts that some curative therapies may be appropriate even though the patient has been diagnosed with a fatal disease.

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Communication

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Communication with the patient and caregivers, communication within the multidisciplinary team, and communication with other healthcare providers.

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Interdisciplinary Team Approach

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Physicians and nurses work side by side with social workers and chaplains to deliver comprehensive and appropriate care.

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Physician Assisted Death

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Involves prescribing lethal doses of medication to a patient to hasten his or her death.

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Physician Assisted Suicide

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The patient is responsible for deciding if and when the medication is used and for administering it himself or herself.

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Physician Assisted Euthanasia

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The physician administers the medication.

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Women in Long Term Care

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More vulnerable to poverty and chronic illness, skilled at multitasking and at forming and sustaining friendships and social supports.

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African Americans in LTC

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Prevalence of chronic disease is twice as high as whites. Less likely than whites to enter nursing homes and they are more limited in their ADLs than whites.

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Latinos in LTC

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Develop chronic and disabling diseases early in life.

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LGBT in LTC

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Aging experience of gay men and lesbians is different due to their sexual orientation and identity. LGBT elders have the same concerns as other elders in terms of accessing healthcare budgeting limited or nonexistent income, and finding living arrangements.

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Cultural Competency

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The ability of individuals or organizations to understand the global view of clients from diverse cultures and adapt their practices to ensure their effectiveness.