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Chapter 38 Long-Term Care


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Mikayla Delenia


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[Front]


Activities of daily living (ADLs)
[Back]


Daily routines of hygiene, dressing, grooming, toileting, eating, and ambulating carries out independently throughout life

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Chapter 38 Long-Term Care - Marcador

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Chapter 38 Long-Term Care - Detalles

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Activities of daily living (ADLs)
Daily routines of hygiene, dressing, grooming, toileting, eating, and ambulating carries out independently throughout life
Adult day care
Community-based programs designed to meet the needs of functionally or cognitively impaired adults through supervised health care and social and recreational activities
Assisted living
A residential care setting in which the adult patient rents a small one-bedroom or studio-type apartment and has the option of receiving several personal care services such as bathing, dressing and administration of meds
Continuing care retirement community (CCRC)
Offers a complete range of housing and health care accommodations from independent living to 24-hour skilled nursing care
Functional assessment
The assessment of the functional status of the patient-the ability of an individual to perform normal, expected, or required activities of daily living
Hospice
End of life services
Instrumental activities of daily living (IADLs)
More complex daily tasks-shopping, using the phone, assistance with meds, to more complex car-tube feeding and oxygen therapy
Long-term care
Array of services of individual may find necessary to help in meeting various personal care needs
Minimum data set (MDS)
Provides a system for assessment of each resident's functional, medical, mental, and psychosocial status on admission to a facility and at regular intervals thereafter
Omnibus Budget Reconciliation Act (OBRA)
AKA nursing home reform legislation. Defines requirements for the quality of care given to residents and covers many aspects of institutional life, including nutrition, staffing, qualifications required of personnel and many others
Palliative care
Extends principles of hospice care to a broader population that has the possibility to benefit from comfort care earlier in an illness or disease process
Quality of life
An individualized concept, but it generally refers to an individual's overall well being and feeling of physical, social, and spiritual happiness
Resident assessment instrument (RAI)
Prescribed method of OBRA of resident assessment and care plan development
Residential care
Serve the older adult population and the mentally or physically disabled person and offer a variety of services
Restorative nursing care
Basic concepts of physical therapy for maintenance of functional mobility and physical activity
Skilled nursing care
Provision of care by a team of trained/licensed health care providers
Subacute unit
Type of institutional setting that has become popular since the late 1980s when the advantage of a less expensive alternative to acute care for patients with high-acuity medical and nursing intervention needs
What is the goal of ALL long-term care?
To keep people as independent as possible
Healthy People 2020 includes what?
The initiative health-related quality of life
What are the services to support home care providers for older adults?
Respite care Daycare Home health care Nutrition programs Senior centers Transportation services
Respite care
Scheduled stays who needs long term care to give the caregiver a break
Daycare
A setting that provides structured age appropriate activities during the day
Home health care
Homemakers, shoppers, respite care workers, personal care attendants, home health aides, and nursing care staff
Nutrition programs
Community programs providing one hot meal per day
Senior centers
Govt. or community-funded centers that provide recreational activities, lunch, health screening, exercise classes, education, and transportation to and from the site
Transportation services
Community/govt. funded service to grocery shopping or medical appointments
What is PACE
Program of All-Inclusive Care for the Elderly Helps people remain in their homes while still receiving necessary care
What philosophy is central to hospice care?
The philosophy of the overriding value of maintaining comfort as death approaches is central to hospice care
Who is the director of an adult daycare?
Usually a social worker or RN
Assisted living services are integrated with what?
Skilled nursing homes, hospitals, as components of continuing care retirement communities, or independent housing complexes
Key features of assisted living
Services and supervision available 24 hours per day Services to meet scheduled and unscheduled needs Care and services provided or arranged to promote independence Emphasis on resident's dignity, autonomy, and choice Emphasis on privacy and homelike environment
Why has subacute care become necessary?
Due to increased lifespan as well as changes in hospital reimbursement
Long-term care facility
Provide 24 hour care to individuals who do not need expensive inpatient hospital services but who do not have options for care at home or by other community agencies or services
A long-term care facility is managed by who?
Administrator and a director of nursing
Positive outcomes from OBRA
Empowerment of residents, focus on residents' rights, reduction/elimination of physical restraint use Led to the requirement for long-term care facilities to use greater numbers of licensed nursing staff
Patient protection and affordable care act (PPACA)
The first comprehensive law in a generation to improve the care and safety of the elderly and people with disabilities in nursing homes and other long-term care settings Fully implemented in 2013
Ethical issues related to long-term care
Adherence to a patient's bill of rights Advance directives Do-not-resuscitate orders (DNR) Guardianship Power of attorney Responsible party designation
RAPs
Assessment guides that address common clinical problems ie: delirium, falls, and urinary incontinence
5 major patient safety goals according to The Joint Commission
Identify residents correctly Use medicine safely Prevent infection Prevent residents from falling Prevent pressure injuries
In the nursing process it is stated that the LPN/LVN will______
Participate in planning care for patients based on patient needs Review patient's plan of care and recommend revisions as needed Review and follow defined prioritization for patient care Use clinical pathways, care maps, or care plans to guide and review patient care
When does the need for long-term care services arise?
After the acute stage of an illness has resolved, when the need for services continues in order to maintain the current as well as changing physical, psychological, and functional abilities
In a long-term care facility, how often is the resident's plan of care reviewed and why?
Every 90 days for resolution of problems or revision of expected outcomes and interventions by the team