Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 10 Continuum of Care in Gerontological Nursing

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins TERMS TO KNOW Adult day services: centers that provide health and social services for a portion of the day to persons with moderate physical or mental disabilities and give respite to their caregivers Assisted living facility: residential care for persons who do not require nursing home level services but who cannot fulfill all personal care and/or health care needs independently; are referred to as assisted living communities, residential care facilities, personal care, and boarding homes. Case management: services provided by registered nurses or social workers who assess an individual’s needs, identify appropriate services, and help the person obtain and coordinate these services in the community Hospice: services that provide support and palliative care to dying individuals and their families in the home or an institutional setting Nursing home: facility that provides 24-hour supervision and nursing care to persons with physical or mental conditions who are unable to be cared for in the community Respite care: services to provide short-term care to individuals, thereby offering their caregivers short-term relief from their caregiving responsibilities

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction Effects of a “graying” population Impact of growing number of older adults on society Older adults’ major users of health care services All nurses will care for older adults in various settings

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Services in the Continuum of Care for Older Adults Preventive services Partial and intermittent care services Complete and continuous care services Community-based services Institution-based services Complementary and alternative services

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Supportive and Preventive Services Goal: maintain independence and self-care capacity –Identify service needs –Referral to appropriate services –Supporting and coordinating services –Services provided by communities

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement True or False? The continuum of care for older adults consists of preventive services, partial and intermittent care services, and complete and continuous care services.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True The continuum includes opportunities for community-based services, institution-based services, or a combination of both. Complementary and alternative services may also be included in the continuum.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Supportive and Preventive Services Financial services Employment Food Housing Health care Social support and activities Volunteer work Education Counseling Consumer affairs Legal and tax services Transportation Shopping at home

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Preventive services for older adults support individuals in maintaining their self-care capacity and include all of the following EXCEPT a.Identifying service needs b.Referral to appropriate services c.Suggestion of day treatment programs d.Supporting and coordinating services

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer c.Suggestion of day treatment programs Suggestion of day treatment programs is considered a partial or intermittent care service. Answers A, B, and D act as a preventive services to support independent individuals.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Partial and Intermittent Care Services Provision of assistance for partial limitation in self-care capacity or therapeutic demand Occasional assistance for reduction of risk for new or worsening condition Provided by communities or institutions

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Partial and Intermittent Care Services Assistance with chores Home-delivered meals Home monitoring Telephone reassurance Home health care Foster care and group homes Adult day services Day treatment and day hospital programs Assisted living Respite care Health ministry and parish nurse programs Care and case management Hospice

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement True or False? Adult day care programs have been a growing component of community-based long-term care.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True There are currently over 3,500 centers that provide adult day care in the United States. The programs maximize the existing self-care capacity of participants while preventing further limitations.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Complete and Continuous Services Provision of regular or continuous services to those who need 24-hour supervision Examples: –Hospital care –Nursing homes

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Complementary and Alternative Services Growing awareness of complementary and alternative therapies Older adults seeking new or nonconventional services Advocacy for older adults’ rights to make informed choices related to these therapies –Educate regarding benefits, risks, and limitations –Assist with reputable providers

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement True or False? Additional educational and practice preparation is required of nurses who would like to implement many of the complementary and alternative therapies into their clinical practice.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True Nurses possess a wide range of knowledge and skills that, when combined with additional preparation in complementary and alternative therapies, make them ideal providers of some of these nonconventional services.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Matching Services to Needs Needs of the aging population are diverse and multitudinous Needs of older adults fluctuate as life demands change

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Considerations When Matching Services to Needs Services must address physical, emotional, social, and spiritual factors Services must consider unique, changing needs Care and services must be flexible Services tailored to needs

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Settings and Roles for Gerontological Nurses Opportunities for gerontological nurses in variety of settings Nurses’ roles and responsibilities differ in different settings Functions are varied and multifaceted Diverse health care settings will increase as will the need for nurses with gerontological nursing expertise