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Long term care

-various services provides to individuals having ongoing need for health care
- provides services to those not acutely ill, but cannot function independently at home
- may be licensed for intermediate or skilled nursing


Long term care is defined by who as The provision of series to help people attain, maintain, and regain their optimum level of functioning In The following areas :

The american nurses association (ANA)

- physical
- psychological
- spiritual
- social
- economic


Setting for long term care

(Least restrictive to most restrictive)

-Community services (adult day care, hospice)
- assisted living
- continuing care retirement community
- institutional setting



Activity of daily livings



- provides services to patients and families as the end of like approaches
- maintaining comfort as death approaches
- provide ADLs, pain and symptom management; and spiritual and psychosocial support for the patient, family, and sig other
- care poi ideas include CNAs, HHAs, ect


Adult day care

- protective setting for adults unable to stay home alone, but doesn't exceed 24 hours
- services include:
Nursing care

- designed to meet the needs of functionally or cognitively impaired adults through an individualized plan of care


Continuing care retirement communities

- provide continuous care as individual's health care needs change
- includes:
Independent living
Assisted living
Short term or permanent health care


Residential care setting

- primarily an older adult population offering a variety of services
- most popular are assisted living facilities and retirement communities


Assisted living

- the adult patient rents a small one- bedroom or studio- type apartment and can receive several personal care services
- combination of housing and services for people who require help with ADLs
- nursing care NOT provides


Instrumental activities of daily living (IADLs)

More compleat ADLs such as shopping and using telephone


Palliative care

Extends the principles of hospice care to a broader population that has the possibility to benefit from comfort care earlier in their illness or disease process


Subacute care

-Provides services for clients out of acute stage of illness but still requiring skilled nursing, monitoring, and ongoing treatments
- intended to fill gap between acute care hospital and traditional long term care facility


Skilled nursing facilities

Most subacute units are located in freestanding skilled nursing facilities


Long term care facility

- most dominant setting for long term care services
- commonly known as nursing home or extended care facility
- provides services to primarily older adults
- 24 hour care to individuals who don't require inpatient hospital services but who don't have options for care at home by other community agencies/ services
- becomes home for the older adult
- patients are referred to as residents
- most residents have more then one health disorder when admitted and more than half have three of more


Two categories of long term care facility

1. Short term:
Transferred from an acute care facility primarily for rehab and expected to be discharged within 6 moths

2. Long term:
Usually stay in facility until he or she dies or is transferred to an acute care facility


Different types of nursing in long term care facility

Team nursing
Functional nursing
Total resident care
Combination of above


Role of LP/ VNs

- long term facilities offer many career opportunities
- may supervise evening or night shifts
- coordinate and supervise nursing assistants
- need good assessment skilled and nursing judgement based on assessment finding


Respite care

-May be offered by long term facilities, adult day care centers or in private homes
- provides break to caregivers for a few hours each week, occasional weekends, or longer
- includes:
Planned activities


Foster care

- for individuals u able to live independently, but no not require care in health care facility
- similar to foster home concept or children


Functional assessment

Cornerstone of clinical practice in the setting


Resident assessment instrument (RAI)

OBRA prescribed the method of resident assessment and care plan development In and instrument called resident assessment instrument


Minimum date set (MDS)

Provides a system for assessment of each resident's functional, medical, mental, and psychological status on admission to a facility and at regular intervals thereafter



Omnibus budge reconciliation act
Of 1987
Also known as the nursing home reform legislation
Landmark law affecting long term care facilities


Quality of life

Measure of the optimum energy or force that endows a person with the power to cope successfully with the full range of challenges he or she encounters in the real world