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Flashcards in Long term Car Ch 38 Deck (24):
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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

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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

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Setting for long term care

(Least restrictive to most restrictive)

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

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ADLs

Activity of daily livings

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Hospice

- 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

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Adult day care

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

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

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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

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Residential care setting

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

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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

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Instrumental activities of daily living (IADLs)

More compleat ADLs such as shopping and using telephone

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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

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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

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Skilled nursing facilities

Most subacute units are located in freestanding skilled nursing facilities

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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

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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

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Different types of nursing in long term care facility

Team nursing
Functional nursing
Total resident care
Combination of above

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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

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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:
Supervision
Meals
Planned activities

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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

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Functional assessment

Cornerstone of clinical practice in the setting

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Resident assessment instrument (RAI)

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

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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

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OBRA

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

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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