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HCMN 413 Review for Exam 1

by: Amend

HCMN 413 Review for Exam 1 HCMN 413

Marketplace > Towson University > Health Sciences > HCMN 413 > HCMN 413 Review for Exam 1
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These notes cover the first exam.
Services & Housing for the LTC Consumer
Dr. McSweeney- Feld
Study Guide
longterm-care, Healthcare, Management
50 ?




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This 6 page Study Guide was uploaded by Amend on Wednesday August 24, 2016. The Study Guide belongs to HCMN 413 at Towson University taught by Dr. McSweeney- Feld in Fall 2015. Since its upload, it has received 5 views. For similar materials see Services & Housing for the LTC Consumer in Health Sciences at Towson University.


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Date Created: 08/24/16
Review for Quiz 1 – HCMN 413 Services and Housing for the Long­Term Care Consumer 1. Who are the consumers of long­term care services?  Older adults   Younger adults with long­term care needs  Family caregivers and friends who help those with chronic care needs  People who have special needs   People interest in the aging network   Grandparents raising grandchildren  LGBT elders  Older veterans 2. Know the demographic shifts in the US affecting demand for long­term care services: increases in numbers of consumers, life expectancy and age mix shifts, changes in ethnicity, changes in living arrangements, and  economic drivers of housing decisions (income, retirement savings, housing market changes and expense).   Will future generations have to work longer as they approach retirement? ­ Ten­thousand Baby Boomers will turn 65 every day for the next 19 years ­ Critical legislature: Medicare, Medicaid, OAA ­ 44% of older adults living in community rated their personal health as excellent or very good ­ African Americans, American Indians, Asians, and Hispanics were less likely to rate personal health as  excellent  ­ Population aging started in Sweden and France as a result of a decline in birth rates ­ Implications: o Decrease in mortality rates o China is home to 20% of all people over the age of 65 o Rapid growth of aging Chinese is a function of enforced one­child policies o China does not have strong pension program for aging population­ lead to weaker economy o Advanced age is risk factor for institutionalization­higher disabilities among old­old (90+)  Poverty rates ranking: African Americans (25%) & Hispanics (21%)  Higher rate of widowed woman since women outlive men ­ Most have at least one chronic condition & prefer to reside independently (Aging in place) ­ Aging in place is policy goal of the Older Americans Act  ­ Close association between educational attainment & health status and income for future elders (good news) ­ A woman is expected to live 20.4 years & a man 17.8 years additional of age 65 ­ A child is expected to live the age of 78.7 years­ 30 years longer than 1900 ­ 1970:  o 89.5% of aging population was White & 15.9% born in foreign country ­ In between: o Hispanic elder population increased from 1.9% to 7% o Those born outside the U.S. shifted from 77.6% from Europe to 30.4% o Asia increased from 3.7% to 27.1% o Latin American increased from 6.3% to 35.5% ­ 2009:  o 80% were White ­ 2011: o 8.7% lived below the poverty level  o New measure: Supplemental Poverty Measure­ regional variations in cost of living­ 15.1%  Two demographic facts about elder population: 1) The median age of foreign­born individuals is above 52 2) Foreign­born population is very diverse ** Differences in cultural attitudes toward aging, use of services, and lack of fluency in English (foreign­ born) will create problems for service providers in attempt to implement aging programs that are inclusive Retirement: withdrawing from one’s occupation, business, or office and pursuing new activities  Employment difficult: o Limited support & resources for older persons in search of jobs o Age discrimination   Retirement Income (4 Pillars) 1. Social Security a. Trust fund payment b. Major source of income for low­income retirees i. Problems: 1. Increasing # of beneficiaries 2. Declining birth rates 3. Perception of problems with trust fund 2. Employer­sponsored pensions 3. Private savings 4. Employment in retirement Yes future generations will have to work longer as they approach retirement because pension plans changed to  defined contribution plans (employer, employee or both make contributions on a regular basis), while employers  have limited post­retirement healthcare benefits. The Federal Interagency Forum on Aging Related Statistics (2010)  Report included that many are working past age 55 due to financial necessity. 1. Know the Older Americans Act (1965) and its seven titles and the term, and what is the Aging Network OAA: Americans age 60+ regardless of health status, income, or other personal characteristics  Supports autonomy and independence a. TI: Declaration of Objectives­ service philosophy continues today, nearly 50 years after enactment b. TII: Establishment of AoA­ scheduled to be reauthorized every 5 years; not since 2006 c. TIII: Grants for State and Community Programs on Aging d. TIV: Activities for Health, Independence, and Activity e. TV: Community Service Senior Opportunities Act f. TVI: Grants for Native Americans g. TVII: Vulnerable Elder Rights Protections The Aging Network is dedicated to providing assistance and support to older adults and their informal caregivers  that allow them to remain in the community and avoid unnecessary institutionalization. 2. Know the evolution of the Disabilities Network and the legislation supporting this transition (Rehabilitation Act, IDEA Act, ADA, and the Fair Housing Act.) a. IDEA Act: Individuals with Disabilities Education Act i. Enacted in 1990 & reauthorized in 1997 & 2004 ii. Designed to protect the rights of students w/ disabilities by ensuring that everyone  received a free appropriate public education (FAPE), regardless of ability  b. ADA: Americans w/ Disabilities Act of 1990 i. Prohibits discrimination against people w/ disabilities in employment, transportation,  public accommodation, communications, and governmental activates  c. The Fair Housing Act: Title VIII Of the Civil Rights Act of 1968 i. Introduced meaningful federal enactment mechanisms ii. Outlawed: refusal to sell or rent a dwelling to any person because of race, color, religion,  sex, or national origin ­Factors increasing risk of disability: excess body weight, tobacco use, chronic health conditions, substance abuse,  and high­risk activities ­Factors decreasing risk of disability: healthy body weight, diet and exercise, no tobacco or substance abuse, healthy stress level, effective treatment of chronic health conditions 3. What is the Administration for Community Living, and why is it important The Administration on Aging became part of the Administration for Community Living (ACL), which is a new  operating division within the DHHS. It is important because it created a single organization devoted to  strengthening and enhancing efforts to support seniors and people with disabilities in order to satisfy the  growing need to better understand and advocate.   Created to bring the aging services and disabilities services networks together  Consists of: Administration of Aging (AoA; OAA)  Administration on Intellectual and Development Disabilities (AIDD) 4. Know the information and referral services for long term care services – and the name of the one that  serves this function Long­Term Services and Supports (LTSS) is the range of support services that are needed by adults of all ages  with care needs as a result of a physical or mental limitation that prohibits their ability to see to all their own  care needs; Residential, HCBS, & Technology  Makes a difference in ability to remain in community or needing to relocate to care setting  Estimated 11 million adults over 18 who receive LTSS o 57% over age 65 o 43% between 18 and 64 5. Know residential options for long­term care services: Provide Overnight Stay a. Independent living (age­segregated housing) i. Great diversity; ranging from inner­city housing projects to trailer parks to upscale  continuing care retirement communities b. Assisted Living (its characteristics, who resides there) i. Those with minimal needs for assistance with daily living (DLA) and care; 24 hr.  personal care ii. Provide private or shared rooms, meals, supervision, security, transportation iii. Different in each state c. Board and Care Homes /Adult Foster Care i. Allow varying degrees of assistance for seniors and disabled persons ii. Seniors who suffer mental health problems (Alzheimer’s or dementia) iii. Own rooms, share common facilities iv. Residents maintain social habits and travel with added on­site assistance d. Skilled Nursing Facilities i. Care covered by Medicare Part A (Hospital Insurance) ii. Those who no longer need amount of care provided by hospital but cannot yet care for  themselves after discharge e. CCRCs: Continuing care retirement communities i. Retirement communities that offer more than one kind of housing and different levels of  care 1. Individual homes or apartments (residents living on own) 2. Assisted living facility (DLA) 3. Nursing home (require more care) ii. Residents move from levels based on needs f. Hospice (this last term can also fall under home care) i. Care for the terminally ill (6 months or less to live) & their families ii. Physical care & counseling (provide comfort, not treatment) Know the term HCBS and what services fall under this term:   Home & Community­Based Services­ No Overnight Stay a. Senior centers i. Community focal point where older adults can congregate to fulfill many of their social,  physical, emotional, and intellectual needs ii. Offer meal & nutrition programs, health, fitness, and wellness programs, transportation,  counseling, information and assistance, etc. b. Adult day services i. Provide care & companionship for seniors who need assistance or supervision during the  day (community­based setting) ii. Offers relief to family members or caregivers iii. Delay or prevent institutionalization by providing alternative care, to enhance self­esteem and encourage socialization iv. Elders & other adults with issues related to cognition, development, & physical health v. Services include: counseling, education, evening care, exercise, health screening, meals,  medical care, recreation, transportation, etc.  c. Home care (difference between home health agencies and residential service agencies in the state  of Maryland) i. Home health care­ wide range of health care services given in your home for an illness or injury (physical or occupational therapy) 1. Less expensive 2. More convenient 3. Effective as hospital care of SNF  4. Regain independence & become self­sufficient 5. Covered through Medicare (short­term) ii. Residential service agencies­ include board & care homes and assisted living 1. Assist with ADL: nursing services or help with medication 2. Social and recreational activities provided d. PACE programs (who is eligible, services provided) i. Manages medical, social, and long­term care services ii. Offered to frail people to remain in their homes and maintain their quality of life iii. Available in states that offer it under Medicaid iv. Help to stay independent & live in community as long as possible v. Must be 55 or older, live in the service area of a PACE program, be certified for nursing  home care by State agency, & live safely in the community Technology: a) Telehealth/telemedicine­ group therapy thru webcam b) Assistance technologies­ hearing aids, prosthetics c) Smart Homes d) Other technology to be developed Green House Nursing Homes: Shabbazim (CNAs, GNAs): nursing, cleaning, and cooking What are the principles of Age Friendly Communities? [5 Cs….} e. Continuity­ activities that maintain good health f. Compensation­ access to services, products and structures that meet community needs g. Connection­ sources of social interaction and support h. Contribution­ opportunities to contribute to community well­being i. Challenge­ new activities to engage and excite participants What is a Certified Aging in Place specialist, and what do they do? A CAPS is someone who understands the aging­in­place home remodeling marketing and the technology, tools, and resources that are available for seniors to age in place. They are trained in the needs of the aging  population, common remodeling projects and expenditures, codes and standards, and product ideas and  resources (senior market in mind). Trained in: a) Unique needs of people 50 & over b) Home updates that can help people continue living independently in their homes longer c) Common remodeling projects d) Solutions to common barriers 2. What is universal design, and what are its features?  What are some examples of how these principles have  been applied in housing for older adults and adults with disabilities? Universal design is about creating a home that is adaptable, flexible, safe, and easy­to­use for all residents and  visitors, regardless of age, size, or ability. Trained in: *Found on AARP pages 3­4* 3. What role do occupational therapists play in home fit assessments? Occupational therapists can evaluate the fit between an individual and their home environment to assess for  livability. Many are specialized in the area of home modifications and can identify strategies for increasing home  safety and changing a home to meet needs, abilities, and lifestyle.  4. How does a Home Fit assessment improve the quality of life and safety of older adults and individuals with disabilities living in the community? A home fit assessment improves the quality of life for older adults and individuals with disabilities living in a  community by evaluating current living situations and addressing any need for change or modification in order to  secure one’s safety and livability.  A well designed or updated home that has been made to accommodate the needs  of individuals provides independence, comfort, and safety, which matches lifestyle changes overtime.  In addition,  livable communities need to include easy access to shopping, entertainment, health services, and transportation  options in order for individuals to be able to remain independent and offer a better quality of life.  N4A­ National Association of Area Agencies on Aging­ Recommendations  Preserve person­centered nature of OAA programs  Strengthen role of aging network of services­ integrate physical & mental  Increase level of funding   Strengthen capacity of initiatives that will increase competencies o Provide evidence on outcomes and evaluations o Staff & volunteer training, development, and retention Disabilities Network:  PL 93­112 Rehabilitation Act of 1973  Section 504: Nondiscrimination Under Federal Grants  7 titles similar to OAA LTC: combination of health services, supportive services, and formal & informal assistance  Services based on: o Activities of Daily Living (ADLs); bathing, dressing, eating, toileting, bed to chair transfer o Instrumental Activities of Daily Living (IADLs); cooking, cleaning, medications, handling $  Genetic factors: Family history of illness or disease  Environmental factors: Lifestyle choices­ diet, exercise, alcohol or tobacco use, etc.  Continuum of LTC: ­ System of services and mechanisms ­ Tracks clients over time through health, mental health, and social services ­ Organizes services and includes operations for a cohesive system Livable Community: • Livability is the sum of the factors that add up to a community’s quality of life—including the built and  natural environments, economic prosperity, social stability and equity, educational opportunity, and  cultural, entertainment and recreation possibilities • A community for all types of people – all ages and abilities


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