Levels of intensity

1. Levels of intensity A variety of services are now available to address the varied requirements from basic personal to the more specialized sub acute long term care.

2. 5 types of Long Term Care Personal Care • Personal care refers to light assistance with basic ADLs such as bathing. • Paraprofessionals are the ones that provide this kind of service such as HHA, CNA, and TA. • Personal Care can be provided by informal caregivers such as Home Health Agencies, Adult Day Care (ADC), Adult Foster Care (AFC) and residential and assisted living facilities. Custodial Care • Is a non-medical care provided to support and generally maintain the patient’s condition and the essential of daily living. The emphasis of this care is to prevent further deterioration. • This care doesn’t require active nursing treatments only a routine assistance with ADLs services. • This care is generally longer term its is continued after the patient shows no potential improvement and cannot participate in therapy.

3. Restorative Care • Also known as rehabilitation care which is based on philosophy of caregiving in which the patients is viewed as a participant who can reach their maximum potential in physical and mental functioning. • In RC therapies are included into the daily routine such as physical, occupational and speech therapy. Example; bowel and bladder training and assisted walking. • This service is provided by paraprofessionals as well. Skilled Nursing Care • This service is provided by a licenses nurse under the overall direction of a physician. • This care provide services such as monitoring of acute and unstable chronic conditions, it also includes wound care, tube care management, intravenous therapy, HIV/AIDS care, and phlebotomy. • Skilled Nursing Care is provided by Home Health Agencies and Skilled Nursing Facilities.

4. Subacute Care It is required during the postacute phase of an acute episode. This care is for patients who remain critically ill during the postacute phase of illness or injury. It includes various medical, surgical, oncological, rehabilitation and other intensive services. There are four levels of Subacute Care which are extensive, special, clinically and rehabilitation care.

5. Key Social Aspects of LTC Housing • The national Affordable Housing Act of 1990 is a program that provides federal funds to construct a supportive house designed for low-income elderly. • Housing is an option for seniors and disabled adults who do not want to live alone. This service offer patients a private bedroom and supportive services such as meals, transportations, housekeeping, security and social activities. • End-of-Life Care • Dealing with death and dying is very much a part of LTC. End-of-life care deals with preventing needless pain and distress for terminally ill patients and their families. • End-of-Life clinical pathway video with examples of good practice. http://www.youtube.com/watch?v=weFqpNzflug

6. Clients of Long Term Care Older Adults Children and Adolescents The second highest % of clients in the LTC are Children and adolescents that are born with birth disorders such as logical palsy, autism, epilepsy etc. Children that develop physical disability such as dysfunctions are referred to as developmentally disabled, and children that are bellow-average intellectually lead to the MR. Today the average life expectancy of those whit MR approaches 66 years. Fact: DS is the most common cause of MR in America. • At the beginning of the 20th century, persons 65+ years of age constituted 4% of the population in the US. Today, roughly 12.5% of the populations falls in that age group. • This been said , elderly in the lowest socioeconomic status are the greatest risk of need for LTC and are also the least able to pay for such services.

7. pic Young Adults PPL with HIV/AIDS Aids has evolved from an end-stage terminal illness into a chronic condition. Over a period of time people with AIDS are subject to a number of debilitating conditions, creating the need of assistance. Furthermore, HIV/AIDS patients are likely to be younger than 60 years, male and Black or Hispanic. This patients require special challenges than the rest of the patients in the LTC because they have higher prevalence of depressions, psychiatric disorders, and dementia associated with AIDS. • The most common disability in young adults is neurological malfunctions. For example; multiple sclerosis is potentially the most common cause of neurological disability in young adults. PPL requiring Specialized Care • A growing # of nursing facilities have developed specialized services such as ventilator care and specialized care for head trauma victims.

8. Types of community –based Long-term care service: · To deliver LTC in the most economical and least restrictive setting whenever appropriate for the patient’s health care needs. · To supplement informal care giving when more advance skills are needed · To provide temporary delay to family from caregiving stress · To delay institutionalization by meeting the needs of the most weak elderly community settings.

9. What is Home Health Care? HHC refers to health care provided in the home of the patient by health care professionals. It commonly requires a community or hospital-based home health agency that sends health care professional and paraprofessionals to patient’s homes to deliver services approached by a physician. What is Adult Day Care? ADC referred to as adult day service, is a daytime program of nursing care, rehabilitation therapies supervision, and socialization that enables weak people to remain in the community. The national adult day services association is designed for people who because of physical or mental conditions cannot remain along during the day, but who have family members to take care of them so this allows family caregivers to work during the day .It provides a variety of health, social, and other related support services in a protective setting during any part of a day but less than 24-hour care. It normally operates during normal business hours five days a week

10. Adult Foster Care: Is a service characterized by small, family-run homes providing room, board, and various levels of supervisions, oversight, and personal care to nonrelated adults who are unable to care for themselves. Typically, the care giving family resides in part of the home, however; many people habe made a business of AFC by buying several houses and hiring families to live in them to care for functionally impaired elderly people.