Home Care Assistance shares how they are changing the way the world ages
Guide to Senior Care Options & Patient Care Assisted/Alzheimer’s • Home Healthcare • Home Care Private Duty Nursing Skilled Nursing & Rehabilitation • Rehabilitation Hospital MOBILE AND DIGIAL AVAILABLE
1
CASEMANAGEMENTSOCIALWORK.COM
CaseManagementSocialWork.com
Located Near You In Southwest Ohio!
Independent Living Homes & Apartments, Assisted Living, Rehab & Skilled Nursing
Independent Living Homes & Apartments, Assisted Living, Rehab, Memory Care & Skilled Nursing
175 Cape May Drive Wilmington, OH 45177
1701 Llanfair Avenue Cincinnati, OH 45224
937.382.2995
513.681.4230
Independent Living Homes & Apartments, Assisted Living, Rehab, Memory Care & Skilled Nursing
Home health, hospice, home care and adult day services
www.capemayohio.org
www.llanfairohio.org
Southwest Ohio Senior Independence 9600 Colerain Avenue, Suite 300 Cincinnati, OH 45251
225 Britton Lane Monroe, OH 45050 Please say, “I found you in 513.539.7391
www.mountpleasantohio.org
2
513.681.8174
Case Management & Social Work.”
www.seniorindependence.org
Contents
VOL 1 ISSUE 2 GREATER CINCINNATI
Meeting Senior Care Needs in the Comfort of Home with Home Care Assistance
11 Levels of Care ALZHEIMER’S 8 Programs and assistance designed with those with memory loss; some communities will provide specially trained security measures to prevent residents from wandering.
SKILLED NURSING & REHAB 17 Licensed and equipped to provide healthcare which meets the needs of more extensive physical issues, and assist residents to regain mobility.
HOME CARE 13 Allowing a non-medical home care assistant (caregiver) provide transportation, meals, and daily needs. HOSPICE 15 In home of facility end of life care for the terminally ill with pain management, comfort, and emotional support being the primary mission for the family.
facebook/casemgmt © 2014 CMSW
3
CASEMANAGEMENTSOCIALWORK.COM
ELIMINATE HARM ACROSS THE BOARD Days Since Last Readmission READMISSIONS PREVENTION:
!
Conduct enhanced admission assessment of discharge needs and begin discharge planning at admission
!
Conduct formal risk of readmission assessment; align interventions to patient’s needs and risk stratification level
!
Perform accurate medication reconciliation at admission, at any change in level of care and at discharge
!
Provide patient education that is culturally sensitive, incorporates health literacy concepts and includes information on diagnosis and symptom management, medications and post-discharge care needs
!
Identify primary caregiver, if not the patient, and include him/her in education and discharge planning
! !
Use teach-back to validate patient and caregiver’s understanding
!
Collaborate with post-acute care and community-based providers including skilled nursing facilities, rehabilitation facilities, long-term acute care hospitals, home care agencies, palliative care teams, hospice, medical homes, and pharmacists
!
Before discharge, schedule follow-up medical appointments and post-discharge tests/labs; for patients without a primary care physician, work with health plans, Medicaid agencies and other safety-net programs to identify and link patient to a PCP
!
Conduct post-discharge follow-up calls within 48 hours of discharge; reinforce components of after-hospital care plan using teach-back and identify any unmet needs, such as access to medication, transportation to follow-up appointments, etc.
Send discharge summary and after-hospital care plan to primary care provider within 24 to 48 hours of discharge
Please say, “I found you in
4
Case Management & Social Work.”
Too Much Medication for the Elderly?
As patients become older, they become more vulnerable to the risk of side effects that are present with diabetic medications.... O ld e r d ia b e te s p a tie n ts a re o fte n s w itc h e d o v e r to in s u lin a n d s u lfo n y lu re a d ru g s a s th e y u n d e rg o in te n s iv e th e ra p y to c o n tro l g lu c o s e le v e ls . T h e p u rp o s e o f th is c ro s s -s e c tio n a l s tu d y in p a tie n ts re c e iv in g in s u lin a n d s u lfo n y lu re a s w a s to id e n tify a c o rre la tio n in h ig h -ris k p a tie n ts re c e iv in g in te n s iv e g ly c e m ic m a n a g e m e n t a n d th e ris k o f s e rio u s h y p o g ly c e m ia . H ig h d o s e s o f in s u lin o r s u lfo n y lu re a s ca n c a u s e a n o ld e r p e rs o n 's b lo o d g lu c o s e to d ra m a tic a lly d e c re a s e , e n o u g h to c a u s e lo s s o f c o n s c io u s n e s s a n d e v e n d e a th . D o s in g o ld e r d ia b e tic p a tie n ts c a n b e c h a lle n g in g b e c a u s e o f c h ro n ic m e d ic a l c o n d itio n s a n d s e lf-c a re c h a lle n g e s . In a s tu d y c o n d u c te d b y th e D e p a rtm e n t o f V e te ra n s A ffa irs ,
a p p ro x im a te ly 2 0 6 ,0 0 0 (3 1 .5 % ) o f th e 6 5 2 ,3 7 8 p a tie n ts w h o re c e iv e d in s u lin o r s u lfo n y lu re a s h a d s ig n ific a n tly m o re a g g re s s iv e tre a tm e n t th a n th e re c o m m e n d e d d ia b e te s g u id e lin e s . A n in te n s iv e tre a tm e n t w a s c o n s id e re d an H b A 1 c le s s th a n 7 .0 % in p a tie n ts w h o w e re a g e d 7 5 y e a rs o r o ld e r w ith im p a ire d k id n e y fu n c tio n s , c o g n itiv e im p a irm e n t, a n d o th e r c o m o rb id illn e s s . In th e 2 0 6 ,0 0 0 p a tie n ts w h o re c e iv e d a g g re s s iv e d ia b e tic tre a tm e n t, a n a v e ra g e o f 1 1 .3 % h a d a H b A 1 c v a lu e le s s th a n 6 .0 % , 2 8 .6 % le s s th a n 6 .5 % , a n d 5 0 .0 % le s s th a n 7 .0 % . R a te s o f o v e rtre a tm e n t w e re 1 0 .1 % fo r H b A 1 c le s s th a n 6 .0 % , 2 5 .2 % fo r le s s th a n 6 .5 % , a n d 4 4 .3 % fo r le s s th a n 7 .0 % .
5
CASEMANAGEMENTSOCIALWORK.COM
T h is s tu d y s h o w e d th a t a la rg e n u m b e r o f e ld e rly p a tie n ts w ith d ia b e te s a re b e in g o v e r-tre a te d . D e s p ite d ia b e tic g u id e lin e s fo r p a tie n ts w ith c o m o rb id c o n d itio n s to h a v e a n H b A 1 c o f 8 -9 % , d o c to rs a re s till p u s h in g b e lo w 7 % H b A 1 c le v e ls . A lth o u g h b rin g in g d o w n b lo o d s u g a r is im p o rta n t in tre a tin g d ia b e te s , th e ris k o f h y p o g ly c e m ia c a n b e m o re d a n g e ro u s in th e s h o rt -ru n w h e n c o m p a re d to h y p e rg ly c e m ia . P ra c tic e P e a rls : O ld e r d ia b e te s p a tie n ts a re o fte n s w itc h e d o v e r to in s u lin a n d s u lfo n y lu re a d ru g s a s th e y u n d e rg o in te n s iv e th e ra p y to c o n tro l g ly c e m ic le v e ls . H ig h d o s e s o f in s u lin o r s u lfo n y lu re a s c a n c a u s e a n o ld e r p e rs o n 's b lo o d g lu c o s e to d ra m a tic a lly d e c re a s e , e n o u g h to c a u s e lo s s o f c o n s c io u s n e s s a n d e v e n d e a th A la rg e n u m b e r o f e ld e rly p a tie n ts w ith d ia b e te s a re b e in g o v e r tre a te d d e s p ite d ia b e tic g u id e lin e s fo r p a tie n ts w ith c o mo rb id c o n d itio n s to h a v e a n H b A 1 c o f 8-9 % . A. O’Malley JAMA
un-retire WITH SENIOR LIFESTYLE
Experience our wonderful communities by scheduling a complimentary lunch and tour.
INDEPENDENT LIVING | ASSISTED LIVING SKILLED NURSING | REHAB MEMORY CARE | ADULT DAY SERVICES 230 WEST GALBRAITH ROAD CINCINNATI, OH 45215
888-886-2129
INDEPENDENT LIVING | ASSISTED LIVING SKILLED NURSING | REHAB 7300 DEARWESTER DRIVE CINCINNATI, OH 45236 WWW.SENIORLIFESTYLE.COM
Please say, “I found you in
6
888-474-9070
Case Management & Social Work.”
7
CASEMANAGEMENTSOCIALWORK.COM
It's YOUR time to shine and be recognized for your contribution to quality health care for the patient, your commitment to continue to strive to be the best, and overall leadership.
You're invited to enjoy a complimentary lunch Horseshoe Casino October 15th, 2014 from 11am - 1pm Ballroom B Browse through the 2014 Queen City Boomer & Senior Expo Benefiting SOV - CMSA • Receive $10 FREE PLAY upon arrival • Valet Parking • Register to win a cruise for two! • Enjoy free massages, prizes, gifts, and much more! Sponsored By
0 Please say, “I found you in
8
Case Management & Social Work.”
ALZHEIMER’S
9
CASEMANAGEMENTSOCIALWORK.COM
“We can’t imagine spending our best years anywhere but home.”
Our Life. Our Memories. Our Home. Live Well at Home with Home Care Assistance! Home Care Assistance is the leading provider of in-home care for seniors. We work closely with family members to provide older adults with quality care that enables them to live healthier, more independent lives at home. Founded in 2002, our services are distinguished by the caliber of our caregivers, the responsiveness of our staff and our expertise in live-in care. We embrace a positive, balanced approach centered on the& evolving Please say, “I foundto youaging in Case Management Social Work.” 10 needs of older adults.
• Home Care Assistance is the only home care agency to offer cognitive stimulation therapy. Our proprietary Cognitive Therapeutics Method™ program helps clients stay mentally sharp and delay symptoms of cognitive decline in the comfort of their homes with expertly designed, enjoyable cognitive activities. • Home Care Assistance caregivers receive training in our Balanced Care Method™, which is a holistic program that promotes a healthy mind, body and spirit for aging adults and people with chronic care needs or disabilities. • Home Care Assistance is committed to helping reduce avoidable hospital readmissions. Our From Hospital to Home Care book, guide and website (HospitaltoHomeCare.com), part of our extensive educational suite of materials, provides an overview of the challenges and resources associated with each step in the transition from hospital to home to ensure optimal recovery. • Home Care Assistance boasts a 97% satisfaction rate and has been endorsed by Harvard geriatrician, Dr. Dennis McCullough and Washington University Geriatrics Clinical Director, Dr. David Carr, among others. PLEASE SEE AD ON BACK PAGE
513-891-2273
Changing the Way the World Ages
7712 Montgomery Rd Cincinnati, Ohio 45236 HomeCareAssistanceCincinnati.com 11
CASEMANAGEMENTSOCIALWORK.COM
CONTINUUM of CARE
One of Cincinnati’s finest restaurants
Chef William’s menu is so delicious and our dining room so elegant that our residents feel like they are dining out every night. Join us for a complimentary meal and tour to experience Life at The Lodge. • Luxury independent & assisted living • One and two bedroom, studio & cottage homes
The
Lodge
BEST
NURSING HOMES 2014
RECOGNIZED BY US NEWS & WORLD REPORT AS AMONG THE HIGHEST RATED NURSING FACILITIES IN CINCINNATI
Helping People Enjoy an Active & Healthy Lifestyle 12050 Montgomery Road (513) 683-9966
COMMUNITY Please say, “I foundwww.lodgeretirementcommunity.com you in Case Management & Social Work.”
RETIREMENT
12
The Lodge Retirement Community offers a quality of life along with comfort and care to allow you to “Enjoy an Active and Healthy Lifestyle.”
We offer remodeled accommodations ranging from Cottage style living to 1 and 2 bedroom apartments along with studios and efficiencies. Recent renovations feature all new kitchens which include granite countertops on beautiful light oak cabinets and marble tops on oversized vanities in all baths. These enhancements add to the flair of these senior friendly floor plans. Our list of amenities includes a hair salon, on-site banking, group and individual transportation services, and the best dining experience in Cincinnati prepared by Chef William! We are dedicated to serving the needs of our residents. Many of The Lodge residents come to reside in independent living but as their needs change they can rely on Helping Hands. Helping Hands is our value added assistance program that provides services such as dressing and showering assistance, medication reminders, escorts to meals or activities, bed making, trash removal, or a simple comfort check. If you elect these services, a Lodge Retirement Community staff person comes right to your apartment or cottage to help with these day-to-day needs. With such an extensive pick list of additional services the resident and his/her family will feel reassured and safe that their needs will be met. The Lodge Retirement Community also offers Assisted Living for residents who need a more controlled level of care. These needs may range from medication management, diabetic blood levels testing and injections to assistance with all activities of daily living (i.e. getting dressed, bathing, or toileting). The fee schedule for assisted living is set at one price regardless of the number of daily visits needed. Our assisted living residents have their own dining room to enjoy where they receive more personalized assistance to enhance their dining experience.
13
CASEMANAGEMENTSOCIALWORK.COM
HOME CARE
In-Home Care Services
Care Beyond Compare!
At Comfort Keepers®, we provide in-home care that helps seniors and others live safe, happy, and independent lives in the comfort of their own homes. Companion Care Light Housekeeping Personal Care In-Home Safety Solutions
Contact Us Today West Chester/Mason (513) 755-3710
HydePark/Anderson (513) 752-5533
Miamitown (513) 353-2640
Middletown/Monroe (937) 312-9900
Most offices independently owned and operated. • ©2014 CK Franchising, Inc.
Westchester-123.ComfortKeepers.com Please say, “I found you in
14
Case Management & Social Work.”
HOSPICE
Compassionate. Efficient. Correct.
And right now. When case managers have a problem. VITAS is the answer. When your concern is the frailest of your patients, VITAS has your back. Calling VITAS can reduce lengths of stay, end rehospitalization, and do the right thing for patients and families. Call us for a hospice evaluation; we’re always available.
Referrals: 1.800.93.VITAS VITAS.com
VITAS makes accessing hospice clinical criteria and referrals incredibly simple with our FREE app. Just scan the QR Code and follow the instructions to download the app.
15
CASEMANAGEMENTSOCIALWORK.COM
Making a Difference in Patients' Lives
Hospice of Southwest Ohio shares successes with a variety of programs they offer hospice patients. Hospice is a word that can strike the state, HSWO received a 100%, with 0 fear and loss in the heart of a loved- deficiencies. one. The word generally implies that A new inpatient center for hospice the end is near for a loved-one, and patients set to open at the beginning of they are lying on their death bed with October. The facility will offer nine beds and perhaps only days or weeks to live. increase the quality of care for patients who Hospice does not have to be a negative have pain and/or a symptom to manage that doom and gloom experience. It can be is uncontrolled. Located in Madeira, Ohio, a positive experience for a family, where HSWO’s Care Center is centrally located for memories are made, and the patient in need easy access. of care is in a comfortable environment Part of Hospice of Southwest Ohio’s with quality care and opportunities to enjoy success is due to the variety of programs they precious time with loved ones. offer their hospice patients. Hospice of Southwest Ohio is working “We try to provide whatever services the 7625 Cincinnati, Ohio 45243 to Camargo change theRoad perception of Hospice care. Phone: families513.770.0820 need,” said Joe Killian, CEO. “We offer cutting edge services to meet the have teams that look at and examine all the Fax:They 513.770.0848 e-mail: info@hswo.org needs of the wide range of patients they see. different variables for the programs we offer In their most recent survey performed by Director CareBridge Palliative Care Services to make life easier for patients and families.”
Phone: 513.528.8150 Please say, “I found you in
16
Case Management & Social Work.”
SKILLED NURSING & REHAB
17
CASEMANAGEMENTSOCIALWORK.COM
There is a lot of data these days that available supports the notion that our health care spending is unsustainable. Consequently, the government and health care experts are using this problem as an opportunity to improve quality and reimburse providers based good outcomes. All provider types are now being measured on their quality and this will ultimately impact future partnerships between skilled nursing facilities and acute care hospitals. Skilled Nursing Facilities are an integral part of the post-acute care spectrum. Post-acute is defined as a level of medical care designed to improve the transition from the hospital to the community. The two most common types of post-acute care include skilled nursing facilities (SNFs), home health agencies (HHA), palliative care, and assisted living facilities. The type of care one can expect to receive in a post-acute care setting include skilled nursing, physical therapy, occupational therapy, and speech therapy, as well as a multidisciplinary approach to care that includes social service and nutrition as well. There are a variety of metrics used to measure SNFs. They include patient satisfaction, 30-day all-cause Please say, “I found you in
rehospitalization, emergency department utilization, staff retention/turnover. The national average for 30-day all-cause hospital readmission is 18.4% (as of May 2013). Through a variety of strategies including the use of nurse-practitioners, advanced care-planning and increased training of our nurses, we have experienced positive outcomes when it comes to the 30-day readmission rate at each of the facilities. Glendale Place Nursing & Rehab Center (as of 12/31/13): 14.6% Lodge Nursing & Rehab Center: 15.8% Oak Creek Terrace Nursing & Rehab Center: 13.4% Western Hills Nursing & Rehab Center: 11.3% There is still a lot of work to be done. We continue to evaluate the types of services we can provide and are constantly looking at adding new services such as peritoneal dialysis and mist therapy. Our values are based on results – high patient satisfaction and good outcomes. If you want to learn more about one of our facilities, please contact our Admissions Directors and arrange for a tour.
18
Case Management & Social Work.”
SKILLED NURSING & REHAB
For a quick return home
Set up your tour today!
BEST
NURSING HOMES 2014
RECOGNIZED BY US NEWS & WORLD REPORT AS AMONG THE HIGHEST RATED NURSING FACILITIES IN CINCINNATI
Providing post-acute services including: • Post Surgical Rehab • Physical Therapy • Speech Therapy
• Occupational Therapy • Wound Care
Helping People Resume an Active & Healthy Lifestyle. 19 CASEMANAGEMENTSOCIALWORK.COM 9370 Union Cemetery Road • (513) 677-4900 • www.lodgecarecenter.com
Live Well at Home with a Higher Class of Care Home Care Assistance’s three concentrations of care are always available to clients at no extra cost. While most agencies merely offer a general plan of care to the unwell, Home Care Assistance features three specialized areas of home care: Balanced Care, Cognitive Stimulation and Post-hospitalization Care. Through our proprietary Home Care Assistance University, caregivers master care in each of these areas, reflecting best practices and up-to-date research. Just take a look... Balanced Care is for those seniors who choose to age in their own homes. All caregivers receive training in our Balanced Care Method™, which is a holistic program that promotes healthy mind, body and spirit for aging adults. The Method supports healthy longevity through five major tenets: healthy diet, physical exercise, mental stimulation, socialization and sense of purpose. Cognitve Therapeutics is designed to keep aging minds sharp and delay cognitive decline. The Cognitive Therapeutics Method™ engages clients in research-based activities to improve mental acuity and slow the progression of symptoms in individuals with mild to moderate cognitive decline. Hospital to Home Care is for those seniors who need help after a medical incident. We are the experts on a smooth recovery at home, having written the popular book From Hospital to Home Care. And most important, our caregivers are available 24/7 at a cost-effective live-in rate.
Call today to learn more about our unique approach to home care! Receive a FREE copy of our book Happy to 102 when you schedule a complimentary in-home assessment!
513-891-CARE Please say, foundAges you Changing the Way the“IWorld
in
HomeCareAssistanceCincinnati.com Case Management & Social Work.” 20