Referral Guide
Managing Alzheimer’s Guide to Senior Care Options & Patient Care Assisted / Alzheimer’s – Home Healthcare – Hospice – Home Care Senior Living - Skilled Nursing & Rehabilitation – Rehabilitation Hospital MOBILE AND DIGITAL AVALIABLE
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CONTENTS
Volume 2 Issue 3 Colorado
Managing Alzheimer’s Symptoms: Sleep Problems
Levels of Care
FEATURE
ASSISTED LIVING / ALZHEIMER’S 4 Programs and assistance designed with those with memory loss; some communities will provide specially trained security measures to prevent residents from wandering. Along with assistance with daily activities, some level of healthcare services are provided. HOME HEALTHCARE 10 Allowing patients to remain at home eliminating travel for treatment; alternative to hospital stay or a skilled nursing facility. SKILLED NURSING & REHAB 12 Licensed and equipped to provide healthcare which meets the needs of more extensive medical issues, and to regain strength
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ALZHEIMER’S 5 10 Helpful Tips When Communicating with Patients Who have Alzheimer’s. BROUGHT TO YOU BY Bethesda Senior Living
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ASSISTED LIVING / ALZHEIMERS
Welcome Home We offer these
2045 Roanoke St. Colo Spgs, CO 80906 (719) 471-2285
5055 S. Lemay Ave. Ft Collins, CO 80525 (970) 223-3552
2680 N. 15th St. Grand Junction, CO 81506 (970) 241-9706
12610 Hudson St. Thornton, CO 80241 (303) 350-5820
555 S. Rockrimmon Blvd. Colo Spgs, CO 80919 (719) 528-8000
With social and recreational activities, it’s an adventure every day. No Long-Term Contracts Elegant Living Atmosphere Compassionate Care Staff Available 24/7 Enriching Activities and Outings Spacious Floor Plans Transportation Available
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Helpful Tips When Communicating with Patients Who Have Alzheimer’s
1. Make eye contact. Alzheimer’s leads to loss of peripheral vision that could scare patients if approached from behind. It’s important to approach patients from the front, creating a calm situation, and to prevent any unintentional harm. 2. Talk slow: Going to the hospital is a daunting and stressful experience that can be challenging for patients to communicate their level of pain, or may need assistance to express their feelings due to the limited verbal abilities. 3. Listen without interrupting patients. The ability to complete sentences may take a longer amount of time, be patient and try to understand their needs. 4. Avoid arguing or correcting patients with Alzheimer’s, as the short-term memory and rational skills are limited. 5. When speaking with patients, sit next to them, look at them in their eyes, soft spoken and calm tone of voice. Limit the amount of distractions around the room when you are speaking with them in. 6. Avoid being too loud, or talking too quick, or harsh. 7. Make short talk with asking questions with “yes” or “no” answers, to create a limited amount of time in having to
use their memory skills. 8. Address patients by using their name to keep them focused and know you are speaking to them. 9. Limit their ER visit time to assist them from gaining confusion in a being in an unknown location. If patient is staying in the hospital, place visuals; for example, family photos, etc.. to make them feel comfortable with their surroundings. 10. Ensure patient has more than normal amount of nurses, staff, or family to check on them during their stay at the hospital. Do not discharge patients without a memory care community like Bethesda Senior Living to see if they can assist in discharge planning for the patient. BROUGHT TO YOU BY
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Managing Alzheimer’s Symptoms: Sleep Problems
Brain disease often disrupts the sleep-wake cycle. Alzheimer's patients may have wakefulness, disorientation, and confusion beginning at dusk and continuing throughout the night. This is called “sundowning.”
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HELPGUIDE.ORG
There are two aspects to sundowning. First, confusion, over-stimulation, and fatigue during the day may result in increased confusion, restlessness, and insecurity at night. And second, some Alzheimer's patients have fear of the dark, perhaps because of the lack of familiar daytime noises and activity. The patient may seek out security and protection at night to alleviate this discomfort. WAYS TO REDUCE NIGHTTIME RESTLESSNESS • Improve sleep hygiene. Provide a comfortable bed, reduce noise and light, and play soothing music to help them get to sleep. If the person prefers to sleep in a chair or on the couch, make sure they can’t fall out while sleeping. • Keep a regular sleep schedule. Be consistent with the time for sleeping and keep the nighttime routine the same. For example, give the person a bath and some warm milk before bed.
• Keep a night light on. Some people with dementia imagine things in the dark and become upset. Stuffed animals or a pet may also help soothe the patient and allow them to sleep. • Place a commode next to the bed for nighttime urination. Walking to the bathroom in the middle of the night may wake the person up too much, and then they can’t get back to sleep. Increase physical activity during the day to help the person feel more tired at bedtime.
• Monitor napping. If the person seems very fatigued during the day, a short rest in the afternoon can lead to a better night’s sleep. But keep naps short—too much daytime sleep can increase nighttime wakefulness. • Limit the patient’s caffeine, sugar, and junk food intake during the day. If the patient paces during the night, make sure that the primary daytime caregiver can sleep. This requires either a very safe room for the patient to pace in, or else another caregiver who takes over at night. You need your rest, too. Do not restrain the patient in bed, but consider a hospital bed with guardrails in the later stages of Alzheimer’s. If night wakefulness has gotten too hard for you to manage, consult with a doctor if you wish to try administering sleeping pills.
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HOME HEALTHCARE
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SKILLED NURSING & REHAB
TAKE YOUR PICK Wherever you are in Colorado, there’s a Life Care Centers of America facility close by. Berkley Manor Care Center Denver | 303.320.4377
Life Care Center of Longmont Longmont | 303.776.5000
Briarwood Health Care Center Denver | 303.399.0350
Life Care Center of Pueblo Pueblo | 719.564.2000
Cañon Lodge Care Center Canon City | 719.275.4106
Life Care Center of Stonegate Parker | 303.805.2085
Columbine Manor Care Center Salida | 719.539.6112
Life Care Center of Westminster Westminster | 303.412.9121
Evergreen Nursing Home Alamosa | 719.589.4951
San Luis Care Center Alamosa | 719.589.9081
Garden Terrace Alzheimer’s Center of Excellence Aurora | 303.750.8418
University Park Care Center Pueblo | 719.545.5321 Valley View Villa Fort Morgan | 970.867.8261
Hallmark Nursing Center Denver | 303.794.6484 Heritage Park Care Center Carbondale | 970.963.1500 Life Care Center of Aurora Aurora | 303.751.2000
Villa Manor Care Center Lakewood | 303.986.4511 Western Hills Health Care Center Lakewood | 303.232.6881
Life Care Center of Colorado Springs Colorado Springs | 719.630.8888 Life Care Center of Evergreen Evergreen | 303.674.4500 Life Care Center of Greeley Greeley | 970.330.6400
Joint Commission accredited Rehabilitation and skilled nursing
Life Care Center of Littleton Littleton | 303.795.7300
LCCA.COM
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SKILLED NURSING & REHAB
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For many caregivers, there comes a point when they are no longer able to take care of their loved one at home. Choosing a residential care facility—a group home, assisted living facility, or nursing • It's helpful to gather information about services and options before the need actually arises. This gives you time to explore fully all the possibilities before making a decision. • Determine what facilities are in your area. Doctors, friends and relatives, hospital social workers, and religious organizations may be able to help you identify specific facilities. • Contact the places that interest you and make an appointment to visit. Talk to the administration, nursing staff, and residents. • Observe the way the facility runs and how residents are treated. You may want to drop by again unannounced to see if your impressions are the same. • Find out what kinds of programs and services are offered for people with Alzheimer's and their families. Ask about staff training in dementia care, and check to see what the policy is about family participation in planning patient care.
• Check on room availability, cost and method of payment, and participation in Medicare or Medicaid. You may want to place your name on a waiting list even if you are not ready to make an immediate decision about longterm care. • Once you have made a decision, be sure you understand the terms of the contract and financial agreement. You may want to have a lawyer review the documents with you before signing. • Make a list of questions you would like to ask the staff. Think about what is important to you, such as activity programs, transportation, or special units for people with Alzheimer's disease. Moving is a big change for both the person with Alzheimer's disease and the caregiver. A case manager or social worker may be able to help you plan for and adjust to the move. It is important to have support during this difficult transition.
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ELIMINATE HARM ACROSS THE BOARD Days Since Last Readmission READMISSIONS PREVENTION:
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Conduct enhanced admission assessment of discharge needs and begin discharge planning at admission
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Conduct formal risk of readmission assessment; align interventions to patient’s needs and risk stratification level
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Perform accurate medication reconciliation at admission, at any change in level of care and at discharge
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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
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Identify primary caregiver, if not the patient, and include him/her in education and discharge planning
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Use teach-back to validate patient and caregiver’s understanding
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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
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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
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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
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