Dallas-Collin-Denton Case Management Social Work by Case Management & Social Work

Referral Guide

PRIOR TO YOUR NEXT DISCHARGE: Tips & Tools for Caregivers Guide to Senior Care Options & Patient Care Assisted / Alzheimer’s – Home Healthcare – Hospice – Home Care Private Duty Nursing - Skilled Nursing & Rehabilitation – Rehabilitation Hospital MOBILE AND DIGITAL AVALIABLE

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Educate your patients ! and their loved ones on the benefits of!!

Residential*Care*Homes.! Residential Care Homes are dedicated to promote excellent quality living environment for senior adults. Each residential care home provides an enhanced lifestyle to meet the daily needs of each resident from healthcare to personal care. Families (Caregivers) need to have assurance and feel safe knowing their loved one is receiving the highest level of enriched living services and activities based on their condition and individual circumstances. Residential Care Homes understand emotional and physical need of each resident. Staff members can both care for them and appreciate and respond to their needs as elder adults.

Caregivers)may)call)today)for)a)tour)or)one)of)our)friendly)staff) members)would)be)more)than)happy)to)visit)the)family)or)senior)adult) at)the)hospital)or)skilled)nursing)facility.))

Loyds%of%Dallas! 214.924.5446! www.loydsofdallas.com!

Groom%Senior%Living! 214.383.9077! www.groomseniorliving.com!

Hillcrest%House! 214.213.3062! www.thehillcresthouse.com! 3 CASEMANAGEMENTSOCIALWORK.COM

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CONTENTS

DALLAS-COLLIN-DENTON Vol 4 Issue 3

15 Levels of Care ASSISTED LIVING / ALZHEIMER’S 6 Programs and assistance designed with those with memory loss; some communities will provide specially trained security measures to prevent residents from wandering. HOME HEALTHCARE 9 Allowing patients to remain at home eliminating travel for treatment; alternative to hospital stay or a skilled nursing facility.

PRIVATE DUTY NURSING 18 Working one-on-one with individuals involve pediatric to geriatric patients on Supplemental Security Income (SSI) that have long term illnesses such as Cerebral Palsy (CP)and Traumatic Brain Injuries (TBI). Many of the patients have Gastrostomy Tube (G-Tube), Tracheostomy Care (Trach), or Ventilator (Vent). The private duty nurse are in many cases Registered Nurses (RN) or Licensed Vocational Nurses (LVN)

HOME CARE 12 Allowing a non-medical home care assistant (caregiver) provide transportation, meals, and daily needs.

REHABILITIONAL HOSPITAL 20 Providing various neurological, musculoskeletal, orthoped\ic and other medical conditions following stabilization of their acute medical issues.

HOSPICE 14 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.

SKILLED NURSING & REHAB 23 Licensed and equipped to provide healthcare which meets the needs of more extensive physical issues, and assist residents to regain mobility.

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ASSISTED LIVING / ALZHEIMER’S

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ASSISTED LIVING / ALZHEIMER’S

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ASSISTED LIVING / ALZHEIMER’S

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HOME HEALTHCARE

Coverage Map If you have a patient who is out of our coverage area, we would be happy to help you find an agency that can accommodate your patients.

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HOME HEALTHCARE

Services Provided:

Lab Work Enterostomal Care Pulmonary Care Anodyne Therapy Fall Prevention

Wound Care Diabetic Care Nutritional Education Rehabilitation

Staff Includes: Speech Therapist Social Workers Home Health Aids

Registered Nurses Physical Therapist Occupational Therapist

Call us! 972.412.1540 Fax 972-475-4443

5001 Rowlett Rd., Ste 300 - Rowlett, TX 75088 info@healthquestoftexas.com Licensed & Certified Home Health Agency Serving Dallas / Ft. Worth Area Since 2003

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We Are Ready to Care for Your Patients

Great Care From Great People Veritas Home Health is different than all other Home Health agencies, as it was designed and engineered around the core values of: Integrity, Honesty, Quality and Truth. ! Experienced in-home Registered Nurses: with minimal clinician turnover to assure quality ! Dedicated team of Therapists: are in-house and lead by a Physical Therapist Skilled Therapy services include: Physical Therapy, Occupational Therapy, Speech Therapy ! Registered Nurse Clinical Supervisors: review every case each step of the way to assure top line results ! Specialized In-Take Coordinators: help to qualify clients and to coordinate immediate clinical results Thank you again for your consideration and care during my mother’s illness. You and your staff were wonderful with her and tremendous support to me and the rest of the family. Please extend my thanks to all. — Susan B.- Dallas Veritas Home Health is always willing to go the extra mile for the residents. They handle referrals in a timely manner and give excellent feedback after discharging patients. I have never received a complaint from a resident regarding the care that they received from Veritas Home Health. — Assisted Living Facility - Plano

We work with several insurance companies ! Medicare ! Medicaid / STAR+PLUS ! United Healthcare ! SecureHorizons

! ! ! !

AARP MedicareComplete HealthSpring Humana Most Fee for Service Plans

Medicare pays 100% for covered Home Health Care services. We work with doctors, social workers, hospital discharge planners to arrange for Medicare-covered home health care.

Call Us Today to Assist You With Your Patients. Veritas Home Health, LLC 2825 Regal Rd. Suite 105 Plano, TX 75075 Phone: 972-519-0308

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HOME CARE

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HOME CARE

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HOSPICE

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HOW TO PREVENT

CAREGIVER BURNOUT In 1963, only 17 million Americans lived to 65 years of age. In 2011, the first of the 78 million baby boomers (those born 1946-1964) turned 65. It is projected that the number of older Americans will reach 71 million by 2030 (when all baby boomers have reached 65 years of age) and 88.5 million by 2050. The coming decades will not only see a significant increase in the aging population, but a growing need for family caregivers. According to the National Alliance for Caregiving and AARP, there are 65.7 million caregivers in the United States, of which 43.5 million work with someone 50 years of age or older. On average, caregivers spend 21 hours a week at the job, with those that live with their care recipient providing 39.3 hours per week. Although these unpaid family caregivers play an important role and make many contributions, it often comes at a considerable cost to themselves. Caregiving can be a long and often overwhelming journey, impacting a caregiver’s physical health, mental health, employment, social relationships, family relationships, and overall quality of life. It is estimated that families provide between 80 to 90 percent of the overall long-term care to older Americans, including helping with activities of daily living tasks (dressing, feeding, grooming), monitoring medications, laundry, housekeeping, emotional support, transportation, shopping, etc. All the

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ensuing pressure and stress can lead to a condition called “caregiver burnout.” To prevent this problem, one needs to know how to identify the warning signs and manage the stress. Stress can manifest itself emotionally, physically, and/or cognitively. • Emotional warning signs include anger, loss of interest in hobbies, increasingly impatience and irritability, frequent crying or tearfulness, mood swings, and chronic anxiety. • Physical warning signs include tension headaches, problems with sleep, chronic back pain, teeth grinding, chronic fatigue, and weight gain or loss. • Cognitive warning signs include obsessive thinking, short term memory loss, decreased concentration, limited attention span, and difficulty in making decisions. Stress can impact the caregiver’s well-being as well as the ability to provide care. Although we cannot always avoid the circumstances that cause stress, finding ways to reduce caregiver stress will help lessen the toll caregiving has on an individual. Remember that caring for yourself is not selfish; managing your own stress is just as important as managing your loved one. Tips for managing stress include: • Exercise Exercise can keep your circulation going, relieve stress, and enhance your mood. Even 15 minutes of walking or stretching can be enough. Try to get in the routine of doing a physical activity every day. When your body is fit, it can manage stress better. • Make time for yourself Setting aside some time for yourself may seem impossible, but it is necessary to recharge your own batteries. Do what you enjoy — reading, gardening, going for a walk, or knitting for example. Use relaxation techniques such as meditation, yoga, or deep breathing. • DON’T IGNORE YOUR FEELINGS AND EMOTIONS Pay attention to your own feelings and emotions and recognize when to get help. If needed, speak with a trusted friend or family member or seek professional counseling. PLEASE SAY “I FOUND YOU IN

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Feelings such as anger and

frustration are normal and do not mean you are a bad person.

• KEEP ON TOP OF YOUR OWN HEALTH Don’t forget about your own doctor appointments. It is very easy to forget about your own health; however, you need to be healthy so you can be there for your loved one. Stop or don’t start smoking; don’t rely on alcohol or drugs to reduce your stress. • GET ENOUGH SLEEP Your body needs enough rest and sleep to recover from the daily stressors. When you don’t have enough sleep, your mood and energy level will suffer.

care. Stay involved. Maintain or start up a hobby or outside interest. If you can’t get out to socialize, talk on the phone or use your computer or other technology to communicate with others. Staying social is an important part of maintaining emotional well-being.

• EAT WELL Nourish your body with foods that will help maintain your energy level such as whole grains, lean protein, and fresh fruits and vegetables. Stay hydrated; drink six to eight glasses of water a day. Limit your alcohol and caffeine intake.

• Join a support group A caregiver support group cannot only provide support for you but you may be able to provide support for others. Connecting with other caregivers can be invaluable and can reduce feelings of frustration, stress, and isolation.

• ASK FOR HELP Don’t try to do it all alone. Seek and accept the support of others. Enlist friends and family to help. Divide up caregiving responsibilities. Be willing to give up some control and delegate.

• Connect with community resources You don’t have to do it alone. Reach out for help. There are services and programs to help caregivers in the community including individual counseling, caregiver support programs, adult day care centers, home health aides and companion providers, respite care, transportation services, and skilled nursing facilities. A. Kaplan

• Maintain or increase socialization It is very easy to become isolated especially the longer we provide

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PRIVATE DUTY NURSING

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PRIVATE DUTY NURSING

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REHABILITATION HOSPITAL

REAL PATIENTS. REAL STORIES.

Baylor “helped me pickup the pieces.

”

Patti Foster was on her way to a Bible study, when a semi-truck driver rear-ended the vehicle she was riding in at full speed. “The impact ejected me out of the side of the SUV,” she says. “And from there, life changed.” Patti sustained multiple traumatic injuries, including a traumatic brain injury. She spent five weeks in a coma in ICU and then moved to Baylor. “Baylor taught me how to live again. I was like a 34-year-old infant. I had to relearn everything.” Today, Patti is an inspirational speaker and does voiceovers for radio and TV. She also volunteers at Baylor. “I want to tell other patients not to give up. Because I’m a walking miracle.” Baylor Institute for Rehabilitation is one of only 16 facilities throughout the nation to be designated as a model system of care for patients with traumatic brain injury by the National Institute on Disability and Rehabilitation Research. To make a referral, or for more information, call 1.877.7BAYLOR or visit us online at BaylorHealth.com/BIR. DALLAS t NORTHWEST DALLAS t FORT WORTH t FRISCO t GARLAND t IRVING Baylor Institute for Rehabilitation is part of a comprehensive inpatient and outpatient rehabilitation network formed through a partnership between Baylor Institute for Rehabilitation and Select Medical. Physicians are members of the medical staff at Baylor Institute for Rehabilitation and are neither employees nor agents of Baylor Institute for Rehabilitation, Baylor Health Care System, Select Medical or any of their subsidiaries or affiliates. ©2013 Baylor Health Care System BIR_271 CE 02.13

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Introducing Rehabilitation and Wellness Centre of Dallas, where we specialize in providing Transitional Care and Post-Acute Services. Management Team Our management team has over 60 years of combined experience in providing top quality nursing care with a enhanced focus on Customer Service. Location We are conveniently located just blocks from Baylor University, Medical Center, Baylor Specialty Hospital and Baylor Institute for Rehabilitation. Our Community Leaders CEO/Executive Dir. John Berg Dir. of Business Development, Penni Smith Dir. of Clinical Services, Romona S. Few, BSN RN Dining Services Executive Chef, Arturo Liberuto Physicians Partnerships Dr. Ankit Punatar Medical Director of Post-Acute Services Dr. Susan Kohl Medical Director of Quality Assurance Dr. Neeta Nayak Attending Physician Dr. Andrew Applewhite Wound Care Dr. Susan Warden Physical Medicine and Rehab

Where Your Health & Wellness is our top Priority! 4200 Live Oak St. Dallas, TX 75204 (214) 821-0050

www.rehabandwellnessofdallas.com

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REHABILITATION HOSPITAL

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SKILLED NURSING & REHAB

Bridging the Gap From Hospital to Home

Whether you are on a FAST TRACK to recovery or need a place you can call home, we have a place for you. Featuring Physical Therapy • Occupational Therapy • Speech Therapy • IV Therapy Orthopedic Rehabilitation-Hip/Knee Fractures and Replacements Stroke Rehabilitation • Wound Management Pain Management • Comprehensive Discharge Planning

Arlington • 817-274-5571

Ennis • 972-875-9051

Hurst • 817-282-6777 Lancaster • 972-227-6066 Desoto • 972-223-3944

Cleburne • 817-558-8999 Keller • 817-577-9999

Fort Worth • 817-626-5454

Grapevine • 817-488-8585

Richland Hills • 817-589-1734

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SKILLED NURSING & REHAB

A name you can trust for rehabilitation and health care.

Post-Surgical, Short-Term Rehab Heartland - Austin Heartland - Bedford ManorCare - Dallas Heartland - Fort Worth Heartland - North Richland Hills Heartland - San Antonio Heartland - San Antonio North ManorCare - Sharpview ManorCare - Webster ManorCare - West Houston ManorCare - Willowbrook

800.736.4427 www.hcr-manorcare.com

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SKILLED NURSING & REHAB

Spring Into Action... Acadia offers the best care in town! We create a Personal Service Plan for each resident that focuses on individual needs and preferences so you only pay for services used. Our health services staff includes a full time RN, LVN and LVN Charge Nurses. In addition, our and available day and night.

Don’t Wait! Call now to arrange

complimentary meal and tour! 972-247-2266

Dallas, TX Fac.#030401

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SKILLED NURSING & REHAB

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We Are Ready to Care for Your Patients

We work with several insurance companies ! Medicare ! Medicaid / STAR+PLUS ! United Healthcare ! SecureHorizons

! ! ! !

AARP MedicareComplete HealthSpring Humana Most Fee for Service Plans

Medicare pays 100% for covered Home Health Care services. We work with doctors, social workers, hospital discharge planners to arrange for Medicare-covered home health care.

Call Us Today to Assist You With Your Patients. Veritas Home Health, LLC 2825 Regal Rd. Suite 105 Plano, TX 75075 Phone: 972-519-0308

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Senate proposal to give veterans private care carries big price tag

The Senate moved quickly this week to pass a measure that lowers the barrier for veterans to seek healthcare in private settings, in response to the ongoing wait list scandal at Veterans' Affairs facilities. But now a Congressional Budget Office estimate that the measure will cost $50 billion is fueling speculation and concern about how the measure will be paid for. Roughly 8.4 million veterans already receive healthcare from the VA, and another 8 million are eligible, but aren't enrolled, according to the CBO. But as word gets out that there is greater access to private care available, not only could those currently getting care at VA hospitals increase their utilization, but those currently eligible and not using it could jump into the system as well. Such a scenario could ultimately lead to the $50 billion-a-year scenario the CBO projects if the legislation becomes permanent, up from the $35 billion the provision is expected to cost over its first three years, the CBO said. Experts are split as to where such funds could come from.

For instance, any attempt to pull it from Medicare's $526 billion fiscal 2015 budget will meet resistance. “With Medicare, there isn't the low-hanging fruit there used to be,” said former CMS administrator Tom Scully, a general partner at private-equity firm Welsh Carson Anderson & Stowe. Further, there would likely be a major pushback from physician members of the House of Representatives who have PLEASE SAY “I FOUND YOU IN

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been unable to pull funds from that budget to permanently eliminate Medicare's sustainable growth-rate formula, he said.

Taking funds from Patient Protection and Affordable Care Act programs would spark Democratic opposition, just as passing a new tax on wealthy Americans would antagonize Republicans, so those partisan bromides seem out of play, said Ed Lorenzen, a senior advisor to the Committee for a Responsible Federal Budget, a nonpartisan fiscal watchdog group. The revenue could come from the Veterans Affairs Department itself, following a major restructuring, according to economist Chris Edwards of the libertarian Cato Institute. “If they want to offer veterans the option of going to private facilities, than they should start closing government facilities,” Edwards said, suggesting that underutilized centers should be targeted. But restructuring a federal agency takes time, and will likely mean major political battles, as groups such as the Veterans of Foreign Wars and others weigh in to protect what they see as a valuable VA healthcare system for their members. Another possibility is that the non-VA care provision of the measure will be rewritten to be more restrictive, to lower overall costs and so dampen objections, says Paul Van de Water, a senior fellow at the Center for Budget and Policy Priorities, a left-of-center research group. Others see Congress and the president agreeing to waive federal pay-for rules that require any new spending measure to be offset with a cut or new revenue from elsewhere. Given the history of budget battles between the administration and Congress, this also is difficult to imagine. “It would be a general obligation of government. Without new revenue, it would add to the deficit and require increased borrowing,” explains Henry Aaron, a senior fellow at the Brookings Institution, a liberal-leaning think tank. The Senate appeared open to the option, voting 75-19 to bypass pay-for regulations in a separate procedural vote before the bill hit the Senate floor and passed 93-3. However, experts noted that many lawmakers had not yet seen the CBO cost estimate before they voted. And the Republican-controlled House will be expected to be more concerned about any effort to add to the federal deficit, no matter how well-meaning. The Committee for a Responsible Federal Budget, which calls itself non-partisan, Friday had begun the likely chorus against new an unfunded VA bill, saying on its blog “any new spending must be fully offset elsewhere in the budget, both for fiscal reasons

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and to reflect a real commitment to this program. If something is worth doing, it is for, and failing to do so leaves that program more vulnerable.” worth paying

Once a compromise bill is written, and if there is no pay-for solution, the House and Senate would have to vote to waive pay-for rules and then vote on the new bill. Lawmakers are hoping to accomplish all of that by the end of June. The president has indicated he will sign any bill Congress sends him. The three senators who voted against the Senate bill, Bob Corker (R.-Tenn.), Ron Johnson (R-Wis.) and Jeff Sessions (R-Ala.), have been slammed by the powerful Veterans of Foreign Wars for citing concerns about cost. “There is a cost of going to war that includes taking care of those who come home wounded, ill and injured, and if these three senators have determined that we can't afford to properly care for our veterans, then they should seek employment elsewhere!” VFW National Commander William Thien said in a statement. Some hospitals are suggesting that the price tag for non-VA healthcare could be cut if some non-elderly veterans, who are currently not able to get treatment at a VA facility, instead join Medicaid. To that end, Tom Bell, president and CEO of the Kansas Hospital Association and Herb Kuhn, president and CEO of the Missouri Hospital Association have teamed up, using the VA scheduling crisis as a chief talking point in a series of editorials in local newspapers that are aimed at getting their state officials to pass Medicaid expansion laws. They estimate that 37,576 Kansas and Missouri veterans and family members would be eligible for Medicaid coverage under the expansion. “It's the job of elected state officials to help the nearly 40,000 veterans and their family members gain access to that line,” they said in one of the op-ed pieces. “That could easily be done by expanding coverage and access to care for our veterans and for thousands of other hard-working individuals.” The American Legion contends that any provision allowing private care for veterans should only last for a short time. “The next time anyone proclaims that veterans might be better off if we privatized their VA-authorized healthcare, all we have to do is hold up this report [from the CBO] and ask—and who's going to pay for it?,” said Louis Celli Jr., director of the national legislative division of the American Legion. “There's no better bargain or emphasis on quality of [service] specific conditions—on a national scale—than the VA,” he said. V. Dickson PLEASE SAY “I FOUND YOU IN

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Where Your Health & Wellness is our top Priority! 4200 Live Oak St. Dallas, TX 75204 (214) 821-0050

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Bridging the Gap From Hospital to Home

Arlington • 817-274-5571

Ennis • 972-875-9051

Hurst • 817-282-6777 Lancaster • 972-227-6066 Desoto • 972-223-3944

Cleburne • 817-558-8999 Keller • 817-577-9999

PLEASE SAY “I FOUND YOU IN Fort Worth • 817-626-5454

Grapevine • 817-488-8585

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Richland Hills • 817-589-1734