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Depression and Suicide Screening Tools

Depression is a common mental health condition that affects people of all ages. However, older adults are at a higher risk of developing depression due to factors such as social isolation, physical illness, and life changes like retirement or loss of loved ones. Therefore, it is crucial to screen older adults for depression and suicidal ideation to provide early intervention and support.

Screening Tools for

Depression in Older Adults

There are several screening tools available to assess depression in older adults. Some of the commonly used tools include:

1. Geriatric Depression Scale (GDS): The GDS is a 30-item questionnaire that assesses depressive symptoms in older adults. It is a self-administered tool that includes questions about mood, energy, sleep, and appetite.

2. Patient Health Questionnaire-9 (PHQ-9): The PHQ-9 is a nine-item questionnaire that evaluates depressive symptoms in older adults. It includes questions about feelings of sadness, loss of interest in activities, changes in appetite and sleep, and suicidal ideation.

3. Center for Epidemiologic Studies Depression Scale (CES-D): The CES-D is a 20-item questionnaire that assesses depressive symptoms in older adults. It includes questions about mood, sleep, appetite, and social engagement.

These screening tools can help healthcare providers identify older adults who may be experiencing depression and provide appropriate interventions such as counseling or medication.

Screening Tools for Suicidal Ideation in Older Adults

Suicide is a significant concern for older adults who experience depression. Therefore, it is essential to screen older adults for suicidal ideation. Some of the commonly used tools include:

1. Columbia-Suicide Severity Rating Scale (C-SSRS): The C-SSRS is a six-item questionnaire that assesses suicidal ideation in older adults. It includes questions about the frequency, intensity, and duration of suicidal thoughts, as well as any plans or attempts.

2. Geriatric Suicide Ideation Scale (GSIS): The GSIS is a 31-item questionnaire that assesses suicidal ideation in older adults. It includes questions about suicidal thoughts, behaviors, and risk factors.

3. Beck Scale for Suicide Ideation (BSS): The BSS is a 19-item questionnaire that assesses suicidal ideation in older adults. It includes questions about the intensity, frequency, and duration of suicidal thoughts.

In conclusion, depression and suicidal ideation are significant concerns for older adults, and screening tools can help healthcare providers identify those who may be at risk. These tools can be administered easily and quickly and can help healthcare providers provide appropriate interventions to prevent adverse outcomes. Therefore, it is crucial to incorporate these screening tools into routine healthcare assessments for older adults to improve their mental health and overall well-being.

Article Provided by: adapt Integrated Health Care 541-440-3532 www.adaptOregon.org

Rehabilitation Facilities (See also Housing Grids pg #104-105)

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Veteran Services (continued)

Due to the large number, not all are listed in this guide This link provides a complete list: https://ltclicensing oregon gov

Housing Definitions:

Adult Day Care Programs offer a protective setting during the day for those who cannot be left alone due to health care and social needs. The structured program within a community setting offers: socialization, planned activities, care services, companionship, and meals. Adult Day Care provides daytime respite for the caregiver who typically works, needs time for other responsibilities, or simply to take a break. Some programs are designed for older adults with dementia and/or physical limitations. Day Care programs in senior housing communities that are listed in this guide must be able to accept non-residents to be included.

Adult Care Homes or Foster Care Homes are private residences that provide a home-like setting, and serve 5 or less residents. The caregiver may perform several functions such as personal care, housekeeping, activities, and group meals. There are three levels of Adult Foster Care Home licenses. The classification system is based on the level of care the Adult Foster Home may provide to residents who live in the home as well as the experience and training of the providers and their ability to assist residents with: personal hygiene, mobility, eating, dressing, toileting, and behavior management. Residents may require very light assistance or may be dependent with several care needs; it is best to ask individual locations for their specific policies and license.

Assisted Living Communities are state regulated rental properties where six or more residents may reside. Care assistance is available, including: medication management, bathing, dressing, toileting, and eating. Some may be fully self-contained private living units with a lockable door, private bathroom, and kitchenette facilities. Accommodations are typically in a home-like setting and may range from a shared bedroom with a common bathroom to private apartments with a kitchenette and a private bathroom. The fee schedule is regular monthly rent along with additional fees for specific services and amenities. Assisted living communities are best suited for individuals who want to remain as independent as possible and who are able to direct their own care. Pricing can vary greatly depending on the level of care provided and the size and amenities of each apartment.

CCRCs (Continuing Care Retirement Communities) also known as Life Plan Communities, include a continuum of care from independent living, assisted living, residential care, and skilled nursing services all on one campus allowing individuals to live within the same community as their needs progress through the spectrum of care. They typically offer the full selection of amenities associated with retirement living and an endowment fee, in addition to a monthly maintenance fee, can be expected.

Independent Living Communities provide residents an independent living setting without the burden of home ownership. Typically, residency is established on a monthly rental basis. Residents live in fully equipped private apartments or cottages from studios to large two-bedroom units that may be rental-assisted or market-rate depending on the community. Amenities and hospitality services such as housekeeping, linen service, transportation, and social and recreational activities may be included for an additional charge or may not be available at all. These communities do not provide assistance with activities of daily living or personal care.

Memory Care or Dementia Communities offer or provide care for residents with Alzheimer’s disease or other dementia in a home-like environment. These communities must receive an endorsement and are governed by additional regulations that are specifically intended to support individuals with dementia, including: a secure building that alerts staff if a resident has exited, a secure outdoor area that provides outdoor freedom safely, interior finishes that are non-glare and well lit, and visual contrasts between floors, walls, and doorways. Alzheimer’s units must also have programs, which include: gross motor, self care, social, craft, sensory enhancement, and outdoor activities.

Rehabilitation & Therapy is treatment for an injury, illness, or pain with the goal of restoring function, including nursing and therapy services. Rehab is ordered by a physician and services are provided by nurses and physical, occupational, and speech therapists. Examples include working with a physical therapist to help you walk and with an occupational therapist to help you get dressed.

Respite Care is short term relief for family caregivers to take a break from the caregiving responsibilities and allows for a healthier and better quality of life for both the caregiver and care receiver. Respite services include: companionship, personal care, recreational activities, and security. Respite care can be provided as short stay or for a longer period that allows the family caregiver to go on vacation or a business trip. Longer duration respite care is generally found at select senior housing communities although some Companion services may provide this service in the home.

Skilled Nursing Facility (SNF) or Nursing Homes are state licensed facilities that provide a safe therapeutic environment for individuals who require rehabilitative care or can no longer live independently due to functional or cognitive impairment. Nursing Homes offer 24-hour skilled nursing care and medical services by registered nurses and support professionals. This is the highest level of care that can be provided that is not hospitalization. Additionally, nursing facilities offer residents planned social, recreational, and spiritual activities. Nursing facilities are most appropriate for people who need 24-hour medical oversight and a protective/structured setting. Most residents must share their room, but residents are allowed to bring personal items to encourage a more home-like atmosphere.

Sources: Aging & Disability Services Department and Department of Health & Human Services.

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Cascades of Grants Pass, 1357 Redwood Cir, Grants Pass, 97527

103 Countryside Village, 1700 Kellenbeck Ave, Grants Pass, 97527

Foothill Retirement Center I, 2031 NE 'D' St, Grants Pass, 97526

Foothill Retirement Center II, 1997 NE 'D' St, Grants Pass, 97526

Golden Rain Apartments, 845 NE Victoria St, Grants Pass, 97526

Holiday Garden, 1051 E Park St, Grants Pass, 97527

Horizon Village, 3098 University Rd, Grants Pass, 97527

Jasmine Park I, 501 NE Anderson St, Grants Pass, 97526

Jefferson Court, 810 NE Victoria St, Grants Pass, 97526

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Canyonville, 97417

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JACKSON COUNTY

Alderwood, 131 Alder St, Central Point, 97502

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Respite Care: Self-Health isn’t Selfish

Providing care for a loved one can become quite grueling for both the family caregiver and the patient. Caregivers may find themselves feeling burned out from the stress of consistent assistance, often falling into troubling sleeping patterns and neglecting their own self-care. Respite Care provides a mutually beneficial third party resource for caregiver and patient, in which additional short-term assistance is made available in forms such as adult day centers, in-home care and counseling services, or as recovery from a hospital stay. It’s clear that a family caregiver is only as effective as his or her own self-health, and as the emotional weight of an aging loved one persists, taking a break to relax and recalibrate becomes invaluable.

Where to Find Respite Care?

Short term stays at assisted living or nursing facilities, along with additional information including webinars and Medicaid/Medicare assistance can be found at the ARCH National Respite Network’s Respite Locator: https:// archrespite.org/us-map. By simply entering the age of the patient, along with the State, Zip Code, and preferred mile radius, you will find plenty of Respite options at your fingertips.

What does Respite Care Provide?

Respite care amenities may vary by community but will typically provide 24-hour supervision, bathing assistance, meals, and medication management. This resource can be for an afternoon or up to a couple weeks.

What are the benefits of Respite Care?

Respite care provides the necessary perspective into the reality of a caregiving situation. The emotional and physical toll of caring for a loved one can never be overlooked. Maintaining a special connection against the persistence of relentless dementia is profoundly draining. As a caregiver finds their own lives changing and slipping away from them, the quality of care often dwindles, as exhaustion and frustration can start to damage this relationship in the last couple years they have together.

Access to Respite as a temporary resource allows the caregiver to simply get back to their own lives for some time. From simple sleep and relaxation to going out with friends or running errands, this bit of freedom is a way to recharge the batteries and reassess the balance necessary to maintain their own self-health.

It’s hard to acknowledge that family caregiving is often a necessary undertaking in which all parties involved wished it wasn’t necessary. Respite provides a valuable outlet for the guilt a caregiver is prone to feel when they stop and think about themselves in these troubling times. The assistance of Respite care can assure that the threshold of caregiving remains an active task to help a loved one in their final years, as opposed to a burden.

Article Provided by: Retirement Connection www.RetirementConnection.com

Assisted Living Resources

Licensing requirements for assisted living facilities vary by state and can be known by as many as 26 different names including: residential care, board and care, congregate care, and personal care. A complete list of each state’s terminology and state regulations can be found at: http://aspe.hhs.gov/daltcp/ reports/04alcom.htm

Choosing A Community

A good match between a community and a resident’s needs depends as much on the philosophy and services as it does on the quality of care.

The following suggestions can help you get started in your search for a safe and appropriate assisted living community:

• What are your future needs and how will the community meet those needs?

• Is the community close to family and friends? Are there any shopping centers or other businesses nearby (within walking distance)?

• Visit each community more than once, sometimes unannounced.

• Visit at meal times, sample the food, and observe the quality.

• Observe interactions among residents and staff and ask questions.

• Ask about social, recreational, and spiritual activities.

• Ask about the type and frequency of staff trainings.

• Review state licensing reports.

These Steps Should Also Be Considered:

• Contact your state’s long-term care ombudsman to see if any complaints have been filed against the assisted living community you are interested in. In many states, the ombudsman checks on conditions at assisted living units and nursing homes.

• If the assisted living community is connected to a nursing home, ask for information about it too. (Information on nursing homes can be found on the Medicare website at http://www. medicare.gov/nhcompare/home.asp).

It is a good idea to review The Substantiated Facility Abuse Complaints at https://ltclicensing.oregon.gov

This website contains Facility Adult Protective Services (APS) investigations that constitute abuse as determined by Corrective Action Coordinators.

Article Provided By: Retirement Connection

1-800-462-1316 www.RetirementConnection.com

Source: https://ltclicensing.oregon.gov

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What Does Medicare Cover?

Skilled nursing facility (SNF) situations

Medicare covers skilled nursing facility (SNF) care. There are some situations that may impact your coverage and costs.

Medicare Part A: (Hospital Insurance) covers skilled nursing facility care for a limited time (on a short-term basis) if all of these conditions apply:

 You have Part A and have days left in your benefit period to use.

 You have a qualifying inpatient hospital stay.

 Your doctor has decided that you need daily skilled care. You must get the care from, or under the supervision of, skilled nursing or therapy staff.

 You get these skilled services in a Medicare-certified SNF.

 You need these skilled services for a medical condition that’s either: A hospital-related medical condition. A condition that started while you were getting care in the SNF for a hospitalrelated medical condition.

Your costs in Original Medicare

You pay this for each benefit period:

 Days 1 - 20: $0 coinsurance

 Days 21 - 100: Up to $200 coinsurance per day

 Days 101 and beyond: All costs

There's a 100-day limit of Part A SNF coverage in each benefit period.

What it is: Skilled care is nursing and therapy care that can only be safely and effectively performed by, or under the supervision of, professionals or technical personnel. It’s health care given when you need skilled nursing or skilled therapy to treat, manage, and observe your condition, and evaluate your care.

Medicare-covered services in a skilled nursing facility include, but aren't limited to:

 A semi-private room (a room you share with other patients)

 Meals

 Skilled nursing care

 Physical therapy (if needed to meet your health goal)

 Occupational therapy (if needed to meet your health goal)

 Speech-language pathology services (if they're needed to meet your health goal)

 Medical social services

 Medications

 Medical supplies and equipment used in the facility

 Ambulance transportation (when other transportation endangers your health) to the nearest supplier of needed services that aren’t available at the SNF

 Dietary counseling Things to know, situations that may impact your coverage and costs.

Observation services

Your doctor may order observation services to help decide whether you need to be admitted to the hospital as an inpatient or can be discharged. During the time you're getting observation services in the hospital, you're considered an outpatient—this time does NOT count towards the 3-day inpatient hospital stay needed for Medicare to cover your SNF stay. Find out if you're an inpatient or an outpatient.

Readmission to a hospital

If you're in a SNF, there may be situations where you need to be readmitted to the hospital. If this happens, there's no guarantee that a bed will be available for you at the same SNF if you need more skilled care after your hospital stay. Ask the SNF if it will hold a bed for you if you must go back to the hospital. Also, ask if there's a cost to hold the bed for you.

Meeting the 3-day inpatient hospital stay requirement

Here are some examples of common hospital situations that show if you've met the 3-day inpatient hospital stay requirement:

Situation 1: You came to the Emergency Department (ED) and were formally admitted to the hospital with a doctor’s order as an inpatient for 3 days. You were discharged on the 4th day.

Is my SNF stay covered? Yes. You met the 3-day inpatient hospital stay requirement for a covered SNF stay.

Situation 2: You came to the ED and spent one day getting observation services. Then, you were formally admitted to the hospital as an inpatient for 2 more days.

Is my SNF stay covered? No. Even though you spent 3 days in the hospital, you were considered an outpatient while getting ED and observation services. These days don’t count toward the 3-day inpatient hospital stay requirement.

Refusing care

If you refuse your daily skilled care or therapy, you may lose your Medicare SNF coverage. If your condition won't allow you to get skilled care (like if you get the flu), you may be able to continue to get Medicare coverage temporarily.

Stopping care or leaving

If you stop getting skilled care in the SNF, or leave the SNF altogether, your SNF coverage may be affected depending on how long your break in SNF care lasts.

If your break in skilled care lasts more than 30 days, you need a new 3-day hospital stay to qualify for additional SNF care. The new hospital stay doesn’t need to be for the same condition that you were treated for during your previous stay.

If your break in skilled care lasts for at least 60 days in a row, this ends your current benefit period and renews your SNF benefits. This means that the maximum coverage available would be up to 100 days of SNF benefits.

Source: https://www.medicare.gov/whatmedicare-covers/skilled-nursing-facilitysnf-situations

Caregiver Checklist Protect this information by storing it in a safe place. Caregiver Checklist Protect this information by storing it in a safe place.

Personal Information

Name:

Birth Place:

Mother’s Maiden Name:

Social Security Number:

Driver’s License Number:

Medicare Number:

Medicaid Number:

Case Worker: Phone:

Health Insurance: ID #:

Monthly Income: Debt:

Health Information

Medical Conditions:

Caregiver Checklist

Records & Documents y n Location

Savings Accounts

Checking Accounts

Credit Cards

IRA’s

CD’s

Stocks/Bonds

Mutual Funds

Home Owner Insurance

Car Insurance

Life Insurance

Long-Term Care Insurance

Other Insurance

Real Estate

Mortgages

Deed to House

Car Title

Tax Records

Allergies:

Surgeries:

Pharmacy:

Primary Physician: Phone:

Physician #1: Phone:

Physician #2: Phone:

Dentist: Phone:

Health Care Records

Birth Certificate

Marriage Certificate

Will

Power of Attorney

Advanced Directives/POLST

Safety Deposit Box

Valuable Objects