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Long Term Care Administration

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Title: Long Term Care Administration


1
Long Term Care Administration
  • Long Term Care Facilities
  • February 19, 2009

2
Long Term Care Facilities
  • The Current Environment
  • Health reform has focused on improving access,
    quality and cost-effectiveness, and on moderating
    future growth curves.
  • Reforms have occurred in every sector of health
    care.

3
Long Term Care Facilities
  • The Current Environment
  • Cost pressures will continue at a rapid rate.
  • Every province and territory will need to focus
    on the growing demand for health care services,
    fueled by demographics, new technologies and
    other growing costs of providing services.

4
Long Term Care Facilities
  • Support Service Living Units
  • Provide totally integrated units with services
    provided on an as required basis.
  • Availability of 24 hour service and a quick
    response capability provided by on site staff.
  • Amenity spaces, dining room, communal laundry, 24
    hr monitoring, two meals/day.

5
Long Term Care Facilities
  • LifeCare Communities
  • Continuing Care Retirement Communities (CCRC)
    allow seniors to "age in place," with flexible
    accommodations that are designed to meet their
    health and housing needs as these needs change
    over time.
  • Residents entering Continuing Care Retirement
    Communities sign a long-term contract that
    provides for housing, services and nursing care,
    usually all in one location, enabling seniors to
    remain in a familiar setting as they grow older.

6
Long Term Care Facilities
  • LifeCare Communities
  • Many seniors enter into a CCRC contract while
    they are healthy and active, knowing they will be
    able to stay in the same community and receive
    nursing care should this become necessary.
  • Seniors who invest in a Continuing Care
    Retirement Community have adequately planned for
    housing and care for the remainder of their life,
    and have the financial means to support it.

7
Long Term Care Facilities
  • LifeCare Communities
  • Continuing Care Retirement Communities offer
    service and housing packages that allow access to
    independent living, assisted living, and skilled
    nursing facilities.
  • Seniors who are independent may live in a
    single-family home, apartment or condominium
    within the Continuing Care retirement complex.
  • If they begin to need help with activities of
    daily living (e.g., bathing, dressing, eating,
    etc.), they may be transferred to an assisted
    living or skilled nursing facility on the same
    site.
  • Seniors who choose to live in a Continuing Care
    Retirement Community find it reassuring that
    their long-term care needs will be met without
    the need to relocate.

8
Grace Communities Corp.
  • Grace Communities Corporation (GCC) is committed
    to providing quality, affordable housing to
    adults 55. Our customer service approach to
    housing management follows carefully crafted
    rules, regulations, policies and procedures we've
    established to make living here the best it can
    be.   Gracious Living, Simply Amazing!
  • Local CCRC Life Lease in Abbotsford, B.C.

9
Long Term Care Facilities
  • Abbeyfield Vancouver is a non-profit organization
    that offers 18 supportive housing units for
    elderly people in the Marpole area. 

10
Long Term Care Facilities
  • The Abbeyfield Pattern
  • To involve local Abbeyfield volunteers in setting
    up and managing each house, where the residents
    will pay their share of the running costs.
  • Every household will have its own housekeeper to
    look after the house, to provide meals and to
    care generally for the residents.
  • The residents will have their own rooms,
    furnished as they wish, where both their privacy
    and their right to invite visitors are assured.

11
Long Term Care Facilities
  • Home Sharing
  • Provides additional income and companionship.
  • Option for seniors who experience difficulty in
    maintaining their own homes due to accelerating
    costs, reduced income, declining physical health
    and loneliness.

12
Long Term Care Facilities
  • Congregate Housing
  • Elm Ridge is a congregate housing project
    operated by the Baycrest Centre for Geriatric
    Care in Toronto, Ontario.
  • The home for fourteen senior adults provides a
    balance of companionship and privacy, of support
    and independence for those who would otherwise
    find themselves alone and at risk.

13
Long Term Care Facilities
  • The customized project was built in 1985 by
    Cityhome, the former non-profit housing arm of
    the City of Toronto.
  • Elm Ridge was styled as a single family dwelling,
    to blend with the neighbourhood, while graciously
    distinguishing itself with a colourful landscaped
    garden.
  • Its central location offers easy access to
    synagogues, public transit and shopping.

14
Long Term Care Facilities
  • Staff at Elm Ridge offer 24-hour supervision,
    weekly housekeeping, counselling services and
    bi-weekly bathing assistance, if needed.
  • These are complemented with an extensive program
    of activities, which include arts and crafts,
    music, discussion groups, exercise classes,
    outings, and observance of all religious
    occasions and the celebration of festivals.

15
Long Term Care Facilities
  • Home Equity Conversion Plans
  • Allow seniors to have supplemental income.
  • Equity from the ownership of a given property is
    used, monies are obtained to complete any
    required home modifications or to accommodate a
    changed health status.

16
Long Term Care Facilities
  • Garden Suites/Granny Flats
  • Small portable dwellings, provide seniors with
    the opportunity to stay on their own property,
    while freeing up the main house for the use of
    close relatives or friends.

17
Long Term Care Facilities
  • Retirement Homes Assisted Living
  • 24/7, on site staff, security in communal living
  • Room, board, recreation, social activities
  • Nursing and personal care not provided
  • 800 - 7,000 per month

18
Long Term Care Facilities
  • Access to Long Term Care Facilities
  • Severely compromised functional ability and
    self-care
  • Severe chronic illness/disability
  • Abuse and/or neglect
  • Insufficient community services to support care
    at home
  • Absence/unwillingness of informal caregivers to
    continue care

19
Long Term Care Facilities
  • Problems that result in admission
  • Cognitive Impairments
  • Major chronic and/or multihealth problems
  • Major physical frailty
  • Loss of mobility and independent ambulatory
    movement

20
Long Term Care Facilities
  • Problems that Result in Admission
  • Sensory Disorders
  • Incontinence
  • Loss of a spouse or significant other
  • Note 85 have more than one health problem

21
Long Term Care Facilities
  • Desires Prompting Admission
  • Provision of extensive, regular 24 hr nursing and
    personal care
  • Provision of extensive, regular 24 hr
    supervision, monitoring and assistance with ADLs
  • Assurance of safety and security
  • Preservation of self-respect, self-esteem,
    dignity, companionship

22
Long Term Care Facilities
  • The Eden Alternative
  • Tool for improving quality of life in LTC
    facilities.
  • Coalitions of people and organizations are
    created committed to creating better social and
    physical environments for people.
  • Dedicated to helping others create enlivening
    environments and the elimination of the plagues
    of Loneliness, Helplessness, and Boredom.
  • Dedicated to helping people grow.

23
Long Term Care Facilities
  • Eden Alternative
  • Teaches that the environments seniors live in are
    habitats for human beings rather than facilities
    for the frail and elderly.
  • What Mother Nature has to teach is about the
    creation of vibrant, vigorous habitats.

24
Long Term Care Facilities
  • Eden Alternative
  • Companion animals gives the opportunity for
    meaningful care to other living creatures, and
    the variety and spontaneity that mark an
    enlivened environment can succeed where pills and
    therapies fail.
  • The goal is to help people weave together the
    philosophy of The Eden Alternative with the real
    world of daily practice.

25
Long Term Care Facilities
  • GentleCare
  • The system is prosthetic in nature.
  • It seeks to arrange an environmental fit between
    the person with dementing illness and the
    physical space, the programs, and the significant
    people with whom the person must interact.
  • The system accommodates and supports existing
    levels of function and development, rather than
    challenging the person with dementia to adapt and
    perform in ways no longer possible.

26
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27
Long Term Care Facilities
  • GentleCare Includes
  • A correlation between disease pathology and
    client behaviour
  • Environmental design concepts
  • A system of programming that helps locate the
    client's appropriate zone of activity
  • Daily living care planning and implementation
  • Numerous innovative, creative strategies

28
Long Term Care Facilities
  • GentleCare
  • Nutritional assessment and strategies that create
    powerful treatment opportunities
  • Stress identification, prevention and reduction
    that eliminates catastrophic incidents
  • Functional assessment that provides
    individualized care plans
  • Evaluation
  • A unique system of therapeutic partnership with
    families, communities and volunteers

29
Long Term Care Facilities
  • Organizations that use the GENTLECARE system
    report
  • Increased client function
  • Reduced catastrophic incidents
  • Decreased staff and family stress
  • Reduced use of psychotropic medications
  • Cost containment
  • Increased community commitment and involvement

30
Long Term Care Facilities
  • Little Mountain Place
  • This beautiful facility consists of 117 resident
    beds, including a 26 bed Special Care Unit called
    The Garden Terrace.
  • Each of the resident rooms is furnished with a
    bed, night table, dresser and wardrobe closet,
    has a memory display box and a washroom.
  • Memory boxes are located just outside a
    resident's private room and are a great way for
    residents to recognize their room easily.
  • All rooms are private, with an ensuite bathroom
    and nurse-call system.
  • One of the beds at Little Mountain Place is
    maintained solely for respite service, which is a
    valuable resource for individuals and family
    caregivers who require support on a short term
    basis.

31
Long Term Care Facilities
  • Little Mountain Place
  • Provision of 24 hour care and supervision
  • Full nutritional and food service
  • Leisure and volunteer program
  • Medical services supervised by a Medical
    Coordinator
  • Podiatrist, psychiatrist and dentist

32
Long Term Care Facilities
  • Little Mountain Place
  • Each resident's care is individualized to meet
    his/her needs.
  • Primary Nurses, LPNs and Care Aides work with
    residents and their family to develop, review and
    evaluate each resident's plan of care.
  • Through these care plans we acknowledge the
    rights and responsibilities of each resident,
    their family and the staff at Little Mountain
    Place.
  • The staff are committed to ensuring the best
    quality of life for all residents.

33
Long Term Care Facilities
  • Services
  • Environmental - residents' rooms are cleaned
    regularly, clean linens and towels are provided
    as necessary
  • Laundry - in house laundry service is limited to
    washable items only, however a dry clean service
    can be arranged if required
  • Hairdressing - an on-site hairdresser is
    available by appointment
  • Mail - a volunteer will deliver mail directly to
    a resident's private room.
  • Chaplain - conveys the presence of God through
    compassionate listening, recognizing God at work
    in residents' lives and helping to interpret the
    meaning of their life experiences in relation to
    God
  • "The Nook" - a shop operated by volunteers, where
    residents may purchase items such as toiletries,
    gifts, stamps, batteries, or candy

34
Long Term Care Facilities
  • Little Mountain Place, Leisure Services
  • Recognizing that medical and nursing care are
    only a part of providing quality care for
    residents, we provide a wide variety of programs
    such as
  • Tzu Chi Chinese Luncheons
  • Newsweek discussions
  • carpet bowling
  • Bingo
  • video nights
  • bus trips/outings
  • Pub nights
  • Residents are encouraged to participate in "Music
    Therapy" which encourages them to socialize and
    express themselves through music in group
    sessions. Programs and services are ongoing.
  • The staff encourages residents and families to
    make suggestions for any new programs.

35
Long Term Care Facilities
  • Little Mountain Place
  • The Garden Terrace provides a home-like
    environment which supports, nurtures and enhances
    the potential of residents who suffer from
    dementia.
  • Although dementias such as Alzheimer's Disease
    can be debilitating, we believe that we can offer
    residents an outstretched hand, a caring heart
    and programs that maintain and enhance their
    abilities.

36
Long Term Care Facilities
  • Little Mountain Place
  • Specifically designed for individuals with
    Alzheimer's Disease or other types of dementia,
    the Garden Terrace has a home-like common living
    area with limited access and a secured patio and
    garden area.
  • Families will feel comfortable visiting and
    participating in resident's lives.
  • Having a feeling of their own personal space and
    their belongings close by, we believe residents
    will ultimately have higher functioning,
    increased self-esteem, control and independence.

37
Long Term Care Facilities
  • Little Mountain Place
  • Within the Garden Terrace there are three
    categories of leisure programs which occur
    Therapeutic, Home Life, and Activities.
  • These programs occur in a small group or
    individual settings and can be formal or
    spontaneous.
  • Therapeutic Recreation Programs are offered based
    upon residents' needs they have a specific goal
    and purpose, they assist in bringing meaning and
    satisfaction to one's life and they help to
    maintain physical and emotional well being.
  • Examples of such programs include baking,
    reminiscing groups, gardening, socials and
    "discovery boxes".

38
Long Term Care Facilities
  • Little Mountain Place
  • Home Life Programs give the residents the
    opportunity to contribute to their new home by
    assisting with the various chores which need to
    be done to take care of the Garden Terrace.
  • Chores are assigned according to what is most
    familiar to each resident.
  • Through assisting with the various tasks,
    individuals maintain a sense of purpose to their
    life.
  • Examples of chores include sweeping, meal
    preparation, washing dishes, preparing vegetables
    and folding towels.

39
Long Term Care Facilities
  • Little Mountain Place
  • Activities are offered to residents and their
    friends and families.
  • In the Garden Terrace there are supplies and a
    reference book full of activity suggestions and
    we encourage everyone to participate.
  • This is a great way for everyone to socialize.
  • Activities may include polishing silver,
    watering the garden, reading the newspaper or
    enjoying a cup of tea.

40
Long Term Care Facilities
  • Little Mountain Place
  • The Family Council is a independent,
    self-determining group of family members and
    friends of residents living in a care facility.
  • At Little Mountain Place, our group is called
    "Families of LMP" and participants meet once a
    month. There are several benefits which stem
    directly from this council
  • Orientation and information for families of new
    residents
  • ongoing support
  • volunteering and fundraising
  • education and information
  • forum to discuss concerns or problems
  • Family and friends are welcome to attend as many
    or as few meetings as they are comfortable with.
    We believe it is important to have a voice,
    especially if you can make a difference in
    residents' lives.

41
Long Term Care Facilities
  • Food Services
  • Three meals and three between meal nourishments
    are provided daily, utilizing a multi-cultural
    six week menu planned by our full time Nutrition
    Manager and Dietitian/Nutritionist.
  • Due to a significant population of Asian
    residents, menus are written in Chinese as well
    as English.
  • A Food Service Committee is in place to provide
    residents and family input into the menu planning
    and meal service process.
  • A special alternate dining area meets the needs
    of residents who require assistance or
    supervision during meal times.

42
Long Term Care Facilities
  • Food Services
  • The Garden Terrace has it's own small home-like
    relaxed dining area. Residents are provided foods
    of appropriate texture and consistency with
    modified utensils to promote independent eating
    and ensure adequate nutritional intake.
  • A 24 hour feeding program is set up so that extra
    foods and drinks are provided to The Garden
    Terrace residents.
  • The purpose is to allow residents to have food at
    any time they desire and not be restricted to
    fixed meal hours.

43
Long Term Care Facilities
  • Food Services
  • Friends and family are welcome to bring gifts of
    food to their loved ones.
  • The Nutrition Manager and Dietitian/Nutritionist
    would be pleased to help you select appropriate
    foods for the resident's diet as well as for
    storage.
  • Family and friends are encouraged to join
    residents for meals - both in the facility and
    off-site.

44
Long Term Care Facilities
  • Little Mountain Place
  • A social worker is available to meet with you at
    your convenience.
  • The social worker is available for assessment,
    information and consultation with residents,
    families and other professionals and can assist
    with social, emotional or financial concerns.

45
Long Term Care Facilities
  • Application for admission is made by contacting
    the local Health Unit in your community. A Long
    Term Care Manager will assess the eligibility of
    your application and determine the level of care
    you or your family member requires. The level of
    care is determined by an assessment of each
    applicant's physical and mental capabilities.
    When it is determined an applicant is eligible
    for Long Term Care, a Long Term Care number is
    assigned.

46
Long Term Care Facilities
  • Referral/Placement, cont
  • Once accepted, the date of application becomes
    the priority date on the Long Term Care waiting
    list.
  • This list is sent to the Little Mountain Place
    Social Worker.
  • Priority Access for the facility is controlled by
    the Vancouver Coastal Health Authority.
  • If there are problems regarding this procedure,
    the Social Worker or the Director of Resident
    Care Services at Little Mountain Place are
    available to both the applicant and the
    applicant's family for consultation and advice.

47
Long Term Care Facilities
  • Little Mountain Court
  • A wonderful facility designed for independent
    living.
  • Tenants make themselves at home in no time. There
    is a minimum age requirement of 55, except for
    handicapped residents and no more than 2 people
    may occupy a double suite.
  • Social work and nutritional services are
    available from Little Mountain Place for a
    nominal fee.

48
Long Term Care Facilities
  • Little Mountain Court has 96 self-contained
    suites consisting of
  • 81 single suites
  • 1 single handicap suite
  • 10 double suites
  • 4 double handicap suites

49
Long Term Care Facilities
  • Each suite includes
  • 1 bedroom
  • 1 bathroom
  • 1 kitchen
  • 1 living/dining room
  • storage areas
  • The rent at Little Mountain Court is subsidized
    by BC Housing. A wait-list system gives priority
    to those who are in greatest need.

50
Long Term Care Facilities
  • Little Mountain Residential Care Housing
    Society
  • Established in 1983, Little Mountain Housing
    Society (the "Society") is a not-for-profit care
    giving organization. The Society has adopted a
    philosophy of care called "Gentle Care" which
    means residents' needs and wants are our
    priority.
  • "Residents First" is a heart and soul attitude
    towards residents and their families.
  • Residents are the focal point of all our
    activities and everything we do recognizes the
    requirements to serve their needs and exceed
    their expectations.

51
Long Term Care Facilities
  • The Society owns and operates three facilities
    through a board of directors.
  • Adanac Park Lodge
  • Little Mountain Court
  • Little Mountain Place

52
Long Term Care Facilities
  • Mission Statement
  • We are a non-profit care organization. We provide
    accommodation and holistic care for those who are
    aged, infirm and/or disabled, in the spirit of
    compassion and with respect for diversity.
  • Vision Statement
  • Our vision is a dignified and respectful
    community where people feel at home.

53
Long Term Care Facilities
  • Our Values
  • Compassion for the needs of others
  • Effective management of our time, talents and
    resources
  • Building relationships of mutual care and respect

54
Long Term Care Facilities
  • Our Commitment
  • We, at Little Mountain Housing Society, are
    committed to providing an environment which
    upholds the rights of everyone living, working or
    volunteering within the Society. We are committed
    to an environment where
  • everyone is treated courteously, respectfully and
    in a dignified manner
  • everyone is given personal privacy
  • personal, financial and medical information is
    kept in strict confidence
  • information which affects a resident's quality of
    life will be obtained
  • independence and making personal decisions is
    encouraged
  • a choice of services is offered
  • living and working is considered safe, secure and
    satisfying
  • residents' interests, abilities and potential are
    fully developed
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