The Continuum of Long-Term Care
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Long term care Goal
Maximize independence Who
People with functional disabilities What
Health,
mental health, residential, social support Basis
80% - 90% informal by family & friends
10% - 20% formal to sustain the informal Ideal
Integrated set of services
Continuity of care
Over time and setting Reality
Highly fragmented due to:
- financial drivers - local community variations - no uniform federal, state policies
Functional ability
A person's ability to perform basic daily activities
Or instrumental daily activities
ADL
Activities of daily living
Large motor skills lost in a predictable order
Eat, walk, dress, bath, grooming, bowel & bladder continence, transfer from bed to chair
Initially defined by Katz & colleagues through research, 1963
IADL
Instrumental activities of daily living
More loosely defined
Cognitive reasoning, finer motor skills
Using phone, managing money, shopping, using transportation, doing chores, taking medication, house keeping
% of population
Stat 2005 - 12% of US population needs some form of long term care
Chronic condition A condition lasts more than 3 months/90 days
Results from health or mental or both issues
Can be life-threatening or harmless
Can result in functional disabilities
Impairment
Chronic or permanent defects Usually static in nature
Due to diseases, injury, congenial malformation Leads to decreased / lost of functional ability
Limb amputee, blindness, hearing lost
The ideal of continuum of long-term care
A client oriented system
THE FRAMEWORK OF
Operating an array of services in an integrated manner (or with integrated mechanism) Tracks and guides clients over time and level of intensity of care
Comprehensive services in health, mental & social services
- A formal care system to compliment the informal system - Comprehensive and coordinated care system - To meet the multifaceted need of a person with complex or ongoing problems - Executed effective and efficiently
Integrated continuum of care
4 integrated management systems
Inter-entity structure and management
care coordination
Integrated information system
Integrated financing
7 service categories
Extended
Acute
Ambulatory
Home
Outreach
Wellness
housing
What continuum of care do
Match resources to client's health and family's circumstances
Monitor client's condition and change care when needed
Coordinate the cares provided by many professionals and disciplines
Integrate care provided in a range of settings Enhance efficiency, reduce duplication and streamline client flow
Pools or enhances financing so services are based on needs rather than narrow eligibility criteria
Maintains comprehensive record for clinical, financial and utilization data
3 Goals of continuum care
Provide health and related services to foster independence for the client and the family
Achieve cost effectiveness through maximizing the resources
Increase quality of care through appropriateness and continued care
In-patient long term care
Nursing