Who
            Will
          Care?

Genworth United Way Presentation
November 5, 2009
Adult Day Services (ADS):
community-based, non-residential programs
 Meet the assessed needs of
  adults with impairments...
Adult Day Services
                Goals

Maintain or improve
 the highest level of
 independence and
 health.

Provide ...
ADS are important to Virginia
    Provide Quality Care & Delay Institutionalization
• By supporting informal caregiving
  ...
Families provide 80% of eldercare
• 44% of non-
  institutionalized frail
  older adults get care
  from spouses.
• 49% ge...
Long Term Care Services:
  Services are based upon individual functional ability
                                Adult    ...
BARRIERS
                         Internal

• Family caregivers think
  adult day services =
  babysitting
• Lack of aware...
BARRIERS
                     External

• Public/provider awareness.

• Inadequate resources to fund services.

• Adult da...
What does the future hold?
– Estimated 1/2 of boomers
  will live to 90.

– 40% of workers will also be
  family caregiver...
Future ADS Needs
146 additional day care centers
 will be needed in Virginia
              (Robert Wood Johnson, 2002)

...
Recommendation

Change policy and funding to make home-
     and community-based services a
                 priority.
Recommendation

Build Adult Day Services
      Infrastructure.
Recommendation


    Increase
Medicaid waiver
reimbursement to
cover cost of care.
Recommendation

  Advocate family-friendly
employment policies & practices.
Recommendation

Develop a statewide program for
   increased public awareness.
COMPONENTS OF ADULT DAY HEALTH CARE
SERVICE COORDINATION

   • Individual functional and service assessment as intake, and...
PERSONAL CARE ASSISTANCE
   •Daily evaluation of ADL status and needs
   •Assistance with ambulation
          Falls risk ...
NURSING CARE –cont.

   • Emergency response

   • Health education for participants and caregivers

   • Referral to othe...
THERAPEUTIC ACTIVITIES

   • Assessment of activity skills, abilities, interests, needs

   • Development of activity plan...
FAMILY SUPPORT SERVICES

   • Respite

   • Support for working caregivers

   • Support groups and/or counseling for care...
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Genworth 2009 Presentation

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Genworth 2009 Presentation

  1. 1. Who Will Care? Genworth United Way Presentation November 5, 2009
  2. 2. Adult Day Services (ADS): community-based, non-residential programs  Meet the assessed needs of adults with impairments through an individual plan of care.  Provide essential health, social, and related support services in a protected congregate setting.  Support families and other caregivers and enable “I can continue to work because [my participants to live in the parents] are receiving reliable care community. during the day at the Center.” Caregiver
  3. 3. Adult Day Services Goals Maintain or improve the highest level of independence and health. Provide respite and support to caregivers.
  4. 4. ADS are important to Virginia Provide Quality Care & Delay Institutionalization • By supporting informal caregiving – The National Conference of State Legislators estimates 746 million hours of informal care provided in Virginia per year. – Value of $6.6 billion. – Caregivers who experience stress and burden are more likely to institutionalize relatives suffering from dementia. • By reducing health care costs – Health monitoring & preventive health care. – Timely provision of primary care. – Control excess disability. • By supporting the workforce – American businesses can lose as much as $34 billion each year due to employees’ need to care for loved ones 50+. – 77% of Virginia caregivers report being employed. – 96% need support services to maintain their job.
  5. 5. Families provide 80% of eldercare • 44% of non- institutionalized frail older adults get care from spouses. • 49% get care from at least one child. • More than 1 in 5 spouses have disabilities of their own.
  6. 6. Long Term Care Services: Services are based upon individual functional ability Adult In- Bathing Day Home Toileting Services Services Meals On Wheels Respite &Transportation Dressing Transferring The ideal long term care system is Emotional/ flexible to meet the Life functional abilities & Care Psych. Support preferences of the Communities individual. Eating Congregate Adult Foster Mobility Meals Care Nursing Assisted Home Living Care
  7. 7. BARRIERS Internal • Family caregivers think adult day services = babysitting • Lack of awareness • Denial, guilt, worry • Fear of financial burden • Have heard it is too expensive • Concerns about transportation
  8. 8. BARRIERS External • Public/provider awareness. • Inadequate resources to fund services. • Adult day services are not a public policy priority.
  9. 9. What does the future hold? – Estimated 1/2 of boomers will live to 90. – 40% of workers will also be family caregivers. – Increased financial strain – Increase in specialized programs (aging-in-place) • Early-onset Alzheimer’s • Brain injury 53 million boomers expect to • Autism care for parents who are in their • Mental retardation 70s & 80s.
  10. 10. Future ADS Needs 146 additional day care centers will be needed in Virginia (Robert Wood Johnson, 2002) Barriers: capital, operating support, public awareness
  11. 11. Recommendation Change policy and funding to make home- and community-based services a priority.
  12. 12. Recommendation Build Adult Day Services Infrastructure.
  13. 13. Recommendation Increase Medicaid waiver reimbursement to cover cost of care.
  14. 14. Recommendation Advocate family-friendly employment policies & practices.
  15. 15. Recommendation Develop a statewide program for increased public awareness.
  16. 16. COMPONENTS OF ADULT DAY HEALTH CARE SERVICE COORDINATION • Individual functional and service assessment as intake, and ongoing • Development of individualized Plan of Care; quarterly or more frequent update • Coordination of care with other service providers, including transportation • Daily monitoring and documentation of status and care provided • Coordination of daily routines with family caregivers • Coordination of discharge/transfer NUTRITION SERVICES • Nutritional assessment • Noon meal and 2 snacks • Therapeutic diets and counseling • Coaching, assistance with eating or total feeding • Evaluation for adaptive eating utensils/positioning while eating • Supervision for safety while eating • Monitoring weight and hydration
  17. 17. PERSONAL CARE ASSISTANCE •Daily evaluation of ADL status and needs •Assistance with ambulation Falls risk assessment Monitoring of ambulation devices/safety Regular ambulation to limits of tolerance to maintain strength and endurance Referral to rehabilitative services •Assistance with toileting Monitoring intake/output Continence programs Catheter management •Assistance with dressing NURSING CARE •Daily RN or LPN-B supervision •Skilled nursing services Coordination with primary and specialist medical care providers Medication management/administration Monitoring vital signs, changes in condition, response to treatments/medications Tube feeding, wound care, blood glucose monitoring
  18. 18. NURSING CARE –cont. • Emergency response • Health education for participants and caregivers • Referral to other services, coordination of appointments, reports to other providers REHABILITATION SERVICES COORDINATION • Monitoring for rehabilitation needs • Referral/coordination of rehab services • Collaboration for on-site rehab services COGNITIVE AND EMOTIONAL MONITORING AND SUPPORT • Continuous monitoring of cognitive and emotional status • Individualized plan/implementation to maintain/improve function • Crisis intervention (Adult Protective Services, Emergency Medical Services, Mental Health)
  19. 19. THERAPEUTIC ACTIVITIES • Assessment of activity skills, abilities, interests, needs • Development of activity plan to maintain interests, physical/cognitive/emotional skills • Structured opportunities to develop/maintain interaction, relationships, peer group support • Structured opportunities to improve/maintain physical functioning through activity participation • Structured opportunities to participate in activities that support cognitive functioning, provide validation and life review • Structured wellness programs to delay debilitation and encourage highest level of independence and function (daily exercise, strength training, brain health, diet, etc.) • Recommendations to family about meaningful activities at home
  20. 20. FAMILY SUPPORT SERVICES • Respite • Support for working caregivers • Support groups and/or counseling for caregivers • Long-term care planning • Consultation and skill training about home management and safety, adaptive equipment, home modifications, activities of daily living • Referrals STAFFING • Continuous on-site care by professional staff • Cost-effective use of staff with one trained aide or CNA under professional supervision providing care to 6 individuals or one RN caring for 50 • Limited turnover • Continuity of care • Reliable team care approach

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