This document discusses challenges faced by seniors in the Canadian healthcare system when being discharged from the hospital. It aims to raise awareness of issues like Alternate Level of Care (ALC) where patients no longer require acute care but face obstacles to leaving the hospital. It also discusses the "Home First" philosophy of supporting patients to transition home with high levels of home care rather than waiting in the hospital. Resources provided cover topics like hospital discharge planning, shaping attitudes towards seniors, and the role of communication in navigating patient choices and power dynamics during discharge.
Here are a few suggestions to help make Bob more comfortable in his double room during his palliative care experience:
- Speak to the care team about relocating Albert to a private room, if available, to reduce disruptions and allow for a peaceful environment for Bob and his family.
- Ensure Bob's bed is positioned in a way that maximizes his comfort and view (e.g. by the window).
- Set up a quiet, private family space in the room where loved ones can visit without disturbing Albert.
- Provide the family information on palliative care, dementia, and managing disruptive behaviors to help them care for Bob and understand Albert.
- Ask the family about Bob's preferences and
International Public Health and Palliative Care ConferenceKathy Kastner
This document summarizes key points from a presentation on filling gaps in end of life education from the patient's perspective. It discusses how all health care professionals are viewed as playing important roles in addressing goals of care. It also notes that patients may feel reluctant to assert their interests in front of clinicians seen as experts. The document outlines barriers to end of life discussions, the need to improve communication quality, and that strategies are needed to improve advance care planning. It stresses that health literacy can present barriers and impact care choices. The importance of word choice in discussions is highlighted. The document then summarizes a proposed solution to evaluate an end of life planning resource from a lay perspective to increase knowledge and comfort with topics. It provides learnings from
The document discusses barriers seniors face when navigating the emergency department at Kingston General Hospital and proposes two approaches to overcome these barriers: 1) Informing long-term changes to the physical and social environments of the emergency department based on best geriatric practices and senior experiences. 2) Educating and empowering seniors to better navigate the healthcare system and control their own health. It then reviews literature on improving emergency care for seniors, identifying themes such as the need for senior screening, dedicated staff like nurse liaisons, communication, discharge planning, and addressing seniors' unique needs.
Community Based Care Coordination in Australia - State of the NationDXC Eclipse
The three primary goals of healthcare organisations today are:
• improve the experience of care
• improve the health of the population and
• reduce per capita costs of delivery.
This requires healthcare organisations to engage and impact the health of one person at a time. This can only be achieved with the right people, processes and information systems in place.
Today a new digital healthcare solution is available in Australia and New Zealand - DXC Care Coordination powered by Tribridge Health360 and delivered by DXC Eclipse.
Health360 is the only individual-centric CRM-powered Population Health Management solution built for the Microsoft Cloud.
Contact DXC Eclipse at info@uxceclipse.com to find out more.
Palliative care aims to provide relief from the symptoms and stress of serious illness through comprehensive treatment of pain and other physical, psychosocial, and spiritual problems. It can improve quality of life for both patients and families. Palliative care is provided along the illness continuum and can be beneficial at any stage of a serious illness, while hospice care focuses on comfort and support for those nearing the end of life. Both palliative care and hospice aim to improve quality of life, but palliative care is not limited to a prognosis of six months or less.
This document discusses a thesis examining the effects of mental health status and comorbidity on the perceived likelihood of hiring a healthcare advocate. It describes a study that presented participants with vignettes varying the mental health condition (dementia or depression) and presence of comorbid conditions. The results of an ANCOVA showed participants perceived a greater need for healthcare advocate services for dementia than depression. However, there was no effect for comorbidity. The study provides insights into perceptions of burden from various health conditions but more research is needed.
Here are a few suggestions to help make Bob more comfortable in his double room during his palliative care experience:
- Speak to the care team about relocating Albert to a private room, if available, to reduce disruptions and allow for a peaceful environment for Bob and his family.
- Ensure Bob's bed is positioned in a way that maximizes his comfort and view (e.g. by the window).
- Set up a quiet, private family space in the room where loved ones can visit without disturbing Albert.
- Provide the family information on palliative care, dementia, and managing disruptive behaviors to help them care for Bob and understand Albert.
- Ask the family about Bob's preferences and
International Public Health and Palliative Care ConferenceKathy Kastner
This document summarizes key points from a presentation on filling gaps in end of life education from the patient's perspective. It discusses how all health care professionals are viewed as playing important roles in addressing goals of care. It also notes that patients may feel reluctant to assert their interests in front of clinicians seen as experts. The document outlines barriers to end of life discussions, the need to improve communication quality, and that strategies are needed to improve advance care planning. It stresses that health literacy can present barriers and impact care choices. The importance of word choice in discussions is highlighted. The document then summarizes a proposed solution to evaluate an end of life planning resource from a lay perspective to increase knowledge and comfort with topics. It provides learnings from
The document discusses barriers seniors face when navigating the emergency department at Kingston General Hospital and proposes two approaches to overcome these barriers: 1) Informing long-term changes to the physical and social environments of the emergency department based on best geriatric practices and senior experiences. 2) Educating and empowering seniors to better navigate the healthcare system and control their own health. It then reviews literature on improving emergency care for seniors, identifying themes such as the need for senior screening, dedicated staff like nurse liaisons, communication, discharge planning, and addressing seniors' unique needs.
Community Based Care Coordination in Australia - State of the NationDXC Eclipse
The three primary goals of healthcare organisations today are:
• improve the experience of care
• improve the health of the population and
• reduce per capita costs of delivery.
This requires healthcare organisations to engage and impact the health of one person at a time. This can only be achieved with the right people, processes and information systems in place.
Today a new digital healthcare solution is available in Australia and New Zealand - DXC Care Coordination powered by Tribridge Health360 and delivered by DXC Eclipse.
Health360 is the only individual-centric CRM-powered Population Health Management solution built for the Microsoft Cloud.
Contact DXC Eclipse at info@uxceclipse.com to find out more.
Palliative care aims to provide relief from the symptoms and stress of serious illness through comprehensive treatment of pain and other physical, psychosocial, and spiritual problems. It can improve quality of life for both patients and families. Palliative care is provided along the illness continuum and can be beneficial at any stage of a serious illness, while hospice care focuses on comfort and support for those nearing the end of life. Both palliative care and hospice aim to improve quality of life, but palliative care is not limited to a prognosis of six months or less.
This document discusses a thesis examining the effects of mental health status and comorbidity on the perceived likelihood of hiring a healthcare advocate. It describes a study that presented participants with vignettes varying the mental health condition (dementia or depression) and presence of comorbid conditions. The results of an ANCOVA showed participants perceived a greater need for healthcare advocate services for dementia than depression. However, there was no effect for comorbidity. The study provides insights into perceptions of burden from various health conditions but more research is needed.
Health innovation for all conference sustaining and transforming our health s...Paul Gallant
IHI Open School UBC Chapter, Health Innovation for All Conference. Sustaining and Transforming Our Health System(s)
Presentation by: Paul W. Gallant, Gallant HealthWorks
Session Summary:
This interactive workshop encourages participants to contribute their knowledge, views and experiences as health system(s) stakeholders to discuss questions based on the concepts and trends presented.
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...HTAi Bilbao 2012
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Health Technology Assessment
Jackie Tran, MD
University of Medicine and Dentistry of New Jersey, USA
HTAi 9th Annual Meeting, Bilbao
Integrated Care for a Patient Centered System
25 June, 2012
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
Recent advances in the evidence base for technology-based behavioral health applications have provided clinicians a better understanding and guidance on the integration of these tools into clinical care. Participants will learn about research findings on current technologies in use in clinical practice, such as audio conferencing, video conferencing, and virtual reality, in addition to tools available for use between patients, such as the use of websites and mobile applications and wearable sensors.
Mr Grant Brand: Lessons Learned in the First Nine Years of the Glasgow ARBD TeamAlcoholForum.org
The document summarizes lessons learned from the first nine years of the Glasgow Alcohol Related Brain Damage (ARBD) Team. It discusses how the team was set up, missed opportunities at the beginning, and what they have learned over time. Key points include broadening the referral criteria, conducting thorough multidisciplinary assessments, using legislation to help with harm reduction, providing rehabilitation services, and training other services on ARBD. It emphasizes the need for a public health approach, clear strategy, and person-centered flexible services for those with ARBD.
The goal of this webinar is to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care, including common misconceptions, typical diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the
benefits of advance care planning and early referrals.
Risk profiling, multiple long term conditions & complex patients, integrated ...Dr Bruce Pollington
Dr Bruce Pollington web-ex presentation to LTC QIPP programme
Utilising risk profiling, and risk stratification to identify patients with multiple long term conditions requiring complex care through integrated care teams.
Comprehensive geriatric assessment (CGA) involves a multidisciplinary evaluation of an older person's medical conditions, mental health, functional ability, and social circumstances. The goal is to create a holistic care plan addressing treatment, rehabilitation, support, and long-term follow-up. A CGA benefits the patient through a coordinated care plan, benefits caregivers by addressing social needs, and benefits healthcare systems by reducing hospital readmissions.
Dr Scott Payne & Dr Mark Owens: ARBD in the Northern Irish Context AlcoholForum.org
The document summarizes research conducted on alcohol-related brain damage (ARBD) in the Western Health and Social Care Trust area of Northern Ireland. It established a prevalence rate of 9 per 10,000 people and identified 278 individuals with ARBD through data collection from health and social care agencies. Care pathways were informed by the research findings to help improve services for individuals with ARBD.
Advance Directives & Advance Care Planning | VITAS HealthcareVITAS Healthcare
Learn how healthcare professionals can ensure that their patients’ voices are heard by embracing advance care planning (ACP), defined as honest conversations about how patients want to be cared for at the end of life if they are unable to communicate or make decisions. This webinar explores advance directives, the legal documents that spell out patients’ wishes for family members, caregivers and healthcare teams.
Resource allocation in healthcare involves effectively distributing limited resources to provide quality care to as many patients as possible. There are two main methods of resource allocation: capitation and diagnosis-related groups (DRGs). Capitation involves setting prospective budgets for healthcare providers based on the needs of their patient population. Key considerations in capitation include the total funds available, personal factors like age and disability that affect patients' needs, and the weights given to different need factors. DRGs involve classifying patients based on diagnoses and estimated costs of treatment to group similar patients and set reimbursement amounts. Resource allocation in public hospitals in Bangladesh is currently based on the number of employees and beds, which may not fully consider equity and efficiency principles.
The who, what, where, why and how of end-of-life care. A continuing education webinar presented by VITAS Healthcare on March 15, 2018. For more information or future webinars, please visit: https://www.vitas.com/partners/continuing-education
This document describes a service model for treating patients with alcohol-related brain damage (ARBD) in the Wirral area. It outlines the clinical phases of assessment and treatment, including inpatient stabilization, outpatient cognitive assessment and rehabilitation, and long-term community support. Case studies demonstrate positive outcomes such as reduced hospital use, improved cognitive function, and independent living. A review found the program significantly lowered treatment costs while achieving high rates of abstinence and community integration for patients.
The goal of this webinar is to help hospice and healthcare professionals understand the history, philosophy and practice of hospice care and palliative care, including common myths and misconceptions, common diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the benefits of advance care planning and early referrals.
The document discusses current end-of-life care in the United States and potential solutions. It finds that primary care physicians may not be adequately involved in end-of-life issues due to lack of training and comfort discussing death. As a result, patients, families, and caregivers often experience suboptimal care, feelings of abandonment, poor communication, and high financial burdens. Potential solutions proposed include increased education, advanced care planning, greater hospice utilization, and healthcare models that facilitate primary care physician involvement in end-of-life care coordination and decision making.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care, including common misconceptions, typical diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the
benefits of advance care planning and early referrals.
Advance Care Planning & Advance Healthcare Directives with People with DementiaIrish Hospice Foundation
1. The document provides guidance on advance care planning and advance healthcare directives for people with dementia, their families, and healthcare professionals.
2. It outlines four key considerations for good practice: understanding dementia, recognizing patient rights, understanding advance care planning, and being familiar with the Assisted Decision Making Act regarding capacity and advance directives.
3. The guidance stresses the presumption of capacity, engaging the patient, and considering previously expressed preferences when making decisions for those lacking capacity. It also describes what can be included in an advance healthcare directive.
This document provides an overview of issues facing children with special health care needs (CSHCN) in California. It discusses key focus areas like care coordination and family engagement. It notes that California ranks poorly nationally in areas like preventative care, care coordination, and family-centered care for CSHCN. The document also discusses the medical and social complexity of CSHCN, the importance of care coordination systems, and the need to better support families providing care.
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
C-TAC 2015 National Summit on Advanced Illness Care - Master Slide Deckzbarehmi
This document provides an overview of the National Summit on Advanced Illness Care that took place on March 2-3, 2015 in Washington DC. The summit was hosted by C-TAC (Coalition to Transform Advanced Care) and brought together leaders, clinicians, researchers, and policymakers to drive improvements in advanced illness care. Over the two-day event, there were presentations on models of advanced illness care, engaging patients and families, improving clinician-patient communication, the role of research and policies to support high-quality end-of-life care for all Americans.
Nathan Goldstein-Palliative care making the case jewishhome
Palliative care aims to improve quality of life for patients with serious illnesses and their families. Nathan Goldstein argues that hospital-based palliative care is growing in the US for four key reasons: 1) It improves clinical quality by better managing pain and symptoms. 2) It better aligns with patient and family preferences for comfort and honest discussions. 3) It is well-suited to address the growing population of older adults with multiple chronic conditions. 4) It can reduce costs by facilitating decisions to leave the hospital or withhold treatments not achieving patient goals.
Health innovation for all conference sustaining and transforming our health s...Paul Gallant
IHI Open School UBC Chapter, Health Innovation for All Conference. Sustaining and Transforming Our Health System(s)
Presentation by: Paul W. Gallant, Gallant HealthWorks
Session Summary:
This interactive workshop encourages participants to contribute their knowledge, views and experiences as health system(s) stakeholders to discuss questions based on the concepts and trends presented.
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Healt...HTAi Bilbao 2012
Transitional Care for Pediatric Patients with Neuromuscular Diseases: A Health Technology Assessment
Jackie Tran, MD
University of Medicine and Dentistry of New Jersey, USA
HTAi 9th Annual Meeting, Bilbao
Integrated Care for a Patient Centered System
25 June, 2012
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
Recent advances in the evidence base for technology-based behavioral health applications have provided clinicians a better understanding and guidance on the integration of these tools into clinical care. Participants will learn about research findings on current technologies in use in clinical practice, such as audio conferencing, video conferencing, and virtual reality, in addition to tools available for use between patients, such as the use of websites and mobile applications and wearable sensors.
Mr Grant Brand: Lessons Learned in the First Nine Years of the Glasgow ARBD TeamAlcoholForum.org
The document summarizes lessons learned from the first nine years of the Glasgow Alcohol Related Brain Damage (ARBD) Team. It discusses how the team was set up, missed opportunities at the beginning, and what they have learned over time. Key points include broadening the referral criteria, conducting thorough multidisciplinary assessments, using legislation to help with harm reduction, providing rehabilitation services, and training other services on ARBD. It emphasizes the need for a public health approach, clear strategy, and person-centered flexible services for those with ARBD.
The goal of this webinar is to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care, including common misconceptions, typical diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the
benefits of advance care planning and early referrals.
Risk profiling, multiple long term conditions & complex patients, integrated ...Dr Bruce Pollington
Dr Bruce Pollington web-ex presentation to LTC QIPP programme
Utilising risk profiling, and risk stratification to identify patients with multiple long term conditions requiring complex care through integrated care teams.
Comprehensive geriatric assessment (CGA) involves a multidisciplinary evaluation of an older person's medical conditions, mental health, functional ability, and social circumstances. The goal is to create a holistic care plan addressing treatment, rehabilitation, support, and long-term follow-up. A CGA benefits the patient through a coordinated care plan, benefits caregivers by addressing social needs, and benefits healthcare systems by reducing hospital readmissions.
Dr Scott Payne & Dr Mark Owens: ARBD in the Northern Irish Context AlcoholForum.org
The document summarizes research conducted on alcohol-related brain damage (ARBD) in the Western Health and Social Care Trust area of Northern Ireland. It established a prevalence rate of 9 per 10,000 people and identified 278 individuals with ARBD through data collection from health and social care agencies. Care pathways were informed by the research findings to help improve services for individuals with ARBD.
Advance Directives & Advance Care Planning | VITAS HealthcareVITAS Healthcare
Learn how healthcare professionals can ensure that their patients’ voices are heard by embracing advance care planning (ACP), defined as honest conversations about how patients want to be cared for at the end of life if they are unable to communicate or make decisions. This webinar explores advance directives, the legal documents that spell out patients’ wishes for family members, caregivers and healthcare teams.
Resource allocation in healthcare involves effectively distributing limited resources to provide quality care to as many patients as possible. There are two main methods of resource allocation: capitation and diagnosis-related groups (DRGs). Capitation involves setting prospective budgets for healthcare providers based on the needs of their patient population. Key considerations in capitation include the total funds available, personal factors like age and disability that affect patients' needs, and the weights given to different need factors. DRGs involve classifying patients based on diagnoses and estimated costs of treatment to group similar patients and set reimbursement amounts. Resource allocation in public hospitals in Bangladesh is currently based on the number of employees and beds, which may not fully consider equity and efficiency principles.
The who, what, where, why and how of end-of-life care. A continuing education webinar presented by VITAS Healthcare on March 15, 2018. For more information or future webinars, please visit: https://www.vitas.com/partners/continuing-education
This document describes a service model for treating patients with alcohol-related brain damage (ARBD) in the Wirral area. It outlines the clinical phases of assessment and treatment, including inpatient stabilization, outpatient cognitive assessment and rehabilitation, and long-term community support. Case studies demonstrate positive outcomes such as reduced hospital use, improved cognitive function, and independent living. A review found the program significantly lowered treatment costs while achieving high rates of abstinence and community integration for patients.
The goal of this webinar is to help hospice and healthcare professionals understand the history, philosophy and practice of hospice care and palliative care, including common myths and misconceptions, common diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the benefits of advance care planning and early referrals.
The document discusses current end-of-life care in the United States and potential solutions. It finds that primary care physicians may not be adequately involved in end-of-life issues due to lack of training and comfort discussing death. As a result, patients, families, and caregivers often experience suboptimal care, feelings of abandonment, poor communication, and high financial burdens. Potential solutions proposed include increased education, advanced care planning, greater hospice utilization, and healthcare models that facilitate primary care physician involvement in end-of-life care coordination and decision making.
The goal of this webinar was to help hospice and healthcare professionals understand the history, philosophy, and practice of hospice and palliative care, including common misconceptions, typical diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the
benefits of advance care planning and early referrals.
Advance Care Planning & Advance Healthcare Directives with People with DementiaIrish Hospice Foundation
1. The document provides guidance on advance care planning and advance healthcare directives for people with dementia, their families, and healthcare professionals.
2. It outlines four key considerations for good practice: understanding dementia, recognizing patient rights, understanding advance care planning, and being familiar with the Assisted Decision Making Act regarding capacity and advance directives.
3. The guidance stresses the presumption of capacity, engaging the patient, and considering previously expressed preferences when making decisions for those lacking capacity. It also describes what can be included in an advance healthcare directive.
This document provides an overview of issues facing children with special health care needs (CSHCN) in California. It discusses key focus areas like care coordination and family engagement. It notes that California ranks poorly nationally in areas like preventative care, care coordination, and family-centered care for CSHCN. The document also discusses the medical and social complexity of CSHCN, the importance of care coordination systems, and the need to better support families providing care.
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
C-TAC 2015 National Summit on Advanced Illness Care - Master Slide Deckzbarehmi
This document provides an overview of the National Summit on Advanced Illness Care that took place on March 2-3, 2015 in Washington DC. The summit was hosted by C-TAC (Coalition to Transform Advanced Care) and brought together leaders, clinicians, researchers, and policymakers to drive improvements in advanced illness care. Over the two-day event, there were presentations on models of advanced illness care, engaging patients and families, improving clinician-patient communication, the role of research and policies to support high-quality end-of-life care for all Americans.
Nathan Goldstein-Palliative care making the case jewishhome
Palliative care aims to improve quality of life for patients with serious illnesses and their families. Nathan Goldstein argues that hospital-based palliative care is growing in the US for four key reasons: 1) It improves clinical quality by better managing pain and symptoms. 2) It better aligns with patient and family preferences for comfort and honest discussions. 3) It is well-suited to address the growing population of older adults with multiple chronic conditions. 4) It can reduce costs by facilitating decisions to leave the hospital or withhold treatments not achieving patient goals.
Proposed changes in health care payment, from fee-for-service to alternative, risk-sharing payment models, can have a substantial impact on health services for children, especially those with complex care needs. In addition, tying payment to value can increase use of ambulatory and preventive services and encourage creative outreach. However, abrupt changes can interrupt continuity and reduce access to care.
Check this BSN Capstone paper samples to see how to write it right. For more information you can visit site . https://www.capstonepaper.net/our-capstone-papers/capstone-nursing-paper-writing-services/
Palliative care white paper for RegenceErin Codazzi
This document discusses the growing need for palliative care in the United States. It notes that 90 million Americans have a serious long-term illness, and the number is expected to more than double in the next 25 years. Additionally, four in ten Americans care for loved ones with serious illnesses. The document calls for a more holistic approach to palliative care that centers on patient needs, expands access to care for patients and families, engages stakeholders, and encourages industry solutions. It provides examples of organizations working to implement more comprehensive palliative care programs.
Annotated Bibliography
Kimberly Phillips
Colorado Technical University
Abstract
Nursing home or home care are the options loved ones of dementia suffers are faced with. For Comment by user: sufferers
some, nursing homes are not an option because of fear. Many dementias suffer are cared for in his or her place of residence. This paper is going to examine some pros and cons of caring for loved ones who has dementia at home. It is also going to review ways that home-dwelling dementia patients caregivers can receive the support he or she may need to provide good quality care to their loved ones. Comment by user: Keep in mind, you are in a Doctorate of Management Program and your paper has to be related to Management. You must start thinking about how you are going to manage something.
Keywords: Elderly, geriatric, home care, dementia
Running head: ANNOTATED BIBLIOGRAPHY 1
ANNOTATED BIBLIOGRAPHY 2
Annotated Bibliography or Replace with Your Title
This is review of the papers I am going to use to help me focus on my topic. I am interested in keeping elderly people who suffers from dementia in his or her own place of residence than being admitted into a nursing home. Comment by user: This annotated bibliography is a review of sources being used to support my topic of interest. Comment by user: With your dissertation, you aren’t trying to solve anything.
Annotation # 1
Bantry White, E., & Montgomery, P. (2015). Dementia, walking outdoors and getting lost:
incidence, risk factors and consequences from dementia-related police missing-person
reports. Aging & Mental Health, 19(3), 224-230. doi:10.1080/13607863.2014.924091
Author’s Abstract
“Objectives: To estimate incidence, identify consequences and potential risk factors for harm in people with dementia who got lost in one UK policing region. Methods: In a retrospective observational study, data were extracted from missing-person records over a four-year period in one UK policing region (population of 2.1 million). Results: Two hundred and eighty-one incidents of getting lost were identified. Incidence of getting lost was estimated at 0.5% of the regional dementia population. Fifty-nine percent of reports came from domestic settings, 29% from care homes/hospitals, and 12% on excursions from home. Five percent (n= 15) sustained significant harm, including two deaths. Average age was 78 years (SD 8.3). Harm was associated with older age (mean difference 6.16 years, CI 1.86 to 10.46,p= 0.005,t= 2.82), length of time missing (Mdn time 2.48 hours; IQR 0.97 to 9.45,p= 0.02), and season (9% winter, 2% summer,p= 0.006). The length of time missing increased with delays in reporting to police (r= 0.15,p= 0.018), getting lost at night (Mdn time 1.70 hours, IQR 0.52–3.32,p= 0.028), driving themselves (Mdn time 2.45 hours, IQR 0.42–2.00,p= 0.001), and using public transport (Mdn 1.78 hours, IQR 1.07–3.92,p= 0.001). Conclusion: Incidence in this study suggests getting lost is a low-fr.
The document summarizes key ethical issues in geriatric care including principles of autonomy, beneficence, and nonmaleficence. It discusses approaches to analyzing ethical dilemmas, including the four-box method and CASES framework. It also covers topics like moral distress, assessing decision-making capacity, and confidentiality/mandatory reporting laws. Specifically, it provides a case example of an elderly patient refusing discharge to a nursing home and walks through applying the CASES approach to determine the ethically appropriate discharge plan.
This webinar provides resources and guidance on effective conversations with patients and families about their goals, wishes, and values for end-of-life care.
Qualitative Research on Health as a Human Right in Lewis & Clark County, Mont...Purvi P. Patel
The final presentation of my Applied Learning Experience Presentation (ALE), the thesis requirement for my Masters of Public Health degree. The National Economic and Social Rights Initiative (NESRI) served as the host organization for my project. The final community presentation/defense was presented to the Tufts Medical School community in December 2009.
This document discusses homelessness and housing programs. It notes that in 2010 over 400,000 individuals experienced homelessness in the US, with 10% experiencing chronic homelessness. It then describes the Housing First model, which places individuals in permanent housing first before requiring treatment compliance, unlike transitional housing models. The document outlines several housing programs through the VA and HUD. It also reviews research showing the health impacts of homelessness, including increased mortality, hospitalizations, and costs.
The Kaiser Permanente Homeless Navigator Pilot Program in Woodland Hills, California connects homeless patients with community resources to help them find housing and other services, placing over 576 homeless patients in shelters and programs since 2012. The program uses a team approach involving medical, social work, and community staff. It has been successful in transforming lives and ending homelessness for many patients.
The goal of this webinar was to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.
The goal of this webinar was to educate healthcare professionals about advance directives and advance care planning,
including the types and purposes of legal documents that govern patients’ decisions and
preferences.
Mental illness and homelessness mar13.pptSuharnoUsman1
The document summarizes the relationship between homelessness, mental illness, and addiction. It discusses how deinstitutionalization of psychiatric facilities and a lack of affordable housing and income support have contributed to higher rates of homelessness among those with mental health and substance use issues. The document also reviews approaches to prevent homelessness following psychiatric treatment, including providing housing assistance and financial supports. Finally, it discusses the unique challenges of homeless youth and the importance of understanding their needs and goals through research.
This document provides information about hospice care, including statistics on where people die, myths about hospice, eligibility criteria, levels of care under the Medicare hospice benefit, and considerations for choosing a quality hospice provider. It notes that while most people hope to die at home, approximately 50% die in hospitals, but hospice allows three out of four patients to die at home. It aims to educate healthcare professionals about the benefits of hospice to provide timely, quality end-of-life care for terminally ill patients and their families.
This document discusses the development of an innovative program to address the complex needs of older adults. It outlines the need for such a program due to fragmented care leading to poor outcomes and high costs. The program aims to provide coordinated, longitudinal care management for complex patients through an interdisciplinary team approach and connection to health and community resources. It describes the community needs assessment conducted and evidence-based models investigated in designing the program. Implementation details are discussed, including identification of the target population, scope, governance structure, metrics to evaluate financial and clinical outcomes, and challenges in launching the new model of care. Keys to success include clear outcome measures, measuring value across the whole region, change management, and developing a culture of person-centered care.
Mrs. B, a 97-year-old woman living in a residential care home, was admitted to the hospital after a fall. Her daughter informed staff that Mrs. B had an advance health directive. Mrs. B was treated for aspiration pneumonia and other issues. Despite treatment, Mrs. B remained distressed and her condition deteriorated. She was found dead during an overnight medical team call. Opportunities to improve care included the residential home notifying the hospital of Mrs. B's advance directive and discussing her goals of care when she was confused upon admission.
Respond to this post with a positive response a probing.docxwrite4
The document discusses ethical issues surrounding healthcare resource allocation, particularly for elderly patients. It notes debates around macro-allocation of public health resources versus micro-allocation of individual care. While some argue for prioritizing efficiency and cost-effectiveness, solely considering ability to pay for care is unethical. The document advocates for early discussions of end-of-life wishes to ensure care aligns with patient values and preferences rather than unwanted interventions.
The Value Proposition of Hospice | VITASVITASAuthor
The goal of this webinar was to help hospice and healthcare professionals discover the evidence-based benefits of hospice care, while gaining key insights on hospice eligibility guidelines, how hospice differs from other types of care, and how the Medicare Hospice Benefit helps patients facing advanced illness.
The document discusses the value of hospice care within the Medicare system. It notes that recent statistical analyses found hospice generated cost savings in a patient's last six months of life and up to a year of hospice enrollment. The document then proposes examining these results from different perspectives within the serious illness care continuum, including from primary care physicians and considering diversity, equity and inclusion. Expert hospice and palliative care clinicians would discuss the importance of earlier access to such care in a patient's disease trajectory, as well as the
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
nursing management of patient with Empyema pptblessyjannu21
prepared by Prof. BLESSY THOMAS, SPN
Empyema is a disease of respiratory system It is defines as the accumulation of thick, purulent fluid within the pleural space, often with fibrin development.
Empyema is also called pyothorax or purulent pleuritis.
It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space.
Pus is a fluid that’s filled with immune cells, dead cells, and bacteria.
Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.
Empyema usually develops after pneumonia, which is an infection of the lung tissue. it is mainly caused due in infectious micro-organisms. It can be treated with medications and other measures.
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...Kumar Satyam
According to TechSci Research report, “India Medical Devices Market Industry Size, Share, Trends, Competition, Opportunity and Forecast, 2019-2029,” the India Medical Devices Market was valued at USD 15.35 billion in 2023 and is anticipated to witness impressive growth in the forecast period, with a Compound Annual Growth Rate (CAGR) of 5.35% through 2029. This growth is driven by various factors, including strategic collaborations and partnerships among leading companies, a growing population, and the increasing demand for advanced healthcare solutions.
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1. Nowhere to go. Discharge
challenges from hospital for
seniors faced by the Canadian
health care system.
By: Kristan, Angela and Diane
2. Objectives
Classmates will:
• Gain an awareness of the Alternate Level of Care (ALC)
situation in Canada
• Consider other models for elderly patients who no longer
require acute care but are challenged to be able to leave
hospital
• Understand the philosophy of Home First
• Articulate voices silenced
• for patients who are deemed ALC
• staff working with these patients
• family and informal caregivers
3. Objectives Continued
• describe how free choice influences discourse in patient
discharges and describe the relationship between discourse
and power as it relates to patient discharges and
• cite a solution or alternative course of action that could be
taken to eliminate the problems presented
4. Resources and Links
Bauer, M., Fitzgerald, L., Haesler, E., Manfrin, M. (2009). Hospital discharge
planning for frail older people and their family. Are we delivering best practice?
A review of the literature. Journal of Clinical Nursing. 2439-2546. http://0-
content.ebscohost.com.aupac.lib.athabascau.ca/ContentServer.asp?T=P&P=AN&
K=2010366599&S=R&D=rzh&EbscoContent=dGJyMNLe80Sep7Y4yOvsOLCmr02e
prdSsaa4SLWWxWXS&ContentCustomer=dGJyMPGrrk2zr7FJuePfgeyx43zx
Rogers, V., Gilmour, J. (2011). Shaping student nurses’ attitudes toward older
people through learning and experience. Nursing Praxis in New Zealand. 27(3).
13-21
http://0-
content.ebscohost.com.aupac.lib.athabascau.ca/ContentServer.asp?T=P&P=AN&
K=2010366598&S=R&D=rzh&EbscoContent=dGJyMNHX8kSeqK44yOvsOLCmr02
ep7JSs6a4Ta6WxWXS&ContentCustomer=dGJyMPGrrk2zr7FJuePfgeyx43zxo9%2
BK8gAA
Champlain CCAC Home First – YouTube
http://www.youtube.com/watch?v=Pnnsa8WGKDM
5. Tories hiding report showing senior wait times are growing, Liberals
claim. Calgary Herald. (February 9, 2014).
http://www.calgaryherald.com/health/Tories+hiding+report+showing+sen
ior+wait+times+growing+Liberals+claim/9490463/story.html
Canada's first seniors advocate says role needed across country: Isobel
Mackenzie says her office will pinpoint the most urgent issues in long-
term care. December 30, 2014.
http://www.macleans.ca/politics/canadas-first-seniors-advocate-says-role-
needed-across-country
Ernest Madu on World-Class Health Care-inspiring story telling us how it
is possible to provide the best health care to the neediest among us.
June 2007.
https://www.ted.com/talks/ernest_madu_on_world_class_health_care?la
nguage=en
Resources and Links
6. Resources and Links
How Ready Are You for Long-Term Care?
http://money.usnews.com/money/blogs/the-best-life/2011/12/20/how-ready-are-
you-for-long-term-care
Simpsons: Homer in a Nursing Home.
https://m.youtube.com/watch?v=wJUQXkgHM48
Statistics by subject: Seniors - Statcan
www5.statcan.gc.ca
Zakrazjsek, A.G., Schuster, E., Guenther, G., Lorenz, K. (2013) Exploring older adult
transitions from hospital to home: A participatory action research project. Physical
& Occupational Therapy in Geriatrics. 31 (4) 328-344. Retrieved from:
http://cnhs.lms.athhttp://cnhs.lms.athabascau.ca/mod/forum/discuss.php?d=4127
02abascau.ca/mod/forum/discuss.php?d=412702
Resources:
• ACE-Advocacy Centre for the Elderly. A community based legal clinic for low
income seniors. (advocacycentreelderly.org)
• Seniors Canada Online (www.seniors.gc.ca)
• Canadian Government Programs for Seniors (www.longtermcarecanada.com)
7. Awareness – Background Information
• Advances in medical care and prevention have increased the life expectances of
older adults, as well as shifted the major causes of death from infectious
diseases and acute illnesses to chronic diseases that require ongoing medical
care
• As older adults are living longer with chronic illness, health care providers are
challenged with providing high quality and cost effective care that addresses
older adults’ needs as they move from one health service to another
• Health care transitions, such as moving from an acute stay in the hospital to
home, represent a critical moment in older adults’ continuum of care when
communication breakdown, lack of planning and follow-up, and major life
adjustments without necessary supports can pose threats to health and
participation for this population
• Problematic components that contribute to a poor transitioning experience and
create barriers to a successful transition for the patient, caregiver and the
service provider:
• lack of preparedness, lack of coordination, collaboration and communication
among hospital and community-based service providers, lack of information
regarding resources and health care contacts, and patients and caregivers not
understanding the necessary steps to manage their care and treatment (Zakrajsek,
2013)
8. ALC – “Alternate Level of Care”
• Used to identify patients who are admitted to hospital but no
longer require the level of care provided at that facility
• These patients are ready to leave the hospital, but there may
be obstacles to an immediate discharge (Byrick, n.d.)
9. Awareness - Background Information
• More than half (54%) of seniors who waited in acute care were discharged to a residential care
facility
• Persons with symptoms of dementia, including challenging behaviours, were more likely to have
waited in acute care prior to residential care admission, suggesting that they were waiting for
specialized services such as behavioural support
• Persons with complex care needs without a strong support system were more likely to have
waited in acute care before home care admission, suggesting that they were waiting for a
caregiver to be available or services to be put in place
• There is an ongoing concern that acute care beds in Canada are occupied by seniors who are
waiting to be discharged to a more appropriate level of care. These individuals, who no longer
require acute care services, are commonly designated as alternate level of care (ALC) patients
• The majority of seniors express the desire to remain at home, and there is evidence to suggest
that providing care at home is a cost-effective alternative
• Projections show that the proportion of seniors in Canada’s population will nearly double in the
next few decades (from 15% in 2011 to 25% in 2036); the number of ALC patients is therefore
expected to increase as well. For example, in Ontario, the number of ALC patients—the majority
of whom are above age 75—is expected to increase by 32% over the next 10 years. This shifting
demographic will increase the pressure on both acute care and residential care facilities
• Seniors admitted to residential care with ALC days waited an average of 26 days before being
discharged, compared with an average of 7 days among those admitted to home care (Canadian
Institute for Health Information, 2012)
• Nursing home capacity would need to increase by 75% over the next decade to meet the
projected demand (Costa et al., 2012)
10. Awareness – Delayed Discharge
• Delays in discharge from acute hospitals are a critical
challenge for many health care systems
• These are where a patient exceeds the length of stay deemed
medically necessary, commonly associated with older adults
• They often have a substantial influence on patient flow
throughout the hospital including emergency department
crowding, cancelations of day procedures, and poor
coordination of sub-acute and community care resources
• Patients who experience a delayed discharge are at increased
risk of accelerated functional decline, social isolation, as well
as the loss of independence and are a reflection of health
system quality (Costa et al., 2012).
11. Questions (posted individuallywithintheforumso
classmatescananswerappropriately)
• In your opinion, what can our health care system do to
address the demand of nursing homes? Dream big!!
• Please share examples, either from personal or professional
experience, of challenges that older adults have faced when
transitioning from hospital to home or LTC facility.
• In your opinion, what resources would help facilitate the
transition of ALC patients home? (Might not be appropriate in
my section but in another?)
12. Reflection – Home First
Background
Patients waiting for long term care in hospital face significantly long hospital stay. Home First is
a philosophy which supports patients who no longer require acute care but their condition is
such that they may be required to move to Long Term Care.
Most patients will tell you that they would prefer to go home but many are denied this
opportunity
To support patients to go home in the Home First Philosophy , the patients are provided with
high levels of services such as nursing, therapy and personal support care in order to support
them and their informal caregivers so that they can go home rather than wait in hospital.
The premise is that patients / families are better able to make life changing decisions in their
own home environment.
This philosophy exists across Ontario. Despite many successes there has been slow uptake in
some areas
75% of patients – do not return to hospital (L Debuck, June 11, 2015)
Debuck, L., (June 11, 2015). Personal communication
13. Reflection Capability and
Decision Making
• It is important for health care providers to remember that if
patients are able to understand and realize the consequences
of their decision (have insight) then they are considered
mentally capable of making decisions even if it means living at
risk (Government of Ontario)
• Rogers and Gilmour describe ageism whereby “potential for
improved health and wellbeing” is curtailed due to the
attitudes of nurses caring for them (Rogers, Gilmore, 2011 pg.
13).
Government of Ontario. (2000). A guide to the substitute decisions. Queen’s Printer for Ontario. Retrieved from:
http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/pgtsda.pdf
Rogers, V., Gilmour, J. (2011). Shaping student nurses’ attitudes toward older people through learning and experience. Nursing
Praxis in New Zealand. 27(3). 13-21.
14. Reflection Questions
1. For Seniors who want to go home but are challenged
with cognitive disability and poor physical function
what challenges are faced by them – related to power
relations between them and hospital staff – nurses /
therapists / their informal caregivers such as family
2. Who’s voices are silenced – the patient/family/home
care workers, others? Why? How can health care
professionals advocate?
15. Action
• Power struggles are one of the most prominent domains of
discourse analysis. Whether political, sociological or
psychological, the struggle for power is at the root of many
societal issues. Power relations within a health care system is
no exception and from the premise of patient discharges I will
provide a brief discourse analysis outlining how free choice
influences the relations between discourse and power in a
health systems context. Subsequent to this I will offer a few
possible perspectives toward the alleviation of the issues that
have ensued as a result.
16. Action
• Discharging patients from a hospital setting is almost always a challenge.
This challenge is heightened when there is a discrepancy between the
desires of the patient and the health care professionals caring for them.
The purpose of the discharge procedure is to ensure patients who are
leaving the hospital are prepared to do so. This requires a certain
standard of mental and physical wellness in addition to access regarding
information concerning ongoing care. This is often a struggle despite
the discharge protocols and expert discharge planners in place to aid in
a smooth transition. One of the most common examples of this strained
process occurs when the nurse, or other health professional, believes
the patient is best suited toward a discharge to a long-term care facility
and the patient or their family members disagree. Subsequently, a
power struggle ensues. The nurse acting in what he/she believes is in
the best interests of the patient and yields a positive clinical outcome in
consideration of decreasing the possibility of re-admission to hospital.
On the other hand, the patient with awareness of their choices acts and
makes decisions based on what feels right for them, what they are
comfortable with, what they desire; which is not always compliant with
medical recommendations or insight.
17. Action
• Communication is an intertwined and fundamental element of what is going on within the power struggle
between health care providers and patients when there are glitches in the discharge process. This makes a
discourse analysis of the situation an excellent basis for interpretation and study of a hospital systems discharge
framework. Clarity in communication involves looking beyond what is simply being said or surface actions into the
social contexts that they are originating from. In terms of a long-term care discharge, there are many societal
considerations. News and media have illustrated various examples questioning the quality of long term care that
may contribute toward a distrust of the hospital system and sway persons in need of these facilities away from
seeking them as a living solution.
• (a) What is the discourse in power between the patient and health care professional?
• Generally there is an authoritative discourse between the nurse and patient. The nurse is viewed as the “expert”
concerning health matters however, realistically speaking the patient is the expert concerning their own body.
From this baseline communication may become a challenge and research illustrates that nurses often miss clues
that their patients need to be heard and listened to in order for effective communication and results/choices to be
made by the patient (Barrere, 2007). If the patient has spent the majority of their hospital stay feeling unheard or
not-respected, at the point of discharge when there is a choice for them to make, they may not even consider the
points being brought forth by the health professional and just desire to leave the system entirely.
• (b) What solutions or actions could be utilized to smooth the discharge process?
• Education and teaching strategies that discuss how to establish equitable discourse and symmetrical nurse-patient
communication (Barrere, 2007) are paramount to a sustainable solution. In addition to this other literature
suggests that nurse/patient role playing (Brooks, 2008), strategies aimed at empowering patients (Virtanen, 2007)
as well as self-objectivity and more empathetic communication techniques all have the potential to enhance the
hospital systems discharge process.
•
18. Resources
• Barrere, C. (2007). Discourse analysis of nurse-patient communication in a hospital setting: implications
for staff development. Nurses Staff Development. May-June Issue. PubMed online. Retrieved from:
http://www.ncbi.nlm.nih.gov
• Bauer, M., Fitzgerald, L., Haesler, E., Manfrin, M. (2009). Hospital discharge planning for frail older people
and their family. Are we delivering best practice? A review of the literature. Journal of Clinical Nursing.
2439-2546
• Brooks, F. (2008). Nursing and public participation in health: an ethnographic study. International
Journal of Nursing Studies. Jan;45(1):3-13. Elsevier Science.
• Clancy, C.(December 30,2014). Canada’s first seniors advocate says role needed across country: Isobel
Mackenzie says her office will pinpoint the most urgent issues in long-term care. MacLeans. Retrieved
from: http://www.macleans.ca/politics/canadas-first-seniors-advocate-says-role-needed-across-country
• Champlain CCAC Home First – You Tube (May 31, 2011). Youtube.com
• Costa, A. P., Poss, J. W., Peirce, T., Hirdes, J. P., (2012). Acute care in patients with long-term
• delayed-discharge: evidence from a Canadian health region., BMC Health Services Research. p 1-10
• Debuck, L personal communication, ( June 11, 2015).
• Government of Ontario. (2000). A guide to the substitute decisions. Queen’s Printer for Ontario.
Retrieved from: http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/pgtsda.pdf
• Hinton, D., (February 9, 2014). Tories hiding report showing senior wait times are growing, Liberals claim.
Calgary Herold. Retrieved from:
http://www.calgaryherald.com/health/Tories+hiding+report+showing+senior+wait+times+growing+Liber
als+claim/9490463/story.html
19. Resources Continued
• Madu, E., Ted Talks. (June 2007). Ernest Madu on world-class health care-inspiring story telling us how it is possible to
provide the best health care to the neediest among us. Ted Talks. Retrieved from:
https://www.ted.com/talks/ernest_madu_on_world_class_health_care?language=en
• Moeller, P. (Dec 12, 2011). How ready are you for long-term care? US News. Retrieved from;
http://money.usnews.com/money/blogs/the-best-life/2011/12/20/how-ready-are-you-for-long-term-care
• Mulholland, (Tuesday May 21, 2013). CTV News. Nursing home abuse not isolated experts say. Retrieved from:
http://www.ctvnews.ca/mobile/canada/nursing-home-abuse-incident-not-isolated-say-experts-1.1290010
• Ontario Health Coalition. (May, 1999). Fact Sheet on Long Term Care. Retrieved from:
http://www.ontariohealthcoalition.ca/wp-content/uploads/Fact-Sheet-May-1999-General-LTCARE.pdf
• Rogers, V., Gilmour, J. (2011). Shaping student nurses’ attitudes toward older people through learning and experience.
Nursing Praxis in New Zealand. 27(3). 13-21.
• The New York Times. (June 7, 2013). Fine print and red tape in long term care policies. Retrieved from:
http://mobile.nytimes.com/2013/06/08your-money/fine-print-and-red-tape-in-long-term-care-policies.html?referrer=&_r=0
• Simpsons, (n.d.). Homer in a nursing home. Retrieved from : https://m.youtube.com/watch?v=JUQXkgHM48
• Virtanen, H. (2007). Empowering discourse in patient education. Patient Education Counsel. May;66(2):140-146. Epub.
• Zakrajsek, A., G., Schuster, E., Guenther, D., Lorenz, K. (2013). Exploring older adult care transitions form hospital to home: A
participatory action research project. Physical and Occupational Therapy in Geriatrics. 31(4). 328-344.