Please Note: Talk to your doctor, case manager or healthcare professional to see if these options are right for you and are covered by your health insurance. CHOICES FOR Continued Care The appropriateness of each setting/ service may vary due to the specifics of your situation, your overall health, the availability of family or friends to help with your care, recommendations from your physician and/or restrictions of individual medical insurance policies. Optimize your health A guide to help you understand what type of care is right for you or your loved one www.connectedforhealth.org This material was prepared by CFMC (PM-7220-015 CO 2011) the Medicare Quality Improvement Organization for Colorado, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the United States Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. what are my choices? Non-Medical Home Care This guide made possible by your NW Denver Connected for Health Community and your Colorado Quality Improvement Organization (QIO), CFMC Medical Home Health Care Skilled Nursing Facilities Long-Term Acute Care Hospital Nursing Home Care
Non-Medical Home Care What is Non-Medical Home Care? Non-medical home care is supportive care provided in the patient s residence and is a home-based alternative to assisted living. Assistance with activities of daily living; bathing, dressing, transferring, using the toilet, eating and walking Assistance with personal hygiene, including incontinence care Memory care for individuals with Alzheimer s disease and other types of dementia Daily living support for individuals with disabilities and special needs Socialization and companionship Meal preparation Housekeeping assistance Medication reminders Assistance with errands, shopping and transportation Transportation and accompaniment to appointments Medical Home Health Care What is Medical Home Health Care? Medical home health care is short-term medical services ordered by a doctor and provided in the home. These services provide education, training and support to ensure that the patient can stay safely in their home environment. Short-term support services are provided by nurses, therapists and aides to help the patient reach their self-care goals. Skilled nursing care (including assessments) Medication management and teaching Home Health Aide or Certified Nursing Aide assistance for medical care Medical Social Workers Physical therapy Occupational therapy Speech therapy Guidance in accessing financial and community resources Staff on-call 24 hours a day/7 days a week Monitoring and observation The length of time for care may vary from 1 hour to 24-hour care Who benefits from Non-Medical Home Care? Non-medical home care helps keep the elderly or disabled independent, promotes healing and reduces stress. Non-medical home care benefits people who need assistance in private residences and independent living communities. Individuals in assisted living and hospice environments may also benefit from non-medical home care to bridge the gap between clinical visits and family-provided care. National Private Duty Association www.privatedutyhomecare.org Seniors Blue Book www.seniorsbluebook.com Who benefits from Medical Home Health Care? Home health care benefits patients with a new diagnosis, those recently discharged from the hospital and/or with changing medical conditions. Patients and/or their caregiver receive direct care services and education about their disease, conditions and how to better care for themselves. Patients who need help with oxygen management, home safety, medical equipment and/or have moved to a new home setting may benefit from home health care. Patients are seen in their home environment, which can include independent living facilities, assisted living facilities or in the family home. Medicare Home Health Compare www.medicare.gov/homehealthcompare Non-Medical Home Care Medical Home Health Care
What is? Assisted living is a licensed community with a home-like environment that provides supervision and assistance with activities of daily living. Assisted living facilities may vary in size from very small group homes of eight residents to facilities with more than 100 residents. Activity programs On-site foot clinics, beauty shops, church services May have access to in-house physicians and dentists Fall prevention monitoring Laundry service Meal service Medication administration by qualified staff under the direction of a registered nurse Assistance with bathing, dressing, eating, walking, transferring, and using the toilet Skilled Nursing Facilities What is a Skilled Nursing Facility? A skilled nursing facility is a non-hospital facility dedicated to the care of patients whose needs are usually critical enough where they need close attention, but not serious enough for hospitalization. The program of care is designed to help you return home. Short-term rehabilitation (generally fewer than 30 days) Medication management Evaluation, diagnosis and treatment of illnesses Physical, occupational and speech therapies Disease management, dietary and health education Development of a home discharge plan based on the goals and preferences of the patient Ongoing consultation with patient s physician 24-hour skilled medical care Use of home health agencies for physical therapy, occupational therapy, speech therapy and nursing care where needs are safely met Aides on duty 24 hours a day; Nursing on-call 24 hours a day Who benefits from? Assisted living supports care for those whom independent living is no longer appropriate for, but do not need 24-hour medical care. Assisted living benefits residents who have a need for socialization and want a safe environment with staff available to assist with their changing needs. Who benefits from Skilled Nursing Facilities? Skilled nursing facilities benefit patients who need 24-hour care, observation of the patient, daily therapeutic services and/or rehabilitation provided outside of a hospital. Skilled nursing facilities can benefit patients in short-term stays. Medicare Nursing Home Compare www.medicare.gov/nhcompare Seniors Blue Book www.seniorsbluebook.com Information www.assistedlivinginfo.com National Center for www.ahcancal.org/ncal Skilled Nursing Facilities
Long-Term Acute Care Hospital What is Long-Term Acute Care? Long-term acute care hospitals provide an extended level of care for patients with severe illnesses and complex medical conditions that need hospital-level care. Long-term acute care hospitals include on-site intensive care unit, intermediate and medical-surgical levels of care and daily physician rounding with on-site specialist care available to the medically complex patient. Dialysis Nutritional support Pain management team Pharmacy team Rapid response team Physical, occupational and speech therapies Respiratory therapy Wound Care team Physician availability 24 hours a day/7 days a week Nursing Home Care What is Nursing Home Care? Nursing home care provides a variety of services for residents who cannot care for themselves independently for long periods of time (generally more than 90 days). Nursing home care occurs in a residential home setting and can provide help with activities of daily living and skilled nursing care. Long-term Residential living 24-hour medication management Skilled and non-skilled nursing care Services can be provided for people of any age Assistance with bathing, dressing, transferring, using the toilet, eating and walking Promotion of wellness Development of a home discharge plan based on the goals and preferences of the patient Who benefits from Long-Term Acute Care? Long-term acute care benefits patients who are too sick to go home immediately following their discharge from the hospital and need additional medical services. Who benefits from Nursing Home Care? Nursing home care benefits residents who need help with bathing, dressing, transferring, using the toilet, eating and walking and provides professional, supervised services. Nursing home care supports residents care with dignity and independence and can offer individual care tailored to the needs of the resident. National Association of Long Term Hospitals www.nalth.org Medicare Nursing Home Compare www.medicare.gov/nhcompare Long-Term Acute Care Hospital Nursing Home Care
What is? Palliative care is medical treatment that reduces the severity of disease symptoms rather than aiming to cure the disease. Health care professionals representing expertise from various health care disciplines provide care to relieve suffering and improve quality of life for patients with advanced illnesses and their families. It is offered simultaneously with all other appropriate medical treatment. Palliative care neither hastens death nor prolongs life. Management of pain, fatigue, nausea, depression and loss of appetite Goal and preference clarification for care and quality of life Exploration of treatment options Assistance in completing advance directives such as a living will Assistance in navigating the health care system to acquire needed care What is? is a philosophy of care aimed at enhancing the quality of life for those facing life-threatening illnesses and with a life expectancy of six months or less. focuses on the patient s physical, psychological and spiritual needs and coaches the family on how to care for their loved one. Pain and symptom management Education and guidance for family caregivers Emotional and spiritual support for the patient and their family Services provided wherever the patient lives, including an assisted living facility, nursing care center or at home care is available in out-of home, residential facilities for patients who are unable or do not wish to remain at home If needed, short-term, intensive medical care is provided by the hospice team to manage severe symptoms Assistance in accessing community resources such as home care, medical equipment vendors, financial assistance and other services Support system to help patients live as actively as possible Not a 24-hour service Who benefits from? Palliative care benefits people with chronic, long-standing illnesses such as cancer or heart failure as well as those conditions requiring pain and symptom management. Palliative care may also benefit the patient s family by providing services to help cope with grief and stress. Palliative care helps patients who want to improve their quality of life by managing disease symptoms that may be present. Centers to Advance www.capc.org Medication, medical supplies and equipment as needed Not a 24-hour service, but staff is available/ on-call 24 hours a day/7 days a week Who benefits from? benefits patients at the end of life who have decided to forego further curative treatment. Emotional support is also provided for the patient s family. Doctors, nurses, case managers, social workers, chaplains and volunteers work with hospice patients and their families to provide comfort and dignity. The Colorado Center for and www.cochpc.org National and Organizations www.nhpco.org