![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](https://image.slidesharecdn.com/genworth2009presentation-12579622735278-phpapp01/85/Genworth-2009-Presentation-2-320.jpg)
Genworth 2009 Presentation
- 1. Who Will Care? Genworth United Way Presentation November 5, 2009
- 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. Adult Day Services Goals Maintain or improve the highest level of independence and health. Provide respite and support to caregivers.
- 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. 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. 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. 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. BARRIERS External Public/provider awareness. Inadequate resources to fund services. Adult day services are not a public policy priority.
- 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 Alzheimers Brain injury 53 million boomers expect to Autism care for parents who are in their Mental retardation 70s & 80s.
- 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. Recommendation Change policy and funding to make home- and community-based services a priority.
- 12. Recommendation Build Adult Day Services Infrastructure.
- 13. Recommendation Increase Medicaid waiver reimbursement to cover cost of care.
- 14. Recommendation Advocate family-friendly employment policies & practices.
- 15. Recommendation Develop a statewide program for increased public awareness.
- 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. 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. 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. 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. 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