During the poster session at AOTA’s centennial conference, a poster regarding “Effectiveness of a Comprehensive Home Health Program on Functional Independence of Older Adults” has caught my attention. This quantitative study consisted of 47 older adults living independently, and is capable of using assistive technology for a variety of ADL tasks. Clients were over the age of fifty, utilize assistive technology, and were living alone. The researchers correlate the level of independence, number of falls, and pain level when performing ADLs to the effectiveness of home healthcare programs. The level of independence was assessed on an 8-point scale, the number of falls was recorded, and pain level was assessed on a 10-point scale.
This substantial increase in population of those living longer with chronic illness supports that interventions need to be recognized early to decrease loss of independence. The Louisiana Community Choices Waiver provides ancillary support, such as physical, occupational, respiratory and speech therapy to qualifying residents. These services provide functional support while providing socialization in the home environment. This promotion of increased physical mobility and prevention can assist residents to maintain or increase their independence in the home. The expected growth of the elderly population in the next decade demonstrates a critical need for additional measures to support the efforts of individuals desiring to stay in their homes.
Falls among any individual can cause significant trauma, often leading to an increase in mortality. According to the Centers for Disease Control and Prevention (2012), one in every three adults over the age of 65 falls each year. Long-term care facilities account for many of these falls, with an average of 1.5 falls occurring per nursing home bed annually (Vu, Weintraub, & Rubenstein, 2004). In 2001, the American Geriatric Society, British Geriatric Society, and the American Academy of Orthopaedic Surgeons Panel on Falls Prevention published specific guidelines to prevent falls in long-term
The alternative in providing care for a dependent family member is keeping them in their own home, or the home of a family member. In recent years there has been a move in market place to an idea that is much more cost effective to provide most of the same services that traditionally found in a long-term care facility in the home. It is estimated that providing these services in the home are approximately $21,800.00 a year. It is also important that these figures only cover the cost of providing skilled health care. These figures do not cover additional expenses occurred in the home such as the cost of room and board. In many instances, the idea of keeping family members in the home where their care, may be more closely supervised is becoming increasingly appealing. Many health care providers are recognizing this and providing more and more services available in the home. In today’s market place anyone can find nursing, physical therapy, occupational therapy, and respiratory therapy companies
In DC, community based fall prevention programs have been rising to address falls but fall related incident, injuries and the cost has continuously been rising among elderly people (Costello & Edelstein, 2008). In the study conducted by Berland et al. (2012), showed that in home health, not viewing patient safety as primary prevention, lack of investigation causing fall and frailty of elderly adult have been some factors contributing to falls in home health. Falls negatively impacts an individual living in their home by causing them physical, emotional problem, giving rise to additional cost by losing workdays and income.
Participants: 15 total participants, age range 48-78; all community dwelling; independent with ambulation (no assistive devices needed), and independent with transportation.
The widespread falls among the geriatric population reduce their quality of life and take away their functional independence. Lee et al (2013) state that falls leads to the rise in mortality rates and morbidity complications such as fractures and disabilities,1 out of 3 elderly persons in a community setting falls in a year. About 87% of all fractures in the elderly are due to falls. Several of the risk factors that are associated with falls are visual impairments, cognitive impairments, and health-related problems: arthritis, orthostatic, back pains, lack of balance-weakening muscles, previous falls, polypharmacy or psychoactive drugs (Lee et al, 2013).
More and more people will need care in old age, and if they are disabled. Millions of Americans suffer from a chronic illness, or some kind of disability, and many of these people will have limits in their daily activities. Some people experience
Our elderly population is living longer than ever before and not all of them are entering into a nursing home. They are choosing to stay in their own home or their caregiver is choosing it for them. Some caregivers are choosing to move their ageing love one in the home with them. Whatever the case may be, there is an increased need for some type of home health as it applies to the elderly population. “Medicare will pay the full cost of professional help only if the physician
In these services they would usually be offered help with activities of daily life, such as eating or bathing. Some home services also give them other benefits such as residential services, personal care or case management. To give more open details on experiences of Medicaid beneficiaries who need home and communities based services Musumeci and Reaves discuss nine seniors who are disabled and who live in different states. Those include people with different kind of disabilities which can be either developmental, physical or intellectual and issues such as autism, cerebral palsy, multiple sclerosis and their functional limitations that are there because they aged (Musumeci & Reaves, 2014). Based on interview that were given from these people to the Kaiser Commission in 2013 based on Medicaid and uninsured, these peoples’ profiles clearly show us how beneficiaries funds, well-being, status of their employment are affected by the coverage of Medicaid and the role these services play in their daily lives (Musumeci & Reaves, 2014). In the last years states are trying to work on rebalancing long-term care system by dedicating more spending to home and community care rather than institutional care. The reason is this being the efforts that are driven by beneficiaries who are
Program #1: Nixon Home Care, Inc. provides transportation services for otherwise home-bound low-income elderly or impaired individuals. CDC identified gaps in opportunities for seniors and disabled adults to regularly engage in physical activity. They cited this as probable causes for serious mental illness and the development of chronic conditions later in life. CDC research also found that social isolation is a significant problem for impaired adults and that their often sedentary lifestyles contribute to feelings of depression and anxiety. These emotions are linked to obesity and a number of other chronic illness including cardiovascular diseases including diabetes. But, one of the biggest challenges elderly and impaired adults face is
Since falls are a frequent obstruction to independent living among elderly persons, there has been a growing consciousness of the incidence of falls which has led to the development of a lot of community-based fall prevention programs for older adults. Yet, the potential impact of these programs is reduced by the lack of research on factors that may influence older persons' decisions to accept or reject fall prevention behaviors. In an exploratory descriptive study done by Aminzadeh & Edwards, (1998) a focus group approach was used to draw out qualitative data on seniors' views on the use of assistive devices in fall prevention. Four focus group interviews were carried out with a convenience sample of thirty community-living older adults in Ottawa, Canada. "The interviews documented
The functional independence measure (FIM) was utilized to identify patients who are at a high risk for fall and found that patients who fell had a lower admission and discharge FIM scores than the ones who had not fallen; they also found that those with lower FIM scores were stroke rehabilitation patient and had the highest rate of fall. FIM is defined as a measurement of disability specific to patients in rehabilitation; it has has 18 categories broken down into motor and cognitive components with each category scored on a scale of 1 for total dependence to 7 for total independence. The authors of the research article determined that FIM score have significance in predicting patients who are at a highest risk of falls and is more appropriate to aid in implementing interventions. With the above discovery, Salamon, Victory & Bobay (2012) undertook retrospective pilot study to compare the Morse Fall Scale scores and components of the FIM. The result from the pilot study yielded several important correlations between the Morse Fall Scale and the FIM scores. The study revealed that patient with cognitive impairments, and those with decreased ability to expressed needs are more likely to fall and no correlation with comprehension was found with the
The ACL’s programs are easily accessible through doctor’s office referrals, community outreach programs, and they have a phone number online for anyone who has questions. Social workers can also help set up a patient with help from these programs. This is effecting health care now by offering help to those in need and providing support to people suffering from Alzheimer’s. By maintaining independence cost of healthcare is being kept down from the high cost of nursing homes and hospital stays. These programs offer assistance to keep
As the life expectancy in the United States rises, the number of elderly in the population has also expanded. These increases have led to the oldest-old (people aged 90 and older) to become the fastest growing age group in the country. The oldest-old face many unique challenges because of their age, one of which is disability. Disability in the elderly has major impact upon society 1 and will continue will be a growing burden in years to come.
In the field of gerontology, nurses must use a comprehensive process to collect information to fully understand the needs of the elderly patient. This assessment should be holistic covering the individual’s physical, social, psychological and spiritual aspects. It’s also crucial that the nurse evaluate the patient’s level of function and ability to perform self-care activities. This enables the nurse to identify strengths that may enhance the patient’s independence and diminish their disability. For the first part of this assignment, I am using tools and scales to evaluate J.B.’s social history, nutrition, cognitive function, fall risk, and ability to perform activities of daily living.