State Policy Case Study

The Older Americans Act (OAA) funds critical services that keep older adults healthy and independent—services like meals, job training, senior centers, caregiver support, transportation, health promotion, benefits enrollment, and more. The Act is overdue for reauthorization—and Congress needs to seize this opportunity to update and renew its commitment to these programs and those they serve. To ensure America’s aging population is able to maintain and live healthy lives provisions are needed to the current OAA. These provisions include:

* Evaluate the effectiveness of a care home for the elderely organizational policy (safe guarding vulnerable individual policy) in supporting elderly people and

Current literature has exposed many risk factors for falls. There are both intrinsic risk factors and extrinsic risk factors. Intrinsic risk factors include changes that come with age, such as gait issues, urinary incontinence, and fear of falling. Extrinsic risk factors include those that are related to the physical environment such as improper use of assistive devices and poor floor surfaces. No matter the type of risk factor, it is crucial to conduct a risk assessment when trying to prevent falls from occurring. Pearson and Coburn (2011) found that identifying risk factor for falls will help identify appropriate prevention strategies. Fall risk assessments help determine Talk about

The Center for Disease Control (CDC) reported that more than one third of adults 65 and older fall each year. Half of the elderly people, who fall, do so repeatedly. Aside from the health problems related to falls, nearly $20 billion of direct medical costs are associated with fatal and non-fatal falls (Larson & Bergmann, 2008).

Most hospitalized patients of 65 years and above have been established to be more vulnerable to falling within their homes or in a facility. These falls have been attributed to various causative agents that need to be assessed and managed in an attempt to completely avert falls (Wilbert, 2010). Prevention of falls should be mandatory since they cause more danger to patients, including breakage of the main bones and even death. As a result, the patient may develop a more serious condition such as decrease functional immobility in addition to that which caused hospitalization. Most of these falls have been found to be caused by therapeutic impacts and ignored diagnostic information (Naqvi, Lee & Fields, 2009). For instance, a great number of elderly people who are hospitalized are diagnosed with dementia at the time of admission; hence, such information needs to be taken into consideration during the care of such a patient. Dementia is likely to cause disorientation and confusion which may result in recurrent falls. Therefore, falls may be described as the abrupt and unintended loss of uprightness that leads to body displacement towards the ground falls (Wilbert, 2010). The purpose of this paper is to develop a falls prevention, management program that will reduce the number of falls occurring within an organization.

(Tzeng, 2008) It would be ideal to create a fall prevention team that includes current staff who are directly involved in the care of clients. This team would include physicians, former or current staff nurses, assisting personnel, and other healthcare members since they all spend time at the patients’ bedside, and they may have insight into areas of improvement that others may not see. An interdisciplinary effort would be an overall better approach when dealing with precautions that would affect the facility’s policy and procedure changed in the facility. (Hughes, 2007) All of the members input about healthcare improvement may be highly constructive and would greatly benefit safety goals. The Joint Commission emphasizes that a better physical design of facilities may also lead to improved healthcare outcomes such as fewer patient falls. (Joint Commission, 2007)

Every year, about one third of everyone over the age of 65 falls, and do not report it to their doctors. Falls are the leading cause of fatal and nonfatal injuries in older people (Falls Among Older Adults). Falls become more common as people age because their bones become more brittle and their muscle mass decreases. In society today, the baby boomers are aging, which means falls will continue to increase in frequency. When a person falls, it doesn’t just affect the victim; it affects everyone. In 2012, approximately $30 billion went towards medical costs that were associated with falls (Falls Among Older Adults). To prevent more people being injured and more money being spent, there has to be a change.

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 Elder Justice Act was passed on March 23, 2010 as part of the Patient Protection and Affordable Care Act (PPACA) as the first piece of federal legislation to allow funds to address elder abuse, neglect and exploitation nationwide (Federal Laws, 2015). Part I of the Elder Abuse Act is the Elder Justice Coordinating Council made up of federal government representatives charged with the responsibility of coming up with programs for the promotion of elder justice. They have to provide recommendations to the Secretary of the Department of Health and Human Services on the issues of abuse, neglect and exploitation of the elderly. Then there are 27 professionals from the general public who are to give recommendations to the Coordinating Council as well. Part II of the Elder Justice Act talks about funding and enhancing long-term care. Long-term care is important because you need programs committed to training long-term staff,

In the fiscal year 2010, (O’Shaughnessy, 2012) only about 5.1%, or 3 million people, out of the 57.8 million people age sixty and over, received services funded by the Act. These services included home delivered meals, home care, personal care, or case management services on a regular or intensive basis. About 14%, 8 million people, received other services, such as transportation, congregate meals, or information and assistance on a not so regular basis. A report was made by the Government Accountability Office stating that their findings were that many older people are in need of meals and other supportive services to help remain independent in their own communities, but a large portion of them are not getting the help they are in need of. Some barriers causing this lack of help are lack of funding and lack of knowledge among the older Americans that they may be eligible for benefits and services can be available for them.

This is the stage where the issues within senior care are recognized and analyzed further within each organization and facility (Kaminski, 2011). The next step in the change process is, moving to a new level or change stage. Within the change stage of facing issues within senior care, this would be the practice of facilities becoming more involved in the policy changing aspect and lawmakers at certain leveling becoming proactive in making changes for seniors to live healthy and productive lives (Kaminski, 2011). The refreezing stage can be utilized within the issue of senior care by establishing the change by enforcing the new policies which has been made within the change process, such as the care of seniors and new programs to assist in their needs (Kaminski, 2011). It is proven facts that programs which are created by lawmakers allow seniors to become more active in their daily lives and live healthier (Dongre & Deshmukh,

Falls are the leading cause of emergency room visits and unintentional death in Americans 65+ years old. (Centers For Disease Control & Prevention)

The objective of this study is to examine the evolution of programs and services for aging population over the last fifty years. Toward this end, this brief study will conduct a review of literature that addresses these shifts and changes in policy. The timeline of the history of the services and pogroms for the aging population in the United States is shown in the following timeline and an explanation for these develops will next follow the timeline.

The first author of the article, Medicaid Funding for Assisted Living Care: A Five-State Examination, is Eric Carlson. Carlson is the directing attorney under the National Senior Citizens Law Center (NSCLC). He graduated summa cum luade from the University of Minnesota, and obtained his law degree from Boalt Hall School of Law at the University of California Berkeley. Most of his career has been spent advocating for older adults in nursing homes and assisted living facilities. Carlson is very knowledgeable on these topics, and frequently presents to other attorneys and social workers at conferences nation-wide about these issues (NSCLC).

With the numerous intrinsic and extrinsic factors leading to falls, it is probable to regard each factor and recognize constructive steps and safe interventions proven effective for preventing falls. Here are several interventions that can be employed in the best interest of the medical center: