Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities

The guide, “Encouraging Comfort Care:  A Guide for Families of People with Dementia Living in Care Facilities  is available at:

http://www.alzheimers-illinois.org/pti/comfort_care_guide.asp

The following is taken from the website:

“The Alzheimer’s Association-Greater Illinois Chapter is pleased offer this free online resource, Encouraging Comfort Care: A Guide for Families of People with Dementia Living in Care Facilities. This 21-page booklet provides useful information to families and long-term care facilities personnel about Alzheimer’s disease and related dementias, particularly care issues related to the late and final stages.
For families, this guide will enable them to make informed choices about a variety of medical decisions they may face on behalf of loved ones with dementia living in nursing homes, assisted living facilities, and other types of care facilities. It will also equip families to ask good questions aimed at obtaining the best care for their loved ones, including a handy checklist of comfort care measures to be discussed with staff members of care facilities.
 

For staff members of long-term care facilities, the guide will serve as an important tool for those who wish to educate families and assist them in care planning. Individuals and organizations are encouraged to disseminate this booklet in electronic and print formats.
Encouraging Comfort Care was made possible through a generous grant from the Retirement Research Foundation to the Alzheimer’s Association-Greater Illinois Chapter.”

“Qualified” vs. “Licensed” Social Worker in Long Term Care

I want to pass along a recent citation of which you may be interested.  The facility has 2 full time Social Service staff.  One has a Bachelor of Social Work, but is unlicensed.  The other has a Master in Psychology.  Here is the citation:

    “F 251 Qualifications of Social Worker greater than 120 Beds

    ….this requirement is not met a/e/b:  Based on South Carolina Code of Laws, Title 40, Section 40-63-30 a qualified social worker must be licensed to practice social work in the state…..The Administrator was referred to the South Carolina State Laws web page related to social workers must be licensed in the State of South Carolina in order to be identified as a qualified social worker.  The Administrator was also referred to the federal guidelines that indicated some State or local laws are more stringent that the Federal requirement on the same issue”

So, if your facility is greater than 120 beds, you must employ a full time LICENSED Bachelor (or Master) of Social Work.  The stipulation of requiring a year of supervision was not noted; however, it could have been included as well.

On-line Tool: Think About Your Life: Person Centered Thinking Tools

This on-line tool was created by The Learning Community for Person Centered Practices and the Inclusion Movement, and developed by cancer survivors to help individuals find empowerment or a sense of control in their experience. This website offers a number of on-line tools and worksheets that could be useful to individuals with disabilities and those who support them.

http://www.thinkaboutyourlife.org/toolkit.cfm

New Booklet Guides Advanced Cancer Patients Through Tough Conversations With Physicians

http://www.cancer.net/patient/Coping/Advanced%20Cancer%20Care%20Planning/Advanced_Cancer_Care_Planning.pdf

Medical News Today (2.6.11):
“Having advanced cancer is difficult for patients and their loved ones. But discussing the range of treatment options including palliative care with your doctor does not have to be. The American Society of Clinical Oncology (ASCO) has a new booklet to help patients with advanced cancer work with physicians to identify the best, individualized treatment plans.

The free booklet “Advanced Cancer Care Planning,” available on ASCO’s patient website Cancer.Net, is what patients and families need to know about their choices when facing serious illness. It is designed to help initiate candid discussions with physicians about the range, risk and benefits of treatment options including palliative care options throughout the course of cancer.

“Conversations about individualized treatment options for advanced cancer are an integral part of the cancer care continuum. One goal of an oncologist is to help patients understand the types of care available for advanced cancer. Working together to plan a preferred course of treatment, therapy and managing symptoms can enhance the quality of life for patients and their loved ones,” said George W. Sledge, Jr. MD, President of ASCO.”

Cancer.Net Editor-in-Chief Diane Blum, MSW, Chief Executive Officer of the Lymphoma Research Foundation said, “Because informed patient-doctor conversations are so important for quality cancer care, having physician-approved information will make it easier for patients to understand their options and better direct their own care.”

ASCO’s patient guide includes:

– Information on advanced cancer care treatment options;
– The role of the family and caregivers in treatment decisions;
– Ways to cope and find support for patients with advanced cancer;
– Questions to ask the doctor during the course of advanced cancer.”

Social Service Long Term Care Forms

 

Social History and Psychosocial Assessment

 

Social Service Discharge Planning Tool

 

Resident Symptom Tracker

 

Behavior Tracking Tool Log

 

Behavior Management Progress

 

Social Service Telephone Order Log

 

Medication Tracking Log

 

Life Review

Patient Centered Care With A Heart

 

This is a great article for skilled nursing centers and caregivers of those with Dementia.  There are some good ideas which were new to me I plan to incorporate.

http://www.nytimes.com/2011/01/01/health/01care.html?src=me&ref=health

New Tools Featured on AHRQ HealthCare Innovations Exchange

http://www.innovations.ahrq.gov/qualitytools/

Featured QualityTools (October 27, 2010)

• Aging Well in Communities: A Toolkit for Planning, Engagement & Action

• Eldercare at Home: A Comprehensive Online Guide for Family Caregivers

• Eldercare Locator

Other New QualityTools in this issue (Posted on October 27, 2010)

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY – The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators (QIs) COMMUNITY HEALTH FOUNDATION OF WESTERN & CENTRAL NEW YORK – Step Up to Stop Falls Toolkit™ INSTITUTE FOR HEALTHCARE IMPROVEMENT – Prevent Harm from High-Alert Medications Tools and Resources PARTNERS HEALTHCARE SYSTEM – Time and Motion Database

Long Term Care Fact Sheets

The SCAN Foundation (info@scanfoundation.org) has published fact sheets on the following:

• Aging Population Demographics
• Who Needs_Uses LTC
• Demand for LTC
• Where Provided
• Who Provides LTC 
• Who Pays LTC

These are available:

http://www.hcbs.org/moreInfo.php/nb/doc/3341

Sports and Recreation Resources for the Disabled

Disabled Sports USA

“A national nonprofit, 501(c)(3), organization established in 1967 by disabled Vietnam veterans to serve the war injured. DS/USA now offers nationwide sports rehabilitation programs to anyone with a permanent disability. Activities include winter skiing, water sports, summer and winter competitions, fitness and special sports events. Participants include those with visual impairments, amputations, spinal cord injury, dwarfism, multiple sclerosis, head injury, cerebral palsy, and other neuromuscular and orthopedic conditions.”

The link below sends you to the adaptive sports equipment section.

http://www.dsusa.org/equipment-watersports.html

Adaptive Tools for Gardening

http://www.infinitec.org/play/gardening/adaptivetools.htm

Adaptive Sailing for Kids and Adults with Disabilities

http://www.challengedamerica.org/index.html

Lots more resources listed at:

http://www.disability.gov/community_life/sports_&_leisure_activities/sports_&_recreation

More Than You Ever Wanted to Know About PASRRs (Preadmission Screening and Resident Review)

 

I have noticed a lot of searches for “PASRR”.  So I have decided to offer several resources I have found helpful in PASRR compliance.  First, let me say that although PASRRs are a federal requirement, there is not a federally mandated form.  Therefore, states vary greatly in format.

 

I will post a tool I created to make sense of the federal mandate and South Carolina law.  DISCLAIMER:   This tool has not been reviewed by ANY governmental agency and is subject to change without notice.  This is MY interpretation to the best of my ability from the research I have done.  So, ……

 

PASRR Screening and Implementation

 

Below are additional resources:

 

Diagnosis_Codes_Requiring_PASRR_Level_II

 

Title 42 Public Health.PASRR

 

Pre-Admission Screening and Resident Review (PASRR) and the Nursing Home Survey Process

CMS Memorandum September 28, 2007

PASRR and survey guidance transmittal

 

Note the reference in the Memorandum Survey:  “Rebroadcast of PASRR satellite, “Mental Illness in Nursing Homes” will air ….”

This is still available for viewing and is well worth the time:

http://surveyortraining.cms.hhs.gov/pubs/VideoInformation.aspx?cid=1066

 

Screening for Mental Illness in Nursing Facility Applicants:  Understanding Federal Requirements

DHHS Understanding the PASRR Process

 

PASRR Screening for Mental Illness in Nursing Facility Applicants and Residents

“The current report outlines the findings from the second phase of the study, which involved a national survey of the relevant agencies in all 50 States and the District of Columbia to determine how they have organized and administered Federal requirements under PASRR. The second phase of the study also included case studies of four States, which were selected to include each of the entities that conduct Level II screens: private mental health agencies, community mental health centers, individual mental health practitioners, and referring agencies or State agencies. In each State, a total of six nursing homes were selected, with three located in an urban county and three located in a rural county. In each of those 24 nursing facilities, the administrators were interviewed about the PASRR process, and the medical records for the nursing facility residents were reviewed. In two of the four States, clinical interviews were conducted with a total of approximately 50 nursing facility residents.”

PASRR Screening for Mental Illness in Nursing Facility Applicants and Residents

 

Alabama Department of Mental Health and Mental Retardation
Omnibus Budge Reconciliation Act (OBRA)
Preadmission Screening Resident Review (PASRR)  Instruction Manual
May 2009

Alabama Department of Mental Health and Mental Retardation Omnibus Budge Reconciliation Act (OBRA) Preadmission Screening Resident Review (PASRR) Instruction Manual May 2009

 

SC Medicaid Bulletin (March 2001)

SC Medicaid Bulletin 2001 Preadmission Screening and Resident Review