Transcript Chapter 23: Future trends in gerontology

Chapter 28:
Using Current System Models
to Guide Care
Learning Objectives
• Explain geriatric care as a continuum.
• Identify the types of models of care and services
available to older adults, including acute care,
transitional care, care coordination, community
care, and nursing home care models.
• Describe appropriate coordination of the
components of the healthcare system to provide
better services to meet the needs of the older adult
at different points in time.
• Understand the role of the nurse in new models
of care.
Acute Care Models and Programs
• Acute Geriatric Units (AGUs)
– Care for older adults with acute medical
conditions
– More efficient and more functional benefit
than conventional hospital care
• Acute care of the elderly units (ACE)
– interdisciplinary team with special expertise in
geriatric care; environmental adaptations used
to prevent functional decline in older adults in
acute care setting
Acute Care Models and Programs
(cont’d)
• Geriatric resource nurse (GRN)
– Trained by geriatric nurse specialist
• Nurses Improving Care for the Hospitalized
Elderly (NICHE): Hartford Institute Program
– Mission to create better care environments
for hospitalized older adults
• Transforming Care at the Bedside (TCAB)
– Research-based “how to” guide to improve
quality of care; Robert Wood Johnson Foundation
National Program.
Transitional Care
Models and Programs
• Care Transitions Intervention (CTI): Univ. of
Colorado
– assistance with self-management of
medications
– patient-centered medical record that is kept
by the patient
– timely follow-up with primary physician or
specialists
– a list of signs and symptoms that could indicate
worsening of their condition
Transitional Care
Models and Programs (cont’d)
• Transitional Care Model (TCM)
– Addresses needs of elders with chronic
conditions after discharge from hospital
• Money Follows the Person (MFP)
– Helps states rebalance long-term care systems
by transitioning eligible Medicaid recipients
from long-term care institutions back to the
community
Transitional Care
Electronic Resources
• National Transitions of Care Coalition
(NTOCC): provides consumer tools and
resources, healthcare provider tools, and best
practice tips to enhance transitional care.
• Next Step in Care: provides information and
advice to help family caregivers.
http://www.nextstepincare.org
• BOOSTing Care Transitions: Provides
materials to help optimize the discharge
process at any institution
Community Care Models and
Programs
• Adult daycare
– Supervised daily care in a nonresidential facility
for the elderly and disabled
• Aging in place
– Ability to live in one’s own home and
community safely, independently, and
comfortably, regardless of age, income, or
ability level
Community Care
Models and Programs (cont’d)
• Assisted living
– assistance and monitoring of older residential
adults who can’t live independently but don't
need 24-hour skilled nursing home care
• Home care skilled services
– Skilled nursing and/or therapy services in the
home
Community Care
Models and Programs (cont’d)
• Intergenerational care
– Several generations receive ongoing services
or care in the same location
• Program of All-Inclusive Care for the Elderly
(PACE)
– To help older adults remain in the community
Nursing Home Care Models
• Culture change
– More person-centered care in LTCFs
• Eden Alternative model
– Person-centered core
• The Green House
– Homelike environment
• Pioneer Network
– Holistic, individualized care for elderly and
chronically ill
Summary
• Many systems can be used to design care for
older adults
• These models can assist gerontological
nurses to plan system or city-wide care
• Aging in place
• Maintaining quality of life in spite of health
challenges