Transcript Continuum of care

Continuum of care
Jerry Kiesling, LCSW
MU Adult Day Connection
When care needs rise, costs rise
In-home care
 Skilled Home Health – You must be Home bound
 Can be covered by Medicare or Health Insurance
 Homemaker Chore – Help with a bath, cooking,
cleaning, transportation, etc. (non medical services)
 Respite care – in-home  Housekeeping services -
Adult Day Care
 8-10 hours of care in a community setting. Has a
nurse, staff that provides activities.
 Persons with dementia many times attend this if they
have a caregiver at home.
 Ideal for working caregivers
 Usually costs about half of Nursing Home Care
 Delays entry into 24 hour care
Assisted Living
 Residential setting with assistance for housekeeping,
laundry, medications, sometimes bathing.
 Individuals entering assisted living must be able to
find their path to safety in a fire drill.
 Medicaid doesn’t cover Assisted Living.
 Usually you will have a private room with your own
bathroom.
Nursing Home





24 hour care for all Activities of Daily Living (ADLs).
Highest cost of all care.
Look at Medicare.gov for ratings of nursing facilities
Rates - $150.00 to $160.00 per day
Choose quality – look at how other individuals in the
center are being cared for, what does the facility look
like and smell like?
Hospice
 Used when a person has 6 months or less to live.
 Often thought of as end of life care for individuals
with cancer.
 Provides nurse visits, social work visits, chaplain visits.
 Provides some medications and equipment to provide
comfort.
 Is only chosen by a patient when he/she doesn’t want
invasive treatment or curative treatment.
Hospital
 Short term (a few days)
 You may be admitted for observation or fully
admitted.
 Observation is a period (up to 72 hours) where your
physician may do testing and evaluate you to see
what is causing the health concern.
 A full admission is usually when your condition is
being treated –surgery, IV Antibiotic intervention, etc.
Skilled Nursing Facility
 May be covered by Medicare or Health Insurance if
you have been in the hospital as an inpatient for 3
days and need rehabilitation or a skilled service
provided by a licensed nurse.
 24 hour care and assistance with needs for safety,
medication administration and personal care.
 May need to pay privately or use Medicaid to cover
these services.
Advance Directive
 Living Will – a written statement by an individual to
withdraw or withhold medical procedures that merely
prolong the dying process.
 Durable Power of Attorney For Health Care – You appoint an agent to make decisions for
you when you cannot.
 Durable Power of Attorney for Finances – You appoint an
agent to make financial decisions for you when you are
unable to do so.
Guardianship
 Appointed by the court when someone is found to be
incompetent (unable to be safe without someone to
make decisions).
 The guardian may be a family member or the Public
Administrator.
 The Guardian makes decisions to provide basic needs
for the individual (food, shelter and medical care).
 The guardian prepares a report for the court on the
personal status of the ward.
Conservatorship
 Appointed by the court when someone is
incompetent to manage their finances (may be the
same person as the guardian).
 Conservator must manage the financial resources of
the protectee.
 Conservators pay bill, receive public benefits, sell and
buy real estate and personal posessions.
 The conservator must be bonded and must complete
an annual report with the court.
Medicare
 Health Insurance administered by Centers for Medicare and
Medicaid (CMS) to help pay medical costs for individuals age 65
or over and disabled individuals under 65.
 Part A – Hospital Insurance – helps pay cost of hospitalization,
rehab hospital, skilled nursing facility and skilled home health
 Part B – Outpatient Medical Insurance – helps pay doctor visits,
outpatient medical services, medical supplies and some
preventive services
 Part C-Advantage Plans (Managed care plans that take the place
of traditional Medicare.
 Part D – Prescription Drug Benefit – pays for much of the cost of
medications.
Medicaid
 A joint federal-state program designed to pay some of the
costs of health care for financially needy individuals.
 You must qualify by being disabled or over 65 and have no
more than $999.99 in non-exempt assets.
 May pay for home and community based care or Nursing
home care.
 Missouri HealthNet often does an Estate Recovery after
the covered individual dies. They may claim against the
estate to recovery monies payed for care on behalf of the
individual.