continuum of care jerry kiesling, lcsw mu adult day connection
DESCRIPTION
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 - In-home careTRANSCRIPT
Continuum of care Jerry Kiesling, LCSW
MU Adult Day Connection
When care needs rise, costs rise
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 -
In-home 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
Adult Day Care
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.
Assisted Living
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?
Nursing Home
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.
Hospice
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.
Hospital
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.
Skilled Nursing Facility
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.
Advance Directive
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.
Guardianship
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.
Conservatorship
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.
Medicare
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.
Medicaid