Week Two

Chapter one continued

chapter two

Settings
Disability
A look at Acute vs. chronic disabilities
Health Care Options
Acute Care Settings / hospitals
Rehab Centers

Stroke, spinal cord, Drug / alcohol

Nursing homes
only 5% of population over 65 live in nursing homes!
Retirement communities
Assisted Living
Adult Day Care
In Home

Pros and cons ahead

 Disability
An outcome that is not only related to
the level of impairment and functional
limitation, but also is influenced by the
social and physical environment in
which an individual lives.
Disability
Increases:
Lower Socio
Economic Status
Less education
Ethnic minorities Decreases:
Very old females
Better Educated
Unhealthy lifestyles
Higher Incomes
Smoking
Diet Healthy Lifestyles
Low carb
Exercise
Specific Causes that produce
disability
Genetic
Accidents
Nutritional disorders Use of tobacco
Sanitary Lack of physical
Stress
exercise
Alcohol / drugs
Environment
Family / cultural
Lack of access to healthcare
Violence
Poorly educated
Chronic illnessess
Etc.
Genetic most common
Cystic fibrosis
Lack of protein in body / balance of chloride
Breathing issues/ lung infections
Huntingtons
Degenerative loss of nerve cells,
50% chance to pass on
Ages 30 40
Unlimited movements / swallowing
Down Syndrome
Muscular dystrophy
Failure of muscles / weakness
Sickle cell anemia, red blood cells carry little or no O2
African / middle eastern
Celiac Disease Gluten intolerance
Alzheimers
Cancers
Anemia
 Functional impairment /
disability underlie the need
for:
Inpatient
Outpatient
In home care
Co - Morbidity
Prevalence of having more than one chronic
condition at a time
Poverty, lack of education, income, social

isolation contribute to the risks of

institutionalization
Disability / Illnesses
Acute
Quick / Abrupt onset
**Treatable
Short term in duration flu, cold, pneumonias
Cost is minimal (lower than chronic)
Chronic
Progressive
Associated with Lifestyle / behaviors
Lifetime in duration
Irreversible even with treatment
Progressive
Manage with meds and medical care

Some can live well with disabilities stay at home

Acute vs. Chronic
Acute
Respiratory Chronic
Colds High Blood Pressure
Flu Heart Disease
Stroke
Pneumonia
Cancers
Heartburn Asthma
Diarrhea Emphysema
Senses
Vision / hearing
Bacterial / viral
Diabetes Mellitus (DM,
IDDM)
Arthritis
Impairments
Not all result in disability
DM / IDDM
Individual definition
What is an impairment to some, not to others
Characteristics of the environment
Barriers physical and social
Risks
Biological genetics
Unsafe, unsanitary conditions
Lifestyle habits
Health Care Options
Acute Care
Hospitals
Rehab
Brain injuries /
Assisted Living
Spinal Retirement villages
Alcohol / drugs Senior housing
Mental illness Adult Day Care
Nursing and Rehab Home
homes Moving in with
SNF
children
Only 5% populations
Pros and Cons of Settings
Class Discussion
What is available
Acute care settings in CT
43 hospitals
Htfd Hosp., Hebrew hosp. John Dempsey, Rehab
hospital of Htfd., Rockville, SFH
Nursing Homes in CT
252 nursing homes in state
Prices vary greatly for cost of stay Someaverage costs forlong-term carein the United
States (in 2010) were:
$205 per day or$6,235 per monthfor a semi-private room in anursing home
$229 per day or $6,965 per month for a private room in a nursing home
CONNECTICUT >>> Daily rate is $ 400
CT >>>>Yearly average rate is $ 146,000
Settings
Assisted Living
$4,315 month in CT
U.S. $3,600
Nursing , ADLs
Managed residential communities
No real requirements
73 Assisted Living facilities in CT

Adult Day Care Setting

Monthly average fees $1,679
Bathing, dressing, activities, transportation, meals
Minimally regulated
Fast Facts
5% of the elderly population over 65live in
nursing homes
1% of the population between 65 74 live

in nursing homes
22% of the population over 85 live in

nursing homes
More frail / ill / demented
Other services
MFP Money follows the person program
Assists people to stay in the community as
opposed to be in more costly nursing home
Family support
Friendly visitor / Senior volunteers
VNA services / companions
Transportation services

Dial a ride / Para-transit

In home recreation
Senior centers
Money follows the person
The Money Follows the Person (MFP) Rebalancing
Demonstration Grant helps states rebalance their Medicaid
long-term care systems. Over 51,000 people with
chronic conditions and disabilities have transitioned
from institutions back into the community through
MFP programs as of December 2014.
MFP Program Goals
Increase the use of home and community-based services

(HCBS) and reduce the use of institutionally-based services

Eliminate barriers in State law, State Medicaid plans, and

State budgets that restrict the use of Medicaid funds to let

people get long-term care in the settings of their choice
Strengthen the ability of Medicaid programs to provide

HCBS to people who choose to transition out of institutions

Ways to help
Maintain daily / routine schedules
Small group settings
Meaningful activities
Familiar foods, routines
Not overly dependent
FAMILY
notes
Paragraph on illness due for next week
Explain to class