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Module Three: Geriatric Care Models Lecture Notes

Geriatric Care Models are the foundation of care in the older adult. T...
Course

Nursing Care of Older Adult (NUR 2214)

274 Documents
Students shared 274 documents in this course
Academic year: 2021/2022
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Hailey Williams
Rasmussen University
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Module Four – Geriatric Care Models

Overview  Because of aging population, increased demand for health care, and limited resources o New care delivery models are initiated to improve capacity for primary health care of older adults o Help to moderate healthcare costs and improve the patient’s experience o Focus on health promotion and disease prevention  Access barriers to social support and/or financial resources can lead to missed appointments, fragmented care, and poor control of chronic conditions  The purpose of most care models in older adults is to target interventions to maintain health and well-being

Acute Care for Elderly (ACE)  Continuous quality improvement model  Emphasis patient-centered care to improve outcomes in older adult clients in acute care  How does it work? o Frequent (daily) team meetings/rounds  Clearly defined structure and goals for the rounds  Requires training o Method of communicating team recommendations  Will patient’s physicians attend the rounds?  Many units use informal communication sheets o Ongoing geriatric and team functioning training  Interdisciplinary team care in hospitalized older adults o Reduced mortality o Improved functional performance o More likely to be living at home after discharge o Reduced use of restraints o Reduced use of inappropriate medications o Reduced delirium o Reduced length of stay o Reduced health care utilization costs o Improved patient and provider satisfaction

Healthy Aging Brain Center (HABC)  Developed to support primary care providers in the specialized diagnosis and management of patients with cognitive impairment caused by conditions such as Alzheimer’s, delirium, and cognitive and emotional problems that may arise after critical illnesses  Working closely with the patient’s primary care provider, the multidisciplinary care team o Physicians o Nurses o Psychologists o Social workers

 Focus on improving self-management, problem solving, and coping skills  Patient and family education and counseling  Design and delivery of person-centered, non-pharmacological interventions to reduce physical and psychological burden for both patients and caregivers  Brain aneurysm is NOT associated with the HABC care model

Transition Care Model  Focus on coordination and continuity of healthcare between different locations or different levels of care within the same location  The critical concern of geriatric care is the safety and quality that can be jeopardized as they transition across care settings  Care planning is known as the foundation on which coordinated care can be organized and delivered  PROJECT RED: (Re-engineered discharge) focus on transition from the post-acute setting to the community o It was utilized to transition a unique set of patients from the post-acute settings to the community

 IMPACT: (Improving Post-Acute Care Transitions) program was initiated to ensure ideal transitions in geriatric care o Perform an enhanced assessment of post hospital needs o Provide effective teaching and facilitate enhanced learning o Ensure post-hospital care follow-up o Provide real-time handover communication

 Aimed at identifying frailty and commonly associated geriatric conditions among older adults  Examines gait speed and hand grip strength to identify frail older adults who may be at higher risk for health destabilization  Involvement of case management for patients over 75 years who have complex chronic conditions such as end stage renal failure, cancer, CHF exacerbation, and cardiac conditions  It has been widely adopted by healthcare organizations to improve the management of various chronic diseases in ambulatory care

Telehealth Models  The clinical video telehealth (CVT) model is helpful in providing dementia care and supporting dementia caregivers  The CVT model is well received and may be helpful in providing dementia care and supporting dementia caregivers  Used to improve access and quality of care to dementia patients and their caregivers in rural areas  Telehealth service delivery models o Store-and-forward o Live video conferencing o Remote patient monitoring o mHealth

Return to Community Initiative (RTCI) Model  Focus on going back to the community, how to retransition patient back to the community  It facilitates consumer choice in care setting and to achieve cost savings for the consumer and the Medicaid program  Staff work closely with nursing home residents, their families and nursing facility staff to make sure suppor3t is in place for their resident’s return home

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Module Three: Geriatric Care Models Lecture Notes

Course: Nursing Care of Older Adult (NUR 2214)

274 Documents
Students shared 274 documents in this course

University: Rasmussen University

Was this document helpful?
Module Four – Geriatric Care Models
Overview
Because of aging population, increased demand for health care, and limited resources
oNew care delivery models are initiated to improve capacity for primary health
care of older adults
oHelp to moderate healthcare costs and improve the patient’s experience
oFocus on health promotion and disease prevention
Access barriers to social support and/or financial resources can lead to missed
appointments, fragmented care, and poor control of chronic conditions
The purpose of most care models in older adults is to target interventions to maintain
health and well-being
Acute Care for Elderly (ACE)
Continuous quality improvement model
Emphasis patient-centered care to improve outcomes in older adult clients in acute care
How does it work?
oFrequent (daily) team meetings/rounds
Clearly defined structure and goals for the rounds
Requires training
oMethod of communicating team recommendations
Will patient’s physicians attend the rounds?
Many units use informal communication sheets
oOngoing geriatric and team functioning training
Interdisciplinary team care in hospitalized older adults
oReduced mortality
oImproved functional performance
oMore likely to be living at home after discharge
oReduced use of restraints
oReduced use of inappropriate medications
oReduced delirium
oReduced length of stay
oReduced health care utilization costs
oImproved patient and provider satisfaction
Healthy Aging Brain Center (HABC)
Developed to support primary care providers in the specialized diagnosis and
management of patients with cognitive impairment caused by conditions such as
Alzheimer’s, delirium, and cognitive and emotional problems that may arise after critical
illnesses
Working closely with the patient’s primary care provider, the multidisciplinary care team
oPhysicians
oNurses
oPsychologists
oSocial workers

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