Long Term Care Administration

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Long Term Care Administration

• Long Term Care Facilities
• February 19, 2009

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Long Term Care Facilities

• The Current Environment
• Health reform has focused on improving access,
  quality and cost-effectiveness, and on moderating
  future growth curves.
• Reforms have occurred in every sector of health
  care.

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Long Term Care Facilities

• The Current Environment
• Cost pressures will continue at a rapid rate.
• Every province and territory will need to focus
  on the growing demand for health care services,
  fueled by demographics, new technologies and
  other growing costs of providing services.

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Long Term Care Facilities

• Support Service Living Units
• Provide totally integrated units with services
  provided on an as required basis.
• Availability of 24 hour service and a quick
  response capability provided by on site staff.
• Amenity spaces, dining room, communal laundry, 24
  hr monitoring, two meals/day.

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Long Term Care Facilities

• LifeCare Communities
• Continuing Care Retirement Communities (CCRC)
  allow seniors to "age in place," with flexible
  accommodations that are designed to meet their
  health and housing needs as these needs change
  over time.
• Residents entering Continuing Care Retirement
  Communities sign a long-term contract that
  provides for housing, services and nursing care,
  usually all in one location, enabling seniors to
  remain in a familiar setting as they grow older.

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Long Term Care Facilities

• LifeCare Communities
• Many seniors enter into a CCRC contract while
  they are healthy and active, knowing they will be
  able to stay in the same community and receive
  nursing care should this become necessary.
• Seniors who invest in a Continuing Care
  Retirement Community have adequately planned for
  housing and care for the remainder of their life,
  and have the financial means to support it.

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Long Term Care Facilities

• LifeCare Communities
• Continuing Care Retirement Communities offer
  service and housing packages that allow access to
  independent living, assisted living, and skilled
  nursing facilities.
• Seniors who are independent may live in a
  single-family home, apartment or condominium
  within the Continuing Care retirement complex.
• If they begin to need help with activities of
  daily living (e.g., bathing, dressing, eating,
  etc.), they may be transferred to an assisted
  living or skilled nursing facility on the same
  site.
• Seniors who choose to live in a Continuing Care
  Retirement Community find it reassuring that
  their long-term care needs will be met without
  the need to relocate.

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Grace Communities Corp.

• Grace Communities Corporation (GCC) is committed
  to providing quality, affordable housing to
  adults 55. Our customer service approach to
  housing management follows carefully crafted
  rules, regulations, policies and procedures we've
  established to make living here the best it can
  be.   Gracious Living, Simply Amazing!
• Local CCRC Life Lease in Abbotsford, B.C.

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Long Term Care Facilities

• Abbeyfield Vancouver is a non-profit organization
  that offers 18 supportive housing units for
  elderly people in the Marpole area. 

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Long Term Care Facilities

• The Abbeyfield Pattern
• To involve local Abbeyfield volunteers in setting
  up and managing each house, where the residents
  will pay their share of the running costs.
• Every household will have its own housekeeper to
  look after the house, to provide meals and to
  care generally for the residents.
• The residents will have their own rooms,
  furnished as they wish, where both their privacy
  and their right to invite visitors are assured.

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Long Term Care Facilities

• Home Sharing
• Provides additional income and companionship.
• Option for seniors who experience difficulty in
  maintaining their own homes due to accelerating
  costs, reduced income, declining physical health
  and loneliness.

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Long Term Care Facilities

• Congregate Housing
• Elm Ridge is a congregate housing project
  operated by the Baycrest Centre for Geriatric
  Care in Toronto, Ontario.
• The home for fourteen senior adults provides a
  balance of companionship and privacy, of support
  and independence for those who would otherwise
  find themselves alone and at risk.

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Long Term Care Facilities

• The customized project was built in 1985 by
  Cityhome, the former non-profit housing arm of
  the City of Toronto.
• Elm Ridge was styled as a single family dwelling,
  to blend with the neighbourhood, while graciously
  distinguishing itself with a colourful landscaped
  garden.
• Its central location offers easy access to
  synagogues, public transit and shopping.

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Long Term Care Facilities

• Staff at Elm Ridge offer 24-hour supervision,
  weekly housekeeping, counselling services and
  bi-weekly bathing assistance, if needed.
• These are complemented with an extensive program
  of activities, which include arts and crafts,
  music, discussion groups, exercise classes,
  outings, and observance of all religious
  occasions and the celebration of festivals.

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Long Term Care Facilities

• Home Equity Conversion Plans
• Allow seniors to have supplemental income.
• Equity from the ownership of a given property is
  used, monies are obtained to complete any
  required home modifications or to accommodate a
  changed health status.

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Long Term Care Facilities

• Garden Suites/Granny Flats
• Small portable dwellings, provide seniors with
  the opportunity to stay on their own property,
  while freeing up the main house for the use of
  close relatives or friends.

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Long Term Care Facilities

• Retirement Homes Assisted Living
• 24/7, on site staff, security in communal living
• Room, board, recreation, social activities
• Nursing and personal care not provided
• 800 - 7,000 per month

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Long Term Care Facilities

• Access to Long Term Care Facilities
• Severely compromised functional ability and
  self-care
• Severe chronic illness/disability
• Abuse and/or neglect
• Insufficient community services to support care
  at home
• Absence/unwillingness of informal caregivers to
  continue care

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Long Term Care Facilities

• Problems that result in admission
• Cognitive Impairments
• Major chronic and/or multihealth problems
• Major physical frailty
• Loss of mobility and independent ambulatory
  movement

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Long Term Care Facilities

• Problems that Result in Admission
• Sensory Disorders
• Incontinence
• Loss of a spouse or significant other
• Note 85 have more than one health problem

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Long Term Care Facilities

• Desires Prompting Admission
• Provision of extensive, regular 24 hr nursing and
  personal care
• Provision of extensive, regular 24 hr
  supervision, monitoring and assistance with ADLs
• Assurance of safety and security
• Preservation of self-respect, self-esteem,
  dignity, companionship

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Long Term Care Facilities

• The Eden Alternative
• Tool for improving quality of life in LTC
  facilities.
• Coalitions of people and organizations are
  created committed to creating better social and
  physical environments for people.
• Dedicated to helping others create enlivening
  environments and the elimination of the plagues
  of Loneliness, Helplessness, and Boredom.
• Dedicated to helping people grow.

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Long Term Care Facilities

• Eden Alternative
• Teaches that the environments seniors live in are
  habitats for human beings rather than facilities
  for the frail and elderly.
• What Mother Nature has to teach is about the
  creation of vibrant, vigorous habitats.

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Long Term Care Facilities

• Eden Alternative
• Companion animals gives the opportunity for
  meaningful care to other living creatures, and
  the variety and spontaneity that mark an
  enlivened environment can succeed where pills and
  therapies fail.
• The goal is to help people weave together the
  philosophy of The Eden Alternative with the real
  world of daily practice.

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Long Term Care Facilities

• GentleCare
• The system is prosthetic in nature.
• It seeks to arrange an environmental fit between
  the person with dementing illness and the
  physical space, the programs, and the significant
  people with whom the person must interact.
• The system accommodates and supports existing
  levels of function and development, rather than
  challenging the person with dementia to adapt and
  perform in ways no longer possible.

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Long Term Care Facilities

• GentleCare Includes
• A correlation between disease pathology and
  client behaviour
• Environmental design concepts
• A system of programming that helps locate the
  client's appropriate zone of activity
• Daily living care planning and implementation
• Numerous innovative, creative strategies

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Long Term Care Facilities

• GentleCare
• Nutritional assessment and strategies that create
  powerful treatment opportunities
• Stress identification, prevention and reduction
  that eliminates catastrophic incidents
• Functional assessment that provides
  individualized care plans
• Evaluation
• A unique system of therapeutic partnership with
  families, communities and volunteers

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Long Term Care Facilities

• Organizations that use the GENTLECARE system
  report
• Increased client function
• Reduced catastrophic incidents
• Decreased staff and family stress
• Reduced use of psychotropic medications
• Cost containment
• Increased community commitment and involvement

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Long Term Care Facilities

• Little Mountain Place
• This beautiful facility consists of 117 resident
  beds, including a 26 bed Special Care Unit called
  The Garden Terrace.
• Each of the resident rooms is furnished with a
  bed, night table, dresser and wardrobe closet,
  has a memory display box and a washroom.
• Memory boxes are located just outside a
  resident's private room and are a great way for
  residents to recognize their room easily.
• All rooms are private, with an ensuite bathroom
  and nurse-call system.
• One of the beds at Little Mountain Place is
  maintained solely for respite service, which is a
  valuable resource for individuals and family
  caregivers who require support on a short term
  basis.

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Long Term Care Facilities

• Little Mountain Place
• Provision of 24 hour care and supervision
• Full nutritional and food service
• Leisure and volunteer program
• Medical services supervised by a Medical
  Coordinator
• Podiatrist, psychiatrist and dentist

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Long Term Care Facilities

• Little Mountain Place
• Each resident's care is individualized to meet
  his/her needs.
• Primary Nurses, LPNs and Care Aides work with
  residents and their family to develop, review and
  evaluate each resident's plan of care.
• Through these care plans we acknowledge the
  rights and responsibilities of each resident,
  their family and the staff at Little Mountain
  Place.
• The staff are committed to ensuring the best
  quality of life for all residents.

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Long Term Care Facilities

• Services
• Environmental - residents' rooms are cleaned
  regularly, clean linens and towels are provided
  as necessary
• Laundry - in house laundry service is limited to
  washable items only, however a dry clean service
  can be arranged if required
• Hairdressing - an on-site hairdresser is
  available by appointment
• Mail - a volunteer will deliver mail directly to
  a resident's private room.
• Chaplain - conveys the presence of God through
  compassionate listening, recognizing God at work
  in residents' lives and helping to interpret the
  meaning of their life experiences in relation to
  God
• "The Nook" - a shop operated by volunteers, where
  residents may purchase items such as toiletries,
  gifts, stamps, batteries, or candy

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Long Term Care Facilities

• Little Mountain Place, Leisure Services
• Recognizing that medical and nursing care are
  only a part of providing quality care for
  residents, we provide a wide variety of programs
  such as
• Tzu Chi Chinese Luncheons
• Newsweek discussions
• carpet bowling
• Bingo
• video nights
• bus trips/outings
• Pub nights
• Residents are encouraged to participate in "Music
  Therapy" which encourages them to socialize and
  express themselves through music in group
  sessions. Programs and services are ongoing.
• The staff encourages residents and families to
  make suggestions for any new programs.

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Long Term Care Facilities

• Little Mountain Place
• The Garden Terrace provides a home-like
  environment which supports, nurtures and enhances
  the potential of residents who suffer from
  dementia.
• Although dementias such as Alzheimer's Disease
  can be debilitating, we believe that we can offer
  residents an outstretched hand, a caring heart
  and programs that maintain and enhance their
  abilities.

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Long Term Care Facilities

• Little Mountain Place
• Specifically designed for individuals with
  Alzheimer's Disease or other types of dementia,
  the Garden Terrace has a home-like common living
  area with limited access and a secured patio and
  garden area.
• Families will feel comfortable visiting and
  participating in resident's lives.
• Having a feeling of their own personal space and
  their belongings close by, we believe residents
  will ultimately have higher functioning,
  increased self-esteem, control and independence.

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Long Term Care Facilities

• Little Mountain Place
• Within the Garden Terrace there are three
  categories of leisure programs which occur
  Therapeutic, Home Life, and Activities.
• These programs occur in a small group or
  individual settings and can be formal or
  spontaneous.
• Therapeutic Recreation Programs are offered based
  upon residents' needs they have a specific goal
  and purpose, they assist in bringing meaning and
  satisfaction to one's life and they help to
  maintain physical and emotional well being.
• Examples of such programs include baking,
  reminiscing groups, gardening, socials and
  "discovery boxes".

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Long Term Care Facilities

• Little Mountain Place
• Home Life Programs give the residents the
  opportunity to contribute to their new home by
  assisting with the various chores which need to
  be done to take care of the Garden Terrace.
• Chores are assigned according to what is most
  familiar to each resident.
• Through assisting with the various tasks,
  individuals maintain a sense of purpose to their
  life.
• Examples of chores include sweeping, meal
  preparation, washing dishes, preparing vegetables
  and folding towels.

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Long Term Care Facilities

• Little Mountain Place
• Activities are offered to residents and their
  friends and families.
• In the Garden Terrace there are supplies and a
  reference book full of activity suggestions and
  we encourage everyone to participate.
• This is a great way for everyone to socialize.
• Activities may include polishing silver,
  watering the garden, reading the newspaper or
  enjoying a cup of tea.

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Long Term Care Facilities

• Little Mountain Place
• The Family Council is a independent,
  self-determining group of family members and
  friends of residents living in a care facility.
• At Little Mountain Place, our group is called
  "Families of LMP" and participants meet once a
  month. There are several benefits which stem
  directly from this council
• Orientation and information for families of new
  residents
• ongoing support
• volunteering and fundraising
• education and information
• forum to discuss concerns or problems
• Family and friends are welcome to attend as many
  or as few meetings as they are comfortable with.
  We believe it is important to have a voice,
  especially if you can make a difference in
  residents' lives.

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Long Term Care Facilities

• Food Services
• Three meals and three between meal nourishments
  are provided daily, utilizing a multi-cultural
  six week menu planned by our full time Nutrition
  Manager and Dietitian/Nutritionist.
• Due to a significant population of Asian
  residents, menus are written in Chinese as well
  as English.
• A Food Service Committee is in place to provide
  residents and family input into the menu planning
  and meal service process.
• A special alternate dining area meets the needs
  of residents who require assistance or
  supervision during meal times.

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Long Term Care Facilities

• Food Services
• The Garden Terrace has it's own small home-like
  relaxed dining area. Residents are provided foods
  of appropriate texture and consistency with
  modified utensils to promote independent eating
  and ensure adequate nutritional intake.
• A 24 hour feeding program is set up so that extra
  foods and drinks are provided to The Garden
  Terrace residents.
• The purpose is to allow residents to have food at
  any time they desire and not be restricted to
  fixed meal hours.

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Long Term Care Facilities

• Food Services
• Friends and family are welcome to bring gifts of
  food to their loved ones.
• The Nutrition Manager and Dietitian/Nutritionist
  would be pleased to help you select appropriate
  foods for the resident's diet as well as for
  storage.
• Family and friends are encouraged to join
  residents for meals - both in the facility and
  off-site.

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Long Term Care Facilities

• Little Mountain Place
• A social worker is available to meet with you at
  your convenience.
• The social worker is available for assessment,
  information and consultation with residents,
  families and other professionals and can assist
  with social, emotional or financial concerns.

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Long Term Care Facilities

• Application for admission is made by contacting
  the local Health Unit in your community. A Long
  Term Care Manager will assess the eligibility of
  your application and determine the level of care
  you or your family member requires. The level of
  care is determined by an assessment of each
  applicant's physical and mental capabilities.
  When it is determined an applicant is eligible
  for Long Term Care, a Long Term Care number is
  assigned.

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Long Term Care Facilities

• Referral/Placement, cont
• Once accepted, the date of application becomes
  the priority date on the Long Term Care waiting
  list.
• This list is sent to the Little Mountain Place
  Social Worker.
• Priority Access for the facility is controlled by
  the Vancouver Coastal Health Authority.
• If there are problems regarding this procedure,
  the Social Worker or the Director of Resident
  Care Services at Little Mountain Place are
  available to both the applicant and the
  applicant's family for consultation and advice.

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Long Term Care Facilities

• Little Mountain Court
• A wonderful facility designed for independent
  living.
• Tenants make themselves at home in no time. There
  is a minimum age requirement of 55, except for
  handicapped residents and no more than 2 people
  may occupy a double suite.
• Social work and nutritional services are
  available from Little Mountain Place for a
  nominal fee.

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Long Term Care Facilities

• Little Mountain Court has 96 self-contained
  suites consisting of
• 81 single suites
• 1 single handicap suite
• 10 double suites
• 4 double handicap suites

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Long Term Care Facilities

• Each suite includes
• 1 bedroom
• 1 bathroom
• 1 kitchen
• 1 living/dining room
• storage areas
• The rent at Little Mountain Court is subsidized
  by BC Housing. A wait-list system gives priority
  to those who are in greatest need.

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Long Term Care Facilities

• Little Mountain Residential Care Housing
  Society
• Established in 1983, Little Mountain Housing
  Society (the "Society") is a not-for-profit care
  giving organization. The Society has adopted a
  philosophy of care called "Gentle Care" which
  means residents' needs and wants are our
  priority.
• "Residents First" is a heart and soul attitude
  towards residents and their families.
• Residents are the focal point of all our
  activities and everything we do recognizes the
  requirements to serve their needs and exceed
  their expectations.

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Long Term Care Facilities

• The Society owns and operates three facilities
  through a board of directors.
• Adanac Park Lodge
• Little Mountain Court
• Little Mountain Place

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Long Term Care Facilities

• Mission Statement
• We are a non-profit care organization. We provide
  accommodation and holistic care for those who are
  aged, infirm and/or disabled, in the spirit of
  compassion and with respect for diversity.
• Vision Statement
• Our vision is a dignified and respectful
  community where people feel at home.

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Long Term Care Facilities

• Our Values
• Compassion for the needs of others
• Effective management of our time, talents and
  resources
• Building relationships of mutual care and respect

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Long Term Care Facilities

• Our Commitment
• We, at Little Mountain Housing Society, are
  committed to providing an environment which
  upholds the rights of everyone living, working or
  volunteering within the Society. We are committed
  to an environment where
• everyone is treated courteously, respectfully and
  in a dignified manner
• everyone is given personal privacy
• personal, financial and medical information is
  kept in strict confidence
• information which affects a resident's quality of
  life will be obtained
• independence and making personal decisions is
  encouraged
• a choice of services is offered
• living and working is considered safe, secure and
  satisfying
• residents' interests, abilities and potential are
  fully developed