CNA Chap 1 Audio 1 - Lecture notes 1- part 1 PDF

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The Nursing Assistant in Long Term Care...

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Chapter 1: Audio #1- The Nursing Assistant in Long Term Care

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Long term care (LTC)- given in long-term care facilities for people who need 24-hour skilled care Skilled care is medically necessary care given by a skilled nurse or therapist --> available 24/7 ▪ Ordered by a doctor ▪ Involves a treatment plan ▪ Given to people who need high levels of care for ongoing conditions “Nursing Homes” - was once widely used to refer to long term care facilities --> now they are often known as long term care facilities, skilled nursing facilities, rehabilitation centers, or extended care facilities People who live in LTC facilities may be: ▪ Disabled ▪ Elderly ▪ Have a terminal illness Most people who live in LTC facilities have chronic conditions ▪ Chronic: when the condition lasts a long time ▪ Includes physical disabilities, heart disease, dementia, etc. People are LTC are usually referred to as ‘residents’ Stages of illness/disease affect how sick people are and how much care they might need

Tasks for CNAs vary because each resident has their own symptoms, abilities, and needs Other healthcare settings for CNAs: ▪ Home health care ▫ Provided in a person’s home ▫ Person does not want to leave their home environment ▪ Assisted living ▫ Residences for people who need help with daily tasks (showering, eating, dressing, etc.) ▫ Do not need 24-hour skilled nursing care ▫ More independent living ▪ Adult day services ▫ For people who need help and supervision during certain hours, but do not live in the facility where care is being provided ▫ For people who need help, not for disabled/chronic patients ▫ Provides a break for spouses, family members, friends, etc. ▪ Acute care ▫ 24-hour skilled care given in a hospital, ambulatory surgical center, etc. → For people who require short term, immediate care for illnesses or injuries

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Subacute care ▫ Given in hospitals or LTC facilities → Used for people who need less care than an acute, sudden-onset, short term illness but more care than for a chronic, long-term illness ▫ Treatment ends when the condition has stabilized, or after the set time for treatment has been completed ▫ Cost is usually less than for acute care, but more than for LTC Outpatient care ▫ Given to people who have had treatments, procedures, or surgeries and need short term skilled care → Do not require overnight stays Rehabilitation ▫ Care given by specialists (physical, occupational, speech, etc.) ▫ Help to restore/improve function after an illness or injury Hospice care ▫ Given in facilities or homes for people who have about 6 months or less to live ▫ Workers give physical and emotional support and comfort until a person dies → Also support families

LTC facilities are businesses that provide skilled nursing care 24 hours a day ▪ May offer assisted living housing, dementia care, or subacute care ▪ Some offer specialized care ▪ Some care for all types of residents ▪ Typical LTC facility offers personalized care for all residents Focus care- care provided for residents with special needs Personal care includes: ▪ Bathing ▪ Hair, skin, and nail care ▪ Mouth care ▪ Assistance with walking, eating and drinking, dressing, transferring, and elimination (ADLs) Wound care, care of different types of tubes, physical therapy, occupational therapy, speech therapy, nutrition therapy, management of chronic diseases, etc. may also be offered in LTC facilities Many LTC facilities promote meaningful environments with individualized approaches to care Culture change – term given to the process of transforming services for elders so that they are treated based on the values and practices that the person wants to receive ▪ Involves respecting both elders and the people working with them ▪ Core values are promoting choice, dignity, respect, self-determination, and purposeful living ▪ To honor culture change, care settings might need to change their organization, practices, physical environments, and relationships

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Person-centered care – emphasizes the individuality of the person who needs care and recognizes the patient’s unique capabilities ▪ Revolves around the resident, and promotes his/her individual preferences, choices, dignity, and interests ▪ Each person’s background, culture, language, beliefs, and traditions are respected, which improves each resident’s quality of life ▪ Quality of life is the most important goal

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The Centers for Medicare and Medicaid is a federal agency within the United States Department of Health and Human Services ▪ CMS has Medicare and Medicaid, which help pay for healthcare and health insurance Medicare – federal health agency that was established in 1965 for people over the age of 65 and for people of any age with terminal kidney disease or certain disabilities ▪ It has 4 parts: ▫ A: helps pay for care in a hospital or skilled nursing facility, or for care form a home health aid ▫ B: helps pay for doctor services and other medical services and equipment ▫ C: allows private health insurance companies to provide Medicare benefits ▫ D: helps pay for medications prescribed for treatment ▪ Will only pay for care it determines to be medically necessary Medicaid – medical assistance program for people who have low income, as well as for people with disabilities ▪ Funded by both the federal government and each state ▪ Eligibility is determined by income and special circumstances Medicare and Medicaid pay LTC facilities a fixed amount for services ▪ Amount is based on the resident’s needs

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