Long term Care Administration
Please base your case study assignment off of the case study information found below. You are to use the facts provided below, and “fill in the blanks,” so to speak, with information you provide that makes sense, given the context of this case study. For example, because the individual has a mild case of dementia, you will likely want to speak about the necessity for door alarms in her new home, as she sometimes gets up at night and might try to leave alone, which is unsafe. I didn’t provide you with the information that she wanders, but this is a behavior that is very likely to occur, due to her dementia diagnosis. You are welcome to add additional behaviors/information/etc, as long as it’s related to the original example.
The information you are to use in discussing the options and your decision/reasoning can be found in the readings for this week. You are also welcome to use information from sources outside the class. Citations are required for information being cited from resources.
**Please be sure to take into consideration finances, care needs, social needs, cognitive status, and family/individual wishes when writing your recommendations.**
Case Study Information
Ms. Abby Jones is an 85 year old grandmother, who currently lives at home alone. Due to a recent fall, which has landed her in the hospital, as well as difficulty properly taking care of herself at home, Ms. Jones will need to move into a setting that provides care and other services upon her discharge from the hospital. According to her daughter, Ms. Jones started having mild memory issues several years ago, and they have progressed from minor instances of forgetting to pay bills or remembering where she parked her car, to being unable to recall when her last meal was, if she has taken her medication, and whether or not she turned the stove off after cooking breakfast. Ms. Jones sometimes has difficulty remembering who her children are as well, and often asks the same question and tells the same story repeatedly.
Due to her cognitive state (she sometimes is unable to follow simple directions) and pain from the recent surgery to repair her broken ankle, it’s unclear exactly how much therapy Ms. Jones will be able to tolerate upon discharge. While in the hospital, some days therapists are able to work with her for 3.5 hours per day, but other days Ms. Jones is only able to successfully complete between 1-2 hours of therapy. Her daughter has expressed the family’s desire to find a community where Ms. Jones will be able to stay long term, as the family believes she is unsafe to remain at home alone. They are also very eager for her to leave the hospital, as her stay has been very upsetting and disorienting to her. Financially, Ms. Jones is unable to afford any type of long term care option on her own, and will be counting on her Medicare benefits to fund her therapy services. Once those funds have been exhausted at the end of 100 days, the family is unsure how her care will be funded, as Ms. Jones’ social security check is only enough to cover her rent and a little bit of food each month.
The recent trauma of the fall, surgery, and hospital stay has left Ms. Jones considerably more disoriented and confused than her baseline before the fall. While she is able to voice her concerns and desires in the present tense, her ability to think rationally and abstractly about the long term implications of going home, staying in the hospital, or going to a rehab facility is not in place. She is able to tell her family that she “wants to get better,” as well as that she “wants to go home as soon as possible because she misses her cat” (she hasn’t had a cat in several years). From what the social worker at the hospital can surmise, Ms. Jones needs to find a consistent environment, one that she will not have to leave any time soon, as the disruption takes a toll on her mental health. It also seems that the family is unable or unwilling to visit her very often, as Ms. Jones often makes statements about feeling alone, lonely, or isolated at home. The family confirms that they have difficulty visiting her frequently, as they all live an hour+ drive away, and they feel it’s very hard to see their mother in that condition.
Ms. Jones has an anticipated discharge date of 5 days.