Care not cure: Exploring care options for the elderly

Demonstrate understanding of the emotions involved when families need to transition elderly relatives to more structured care.
“…sadness, anger, guilt, grief, hopelessness, and fear. The nursing home may signify the loss of familiar surroundings, personal possessions, health, privacy, self-esteem, and independence. Anger, depression, withdrawal, and confusion are normal initial responses…Patience and understanding are needed.”

Define the physician’s role in functional assessment and in helping families recognize and deal with the need for structured care.
The physician’s role in the geriatric functional assessment includes not only judging a patient’s physical function, but also his or her mental and emotional competence as well. By using the plethora of screening devices mentioned in this session, physicians can identify the factors that cause functional or cognitive impairment. A physician is only a part of the health care team that makes this comprehensive multidisciplinary assessment which serves the overall purpose of helping older patients add overall quality to their lives.

Describe potential methods of physician support for elderly patients and family members and potential resources for physicians.
A physician can serve as a source of support in a variety of degrees and contexts, and the more informed a physician is about the care options available for geriatric patients the better served their patients will be.

Describe differences between various care options available and note how patient management techniques and care philosophies vary from facility to facility.
Retirement Homes -> Residential and Assisted Living -> Adult Foster Care -> Nursing Center. Retirement Homes – Designed for active seniors; able to live independently. Residential and Assisted Living – Additional levels of personal care and assistance with medications. Adult Foster Care – 24-hour supervision and meals. Nursing Homes – 24-hour nursing (immediate, skilled, or both) care. Refer to chart on page 375.

Describe the order of intensity of care of care facilities

 * In home services
 * (least intense level of care). Person continues to live in their own home and receives care from personal care aides, meals on wheels, etc


 * Retirement communities
 * Active people live independently. Like condos with full/partial kitchens


 * Assisted living
 * Retirement communities + additional levels of personal care and assistance with medications, etc.


 * Residential care facilities (RCF)
 * housing option between retirement living and nursing home care. help with dressing, grooming, bathing, help at meals, etc.


 * Adult Foster Care
 * 24 hour supervision for up to 5 people in a private home environment. May receive personal care assistance with grooming, bathing, etc.


 * Nursing Homes: Intermediate care facilities
 * patients have chronic disabling conditions, require assistance or total care in dressing, feeding, toileting, etc. Most care provided by nurses aides.


 * Nursing Homes: Skilled nursing facilities
 * (highest level of care)