1. Providing Wrap Around Service through Adult Day, Home Care, Hospice and Volunteer Collaboration Laura Philbrook, RN-BSN Alter Care Adult Day Program Director Lynn Buckley LPN Caring Connection ADHC Director MADSA President

2. Myths of Adult Day Services Only old people are there BINGO is the highlight You Are My Sunshine is the favorite song

3. It’s adult “day care” Everyone is confused It is a passive environment

4. Programs are not PRIMARILY gathering places for: Socialization Education Supervision Caregiver Respite Religious Expression Exercise Nutritious Meals

5. Adult Day Services Facts: Community-based service option Structured, comprehensive, therapeutic programs Health, social and related support services Less that 24-hour care

6. Over 100 licensed centers 60% in Metro area Licensed by DHS with Regulatory Oversight Programs and activities Nutritious meals and snacks Physical plant, building layout Vulnerable adult law, enforcement

7. Programs and services in different shapes and sizes...

8. Why Work Together? An opportunity to increase choice for consumers and their families. An opportunity to provide an added sense of dignity for consumers A chance to foresee the potential for timely referral to other Services-when the full impact and benefit of team approach can be felt

9. Many potential benefits of enhanced coordination and community supports including referrals and increased length of stay Sharing resources through a formal alliance of organizations committed to common goals to reduce costs and effort, and expand levels of service Expanded, more comprehensive team to support participants with life limiting illnesses.

10. Collaboration Increases: Capacity in quality care throughout the industry Exposure in the community & enhanced community partnership Recognition and credibility by other communities of care

11. Teaches new ways to: Enhance choice and support for participants and their families Provide more comprehensive care for people Expand the care team Unites voice targeting physicians and other referral opportunities

12. WAYS TO COLLABORATE Staff involvement (various levels of staff) Finance Time Training

13. Policies/Procedures Programs Advocacy Community Outreach

14. Home Care /Adult Day Collaboration: Home Care and ADS share services to assist clients to remain home longer & fill gaps in care or caregiver support. Home Care assists clients prior to and after ADS program Referral to ADS for services such as bathing and additional health monitoring.

15. Home Care clients have capability of receiving added services while attending Center: Therapeutic Activities Social Work Services Rehabilitative Therapy Out-patient Services

16. Adult Day /Hospice/Palliative Care Collaboration Improves end-of-life care for those individuals enrolled in adult day centers (and their families) Encourages dual service model for those who wish to receive hospice/palliative care and receive or remain in adult day care Provides increased choice and dignity for individuals requiring care and their families

17. Collaboration with Volunteer Services Fill gaps in respite needs of Caregiver The volunteer provides friendship to loved ones while giving caregivers an opportunity to do things they may not be able to do while caring for their loved one. Volunteers provide support and a sympathetic ear.

18. Connections are created to the greater community. Assist with tasks to reduce the caregivers workload Volunteers are friends, both to the caregiver and their loved one

19. What Collaboration Brings to The Table Areas of Expertise. Person Centered Care Pain and Symptom Control Psychosocial Intervention

20. Spiritual care Quality of Life Supporting independence Daily activities and programming

21. Nutrition, social/medical oversight Ethical Issues Pre-Bereavement and Bereavement Increased client and family support Dealing with ethical issues

22. Enabling The Relationship: Board of Directors: Partner Organization hold Board Seat Shows the value of the expertise from partner organization Enables communication Facilitates collaboration and partnership

23. Developing A Coordinated Plan of Care: Determine interventions Reflect Adult Day/ Hospice/Home Care philosophy Designate responsible provider

24. Designate responsible discipline Establish when it will be done Change and update to meet the patients needs (1) (1) Hospice Care in Nursing Facilities: An Educational Resource for Effective Partnerships in End-of-Life Care. Volume I, Module 2: Developing a Coordinated Plan of Care. (Independent Learning, Participant Handouts, Facilitator Guidebook). National Hospice and Palliative Care Organization. 2001.

25. Building Capacity Through Training Collaboration affords access to additional training for management, staff and volunteers Level of knowledge that Hospice, Home Care and ADS providers have on their respective areas Areas of expertise can offer opportunities to help each other build capacity

26. Cross training-allowing staff and volunteers to attend each other’s training Disparate agencies connect in an interdisciplinary way Inter-disciplinary training indicates a real commitment to collaboration

27. Collaboration: Marketing and Outreach Increased opportunities for outreach, partnerships and united voices to referral sources Leverages one another’s established trust and existing relationships –Better serves the community –Opens doors to community coalitions and advocacy

28. Marketing and Outreach: Ideas and Considerations Illustrate partnership on websites and newsletters Approach traditionally difficult to access referral sources with a united voice

29. Demonstrate your approach to coordinated community-based care Pool resources to more powerfully target audiences advertising – co-hosting events – co-branding materials – Spearhead joint initiatives and advocacy efforts

30. Hartle, Marilyn and LaDonna Jensen. Planning and Creating Successful Adult Day Services and Other Home and Community- Based Services. National Adult Day Services Association. 17 Mar 2009.http://www.nadsa.org/documents/hcbs_techbrief.pdf Hospice Care in Nursing Facilities: An Educational Resource for Effective Partnerships in End-of-Life Care. Volume I, Module 2: Developing a Coordinated Plan of Care. (Independent Learning, Participant Handouts, Facilitator Guidebook). National Hospice and Palliative Care Organization. 2001. Medicare Hospice Benefits. Sept 2008. U.S. Department of Health and Human Services. 17 Mar 2009.http://www.medicare.gov/publications/pubs/pdf/02154.pdf National Hospice and Palliative Care Organization. 17 Mar 2009.http://www.nhpco.org/templates/1/homepage.cfm Siebenaler, Kristin, et. al. Regulatory Review of Adult Day Services: Final Report. 26 Aug 2005. U.S. Department of Health and Human Services and Office of Disability, Aging and Long Term Care Policy. 17 Mar 2009. http://aspe.hhs.gov/daltcp/reports/adultday.htm Resources