1. 12/09/2015Home and Community Care 1 Long Term Care Administration Class Agenda Thursday, February 12, 2009 News and Views Home and Community Care Break Presentation Grades Mental Health Services

2. 12/09/2015Home and Community Care 2 Old friends, old friends, Sat on their parkbench like bookends A newspaper blown through the grass Falls on the round toes Of the high shoes of the old friends Old friends, winter companions, the old men Lost in their overcoats, waiting for the sunset The sounds of the city sifting through trees Settles like dust on the shoulders of the old friends Can you imagine us years from today, Sharing a parkbench quietly How terribly strange to be seventy Old friends, memory brushes the same years, Silently sharing the same fears Old Friends

3. 12/09/2015Home and Community Care 3 Simon and Garfunkel

4. 12/09/2015 Home and Community Care 4 February 15, 2007

5. 12/09/2015Home and Community Care 5 Home and Community Care Definitions Home Care Publicly funded programs and services that people with functional limitations access to remain at home. Community-Based Services Range of supportive services such as meals on wheels, transportation, homemaker services, enabling people to remain in the community.

6. 12/09/2015Home and Community Care 6 Community Care Encompasses home care and community based services, includes support provided by family and friends, volunteers and, occasionally facility based care.

7. 12/09/2015Home and Community Care 7 Three Models of Home Care Acute Care Substitution Model Provides services to people who otherwise would be admitted to or remain in acute care facilities. Long Term Care Substitution Model Provides home care services for those who would otherwise require placement in a long term care facility.

8. 12/09/2015Home and Community Care 8 Three Models of Home Care… Maintenance Preventative Model Provides support and services to people with health and functional deficits. Its goal is to maintain their independence and prevent health and functional breakdowns and eventually institutionalization.

9. 12/09/2015Home and Community Care 9 Home Care Program Home Care Teams made up of nurses, physiotherapists, occupational therapists, case managers and nutritionists work together to support people in the community. They work out of the six Community Health Areas providing supportive services to clients in their homes, clinics and other settings. Services include: Pain management Wound care Palliative care Home IV Mobility, endurance and strength training Assessment for Home Support

10. 12/09/2015Home and Community Care 10 Home Care Program Home Support Home Support consists of a range of support options designed to meet the assessed health needs of clients for personal care, safety, prevention of health decline and end of life care. Home Support also assists in enabling safe discharge from hospital. Currently, Vancouver Community is working with five agencies to provide home support services to Vancouver residents. Personal Care includes: grooming and hygiene, bath assistance, assistance with mobility lifts and transfers, assistance with medications, nutritional assistance and family and caregiver respite.

11. 12/09/2015Home and Community Care 11 Home Care Program Caregiver Support Program The Caregiver Support program offers the following programs and services to support family and friend caregivers: Education Series and workshops Support groups Telephone support Information and referral to healthcare and community resources Annual caregiver forum Caregiver Times quarterly newsletter. All services are free.

12. 12/09/2015Home and Community Care 12 Home Care Programs Adult Day Centres Adult Day Centres (ADC) provide a range of health, social stimulation and therapeutic recreational programs in support group settings. Clients attend ADC for: Caregiver & family respite Waiting residential placement Health status monitoring Medication support & monitoring Targeted therapeutic activities Access to health education

13. 12/09/2015Home and Community Care 13 Home Care Programs Home Hospice Program The Vancouver Home Hospice Program provides hospice palliative care to people in their home setting. Hospice palliative care refers to the physical, emotional, social and spiritual care with the goal of providing comfort and improving quality of life for those persons who are living with or dying from advanced illness. This active compassionate care is based on a commitment to the whole person respecting personal, cultural and faith values, beliefs and practices.

14. 12/09/2015Home and Community Care 14 Home Care Programs Home Hospice Program, cont… In collaboration with the individual and their family/caregivers, hospice palliative care services are provided by an interdisciplinary team including: Family physician Community health nurses Community PT/OT Palliative care physicians Nurse clinician Social work consultant Spiritual care consultant Coordinator of volunteers Hospice volunteers

15. 12/09/2015Home and Community Care 15 Home Care Program Meal Programs Meal Programs assist clients to maintain or improve their health by supplementing their present diet wit hot, nourishing meals. The main types of service are Meals-on-Wheels, Wheels-to-Meals, and Congregate Meals.

16. 12/09/2015Home and Community Care 16 Home Care Program Short Term Assessment and Treatment Centre Short Term Assessment and Treatment (STAT) Centre (VGH) has both an inpatient unit and a day hospital whose main function is to provide assessment of the frail elderly. The unit has a strong focus on research, education and holistic geriatric care.

17. 12/09/2015Home and Community Care 17 Home Care Programs Transitional Care Transitional Care is provided for individuals requiring more time for recovery after an acute care episode in order to return to their home. Client needs are less than in acute care but more than residential care. Programs & activities are rehabilitation based and focus on assisting clients in regaining their functioning & abilities.

18. 12/09/2015Home and Community Care 18 Home Care Programs Shop-By-Phone Shop By Phone covers the entire city with the exception of the west-end and provides a volunteer-run grocery shopping service for those people unable to get out to do their own shopping. Registrants must live within the boundaries of the service; have no friends, family or neighbours to assist with groceries; be homebound; suffer from a chronic illness (mental, physical, addiction); have a short- term disability or have no transportation to assist with groceries.

19. 12/09/2015Home and Community Care 19 Private-Public Role in Home Care Three Distinctions 1. Delivery – service provider organization public or private. 2. Financing – Publicly or private financed. 3. Allocation – degree to which government controls delivery system.

20. 12/09/2015Home and Community Care 20 Private-Public Role in Home Care Example 1. Whether the service should be provided, to whom, how much is needed. 2. Recipient pays directly or indirectly. 3. Who will provide the service. Note In some cases the system is publicly financed and private provided.

21. 12/09/2015Home and Community Care 21 Private-Public Role in Home Care Four Models of Home Care Delivery 1.Public-provider model where single entry functions, professional nursing services and home support services are delivered by public employees.

22. 12/09/2015Home and Community Care 22 Private-Public Role in Home Care Four Models of Home Care Delivery 2. The public-professional and private home support model where single entry functions and all professional services are provided by public employees.

23. 12/09/2015Home and Community Care 23 Private-Public Role in Home Care Four Models of Home Care Delivery 3.The mixed public-private model, where single entry functions, plus some professional services, are delivered by public employees, some nursing and all home support are contracted out depending on the region of the province.

24. 12/09/2015Home and Community Care 24 Private-Public Role in Home Care Four Models of Home Care Delivery 4. The contracted model where single entry is provided by public employees and professional and home support employees are contracted out.

25. 12/09/2015Home and Community Care 25 Providers of Home Care Traditional Formal Caregivers Service delivery personnel typically employed by government-funded, for-profit or not-for- profit agencies. Independent Formal Caregivers and Personal Assistants Service delivery personnel who register with an employment agency who are employed on a casual or permanent basis by users of their service

26. 12/09/2015Home and Community Care 26 Providers of Home Care Volunteer Caregivers Typical unwaged service deliverers working with a volunteer or nonprofit agency. Informal Caregiver Family and friends of the person receiving care.

27. 12/09/2015Home and Community Care 27 Emerging Issues in Home Care The increasing medicalization of home and community care. A national home and community care approach. Role of technology. Public-Private Mix in Home Care Future Availability of Human Resources.

28. 12/09/2015Home and Community Care 28 Other Emerging Issues Available Data. Regionalization. Rural Urban Differences. Supportive Housing. Role of Research