In this blog we have often spoken about how smaller assisted living/group living programs are enhancing their clinical edge and serving more of the medically fragile including disabled U.S. veterans. Many of these residents are being discharged from nursing homes. These discharges have increased under programs such as the Nursing Home Transition and Diversion Waiver, a Medicaid initiative designed to promote the transfer of those occupying long-term beds in nursing homes to less expensive and often more dignified community based living settings.
As a result of the upsurge in efforts to innovatively accommodate this population which has greater clinical needs – including some with stroke related paralysis, multiple sclerosis and other limiting conditions – staff in small group homes have to be helped to really bring their A-Game. In this way they can render competent, quality, safe, dignified care. How can this process be enhanced?
In advance of the actual admission key group home staff should visit the nursing home where the prospective resident currently lives and observe the certified nursing assistants rendering care. They can observe how a hoyer or seralift is used along with mobility promoting standing aids with this patient. In addition they can observe how their personal care is rendered in order to address certain personal sensitivities and more.
What is accomplished? The new staff that will have to attend to this resident takes a first hand look at how this person is cared for presently. While there will obviously be some adjustments since people do change and the group home is smaller and operates using a different set of daily dynamics, there can still be value in this process. We are talking value that contributes to person-centeredness in care and that allows the patient to develop a familiarity with those who will soon care for them.
It may not be a bad idea for agents of Medicaid waivers including area agencies on aging to mandate such a process before placing a patient in a group home. This could allow group home owners and staff to collaborate better on whether or not this referred patient is a good fit and if so how best to come together and render quality assistance.
Of course such visits have to be properly arranged in order to avoid stepping on the new resident’s dignity. However, when properly explained surely the patient and/or family representatives will see the value of this important procedure. Independent case managers would do well to embrace its value as well.
One additional benefit is that we stimulate the relationship between community based and institutional care providers along with care planners such as Medicaid waiver agents.
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