Online Program

285879
Wellness promotion among elders in community settings and licensed health care facilities


Wednesday, November 6, 2013

With the implementation of health care reform, care for the elderly at home and in the community will change. One reason is the new emphasis on innovative payment reform models that may improve quality of care and reduce costs. Hebrew Senior Life, a large provider of services to the elderly, has had direct experience with an innovative Medicaid-Medicare partnership model that illustrates the potential for improved care by providing a complete package of coordinated health care and social services for low-income seniors. The model can emphasize wellness, keeping elders independent and out of the hospital because of the way reimbursement is offered. One example involves preventing hospitalizations. All too often older patients end up in emergency rooms, leave the hospital even frailer than when they were admitted, and "bounce back" at alarming rates. I will present an evaluation of Hebrew Senior Life's 3 step approach to addressing this problem and reducing rehospitalizations by 30 percent. It involves rigorous advanced care planning to help patients and their caregivers determine the most appropriate treatment plans; a discharge planning project that counsels patients using a special software program to better understand and comply with discharge instructions; and multidisciplinary patient safety and quality conferences, during which staff analyze the root causes of avoidable readmissions and near misses, encouraging open discussion about what steps can be taken to improve patient outcomes. Once patients are back home, home health-care providers can help reinforce the discharge program's plan and become the eyes and ears for their physicians.

Learning Areas:

Clinical medicine applied in public health
Other professions or practice related to public health
Provision of health care to the public
Public health or related nursing
Public health or related public policy

Learning Objectives:
Describe how health care reform may affect the health of the elderly. Discuss the ways wellness is promoted among elders in both community settings and licensed health care facilities. Identify how to link the public health and prevention approaches to clinical care in work with the elderly. Analyze innovative and evidence-based approaches that are currently being used for work with elderly people.

Keyword(s): Elderly, Health Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Executive Director of the largest facility rehabilitation facility in New England that specializes in care for the elderly. Hebrew Senior Life provides care to thousands of elderly clients in community and facility settings. A central part of my work in this arena has involved research regarding the best practices for maximizing independence and good health among the elderly. I am a former state health commissioner.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.