Pride Institute journal of long term home health care最新文献

Expanding adult day care services successfully by strengthening recruitment and retention, quality assurance, programming, scheduling and financial management requires strong program leadership. Since the vast majority of day care program directors are educated as registered nurses, social workers and recreation therapists, cultivation of effective leadership skills must be achieved through a combination of additional formal education in management, extensive seminar/workshop attendance, outside readings and on the job guidance and experience. The administrator, to whom the program director reports, should devote considerable time and effort toward the director's management development through instruction, counseling and support. Conflicts may arise in areas such as staff and overtime expenses, and marginally efficient equipment purchases, where the director's clinical background may overshadow an objective cost/benefit analysis. Learning to delegate responsibility for basic programming and clinical services to staff, thus developing their skills, is a significant area for director and program growth. A well-trained and motivated nurse's aide can be quite capable of leading discussion and activity groups, perhaps assisted by volunteers. Social work students, with supervision, do a fine job of cofacilitating caregiver support groups and with additional experience, intake assessments.

Consumers who purchase long term care insurance policies can get good value for their money but there are several residual risks. Advisers have an important responsibility to make sure that their clients fully understand these risks. We recommend that consumers who are appropriate candidates for long term care insurance take into account the following guidelines: Make sure that a policy is bought from a well-known, financially secure company that has an A.M. Best Company rating of A or A+ or at least an A rating from Standard & Poor's. Avoid companies that have a history of consumer complaints, post-claims underwriting, high agent commissions, high lapse rates, or abuses in the Medigap market. Buy a policy with level premiums but understand that in the absence of explicit rate guarantees, premiums may be increased in the future. Seek policies that are guaranteed renewable, explicitly ensure fair access to policy upgrades, provide protection in case of late premium payments, and guarantee protection from potential changes in government benefits.

Adult day programs are a rapidly growing alternative for community-based care for the elderly, but there are few descriptions of dementia-specific programs in the gerontologic literature. We present the first overview of such efforts in the United States with a national scope, using information provided by a pool of 283 applicants to the Robert Wood Johnson Foundation Dementia Care and Respite Services Program. Results show program consistency in hours of operation and use of professional staff, and variability in sources of funding and size of the community served. On the average, participant fees accounted for less than 25 percent of total revenues.

LTC insurance is a valuable financial tool to help pay for pending LTC. However, LTC insurance is not for everyone. For those who could benefit from a policy, questions arise as to how much to buy and what consumer options to purchase in a policy. Insurance is most appropriate for couples with assets of $110,000 or more, excluding their house, car, and personal belongings. Single persons with a need to protect assets should have at least $40,000 in assets. These individuals have smaller need for LTC insurance to protect assets for their children. How much insurance to buy depends on the cost of LTC and the financial resources of the person. Premiums for LTC insurance are level. A company cannot raise the premiums for an individual, but may request an increase for a class of people. With the potential that premiums may increase and that buying power of income may decline, the policy should be affordable both at time of purchase and in future. Policies pay a specified benefit amount for a specified benefit period. In deciding how much insurance to buy, it is advisable to buy a higher benefit amount for a shorter benefit period. This provides the greatest likelihood of receiving the policy's maximum benefit. The deductible amount should be between 20 and 100 days. In selecting a policy, the most important criterion is the company itself.(ABSTRACT TRUNCATED AT 250 WORDS)