Providing Wrap Around Service

through Adult Day, Home Care,

Hospice and Volunteer Collaboration

Laura Philbrook, RN-BSNAlter Care Adult Day Program Director

Lynn Buckley LPNCaring Connection ADHC DirectorMADSA President

Myths of Adult Day Services

• Only old people are there

• BINGO is the highlight

• You Are My Sunshine

is the favorite song

• It’s adult “day care”

• Everyone is confused

• It is a passive environment

Programs are not PRIMARILY

gathering places for:

•Socialization

•Education

•Supervision

•Caregiver Respite

•Religious Expression

•Exercise

•Nutritious Meals

Adult Day Services Facts:• Community-based service option

• Structured, comprehensive, therapeutic programs

• Health, social and related support services

• Less that 24-hour care

• Over 100 licensed centers

• 60% in Metro area

• Licensed by DHS with Regulatory OversightPrograms and activities

Nutritious meals and snacksPhysical plant, building layoutVulnerable adult law, enforcement

Programs and services in different shapes and

sizes . . .

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

• 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.

Collaboration Increases:

• Capacity in quality care throughout the industry

• Exposure in the community & enhanced community partnership

• Recognition and credibility by other

communities of care

• 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

WAYS TO COLLABORATE

• Staff involvement (various levels of staff)

• Finance

• Time

• Training

• Policies/Procedures

• Programs

• Advocacy

• Community Outreach

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.

• Home Care clients have capability of receiving added services while attending Center:

Therapeutic ActivitiesSocial Work ServicesRehabilitative Therapy Out-patient Services

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

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.

• 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

What CollaborationBrings to The Table Areas of Expertise.

• Person Centered Care

• Pain and Symptom Control

• Psychosocial Intervention

• Spiritual care

• Quality of Life

• Supporting independence

• Daily activities and programming

• Nutrition, social/medical oversight

• Ethical Issues

• Pre-Bereavement and Bereavement

• Increased client and family support

• Dealing with ethical issues

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

Developing A Coordinated Plan of Care:

• Determine interventions

• Reflect Adult Day/ Hospice/Home Care philosophy

• Designate responsible provider

• 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.

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

• 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

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

Marketing and Outreach: Ideas and Considerations

• Illustrate partnership on websites and newsletters

• Approach traditionally difficult to access referral sources with a united voice

• 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

• 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