Level of Care Acuity Assessment Process

Seniors participating in skill game. Level of Care Acuity Level Assessment will occur on a number of abilities.

Supervisor Alison Sarkozy on Level of Care Acuity Assessment

After some careful planning, a few months ago the Helping Hands Respite Care ADS program implemented a Level of Care Acuity Assessment system for our senior members of the adult day program. By sharing an assessment tool during intake of a new member, families were asked to fill out the assessment tool based on what skills and behaviors they could observe at home. That family-based assessment provided the baseline for determining staffing care ratio needs and a corresponding fee schedule based on staffing. After 30 days the same assessment tool is filled out for that individual through a collaborative effort and input from those care providers who see that individual in action throughout the day at the adult day program.

The Acuity Assessment covers everything from mental sharpness, ability to engage and participate, making needs known, ability to feed self, attend to personal toileting, and mobility. Being able to have these mental, physical, and social markers is the kind of data which, if consistently available for periodic review, provides a real benefit to the member, their family and our staff. Having the family participate from the outset also provides a common language for marking progress or critical changes.

Level of Care Acuity Assessment Well Received

By and large, this new system of assessment has been very well received, and from our perspective helps us do an even better job at monitoring and responding to care needs. This effort is also part of a statewide data collection initiative. Since our Executive Director, John Stauffer, recently concluded two years as President of the Michigan Adult Day Services Association, members of the association are attempting to apply common language and measurement across the state from organizations with similar missions and populations. “As an industry we have seen the writing on the wall, there are mounting challenges that our major health systems are being faced with regarding serving this senior population. If the adult day services industry is going to compete or collaborate with big health systems we need to be able to point to reliable data that demonstrates our industry’s service value and effectiveness,” shares Stauffer. “We, at Helping Hands and at the state level, are proud to be involved in a project which may very well have a positive impact nationwide.”

Health History

Nurse Jane at Helping Hands Respite taking blood sugars to compare with health history.

Why We Take a Thorough Health History

A thorough health history and medicine list is important for our caregiver staff to best take care of your loved one. An example of how the history can be helpful might be if your loved one had a history of radiation in the abdominal region. This may cause radiation colitis, with the most apparent symptom being diarrhea. This helps to narrow down causes for the diarrhea, such as an infection source vs a prior cause.

 

Health History Can Explain Behaviors

Restlessness in our seniors is another area in which we can benefit from looking at a thorough health, medicine and lifestyle history. Using this combined information some reasons for the restlessness might be found and ways to make the senior more comfortable can be added to the care plan.
It is a good idea for families to communicate prior health history and lifestyle behaviors, and then continuing to update your professional caregivers on all health and medicine changes. Not doing so, can leave families vulnerable to having their loved one discharged from our program if we do not have thorough information to modify and deal with behaviors and health problems. And, we don’t want that to happen.
There are five reasons that could put your loved one at risk for discharge:
1. Persistent and uncontrolled incontinence
2. Persistent disruptive or violent behavior, including chronic “run-aways.”
3. Need of physical care beyond the capabilities of the program
4. Inability to feed self
5. No proof of Tb test
The above reasons/problems might be resolved if caregiver staff had your help with maintaining prior health history, and previous and current medications. If you haven’t updated your health history lately check in with Nurse Jane Rogers in our Adult Day Services program.  nursejane@helpinghandsrespite.care

Dementia and Nutrition

Learn more about the link between dementia and nutrition. Eating a healthy, balanced diet is important for people with dementia. Poor nutrition can result in dehydration, reduced muscle strength, and, in some cases, an increase in behavioral symptoms.
Some people with dementia experience problems with eating and drinking. Common reasons include difficulty communicating their likes and dislikes; pain due to constipation or poorly fitting dentures; a change in medication that reduces appetite; or not recognizing the food placed in front of them. It can be a challenge to determine what the problem is, especially if the person is unable to verbalize it.

Making a few changes can help make mealtime less stressful.

  • Limit the number of food items on a plate. Too many foods at once may be overwhelming.
  • If someone is not eating well, sticking with what is familiar and avoiding the introduction of new foods into the diet is recommended.
  • Check the food temperature. A person with dementia may not know if something is too hot to eat or drink. On the other hand, if food goes cold, it could seem less appetizing.
  • Prepare food that is easy to pick up. Loss of motor skills can make using utensils difficult. If the person appears to be struggling, chop food into smaller bites that can be eaten with a spoon.
  • Provide plenty of time to eat. People with dementia can tire easily, and it may appear that they have stopped eating.
  • Don’t force a clean plate. Instead, gently encourage them to eat and remind them what the food is.
  • For those who traditionally start a meal with prayer, not doing so might make it difficult for them to begin the meal.
  • Increase fluid intake by offering soups, gelatin, or popsicles. Sometimes changing the presentation of beverages can make a difference (e.g., using a cup with a straw, or a sippy cup). Maintaining good hydration is very important as dehydration can lead to further challenges with cognition.
  • People with advanced dementia may need a prompt (such as putting the fork or spoon in their hand) along with verbal cues to begin eating.
  • Watch to make sure food is chewed completely to avoid choking.
  • When possible, make meals a social event by eating together.

Eliminate distractions as much as possible and keep the atmosphere relaxed. Recent studies have linked deficiencies in vitamins B12 and D as well as Omega-3 fatty acids with people who have dementia or Alzheimer’s disease. However, use only vitamin supplements recommended by a physician.
With just a few changes, a caregiver can ensure the person they are caring for enjoys their food and eats a healthy, balanced diet.

To answer your questions about your loved one with dementia contact the Helping Hands Adult Day Services (ADS) program Supervisor Alison Sarkozy at 517.372.6671×107 or email Alison@HelpingHands Respite.care; For our Program Nurse, Jane Rogers call 517.372.6671×108 or email NurseJane@HelipingHands Respite.care

This helpful article on Dementia and Nutrition was written by Ava Stinnett and shared by ActivityConnection.com