[MicStar]

Originally Posted by DaisyDoodle

I'm from the U.S. and I work in a nursing home. I am wondering how different we are from what you have. We call it Elder Care. There is a big push now in the United States to make the image of nursing homes seem more like a home and not an institution. I was wondering if you have heard of the Eden Alternative.... it is bringing the outdoors in to the facility. Bringing life in to the facility. For example, we can bring out pets into the facility. I bring my dog to work everyday. This is just very basic. If you have some time, I would really like to have some discussion about how nursing, especially geriatric nursing works in your country. Do you have LPN's? Licensed practical nurses or only RN's. We have both. The LPN's have less school and are limited by the duties that they can perform. The biggest difference is that they are not able to document that they "assess" it is only the nurse that can do assessments. Well, if you have time, I'd like to chat and share exchange information about our countries.

Hi DaisyDoodle

We are regulated for 44 Standards this regulation is monitored by the Aged Care Accreditation Agency, which is an organisation set out to monitor homes; the emphasis is on residents lifestyles, continuous quality improvement and when audited they want to see REAL results for residents. Yes the atmosphere is to make the environment home like, most facilities built these days look like modern apartments...

We have ENs (Enrolled Nurses) who are equivalent to your LPN, RNs assess, very similar roles it would seem. We prodominantly have ENs working in low level care facilities and RNs working in high level care facilities (2 sorts of facilities HIGH CARE or LOW CARE). THe site manger of a low level care facility is usually the only RN on site. But these day low level care facilities having 'ageing in place' approval which means the resident can stay at this site if they proceed to high care; in the past low care residents who 'for example' had a stroke and required high care, couldnt go back to their home and needed to be moved to a high care facility..this is not the case anyone with the agine in place concept.

Let me know how this compares to you facility in the US

[DaisyDoodle]

Originally Posted by MicStar

Hi DaisyDoodle

We are regulated for 44 Standards this regulation is monitored by the Aged Care Accreditation Agency, which is an organisation set out to monitor homes; the emphasis is on residents lifestyles, continuous quality improvement and when audited they want to see REAL results for residents. Yes the atmosphere is to make the environment home like, most facilities built these days look like modern apartments...

We have ENs (Enrolled Nurses) who are equivalent to your LPN, RNs assess, very similar roles it would seem. We prodominantly have ENs working in low level care facilities and RNs working in high level care facilities (2 sorts of facilities HIGH CARE or LOW CARE). THe site manger of a low level care facility is usually the only RN on site. But these day low level care facilities having 'ageing in place' approval which means the resident can stay at this site if they proceed to high care; in the past low care residents who 'for example' had a stroke and required high care, couldnt go back to their home and needed to be moved to a high care facility..this is not the case anyone with the agine in place concept.

Let me know how this compares to you facility in the US

It sounds like where we eventually want to be. We are regulated by state and federal agencies. The age in place concept is something that has been done in our country I would say over the last 10 years and still has not been perfected because of the regulations. We are getting better at assessing people to see if they are able to stay in their current environment or move them to a different environment with a higher skill level. For example, in the community that I work at we have independent living cottages where people live on the campus independently but have everything taken care of such as painting and lawn work, etc. Then we have assisted living where the residents need little things done such as medication reminders, laundry, help with ADL;s. There is no real clear tool until recently that our facility could use to move the people that cognitively were no longer able to stay at the assisted living. We would get resident with multiple falls that would be transferred to us with a fracture and then have to stay with us. I always questioned, why are we waiting for the fracture? There has to be a tool. Now, we use a whats called Lifesteps and it is recognized in our line of business. It tests different areas such as cognition, balance, etc. I wish we could have a true age in place where the resident could actually stay in their own place till they expired but we don't. We have facilities that usually have 3 levels of care like mine, independent, assisted, then skilled and we move people along. As you can imagine, no one wants to wind up at the skilled... because that means it's the last stop.

[MicStar]

So how is everyone going? I just attended a national australian conference for the Aged & Community Services (national peak body for non-profit aged care organisations in australia). They held this conference for 3 days starting 29/9...The best session was on the second day I felt, and that was the panel of 2 government officals and 2 stake holders discussing ACFI (our funding instrument recently released by the federal government). The ACFI has 12 questions in total that is used as an audit tool to 'rate' a resident in 3 different areas; the 12 questions are divided amounst these 3 headings 1. ADLs 2. Behaviours 3 Complex Health Care...I think there is 63 different possible funding possibilities with this funding instrument....how are you funded in the US?

Did anyone attend the conference I mentioned in Adelaide earlier this week, if so what did you like the best? Unfortunately I didnt network very much because I was with 2 other work collegues miss oppurtunity!!


cheers!!

MICSTAR

[DaisyDoodle]

Our funding is multiple. People pay privately to live in the independent living and assisted living. In the nursing home we have people who pay privately, our Medicare people are there for short term rehab and qualify for Medicare benefits which pay 100% for the first 20 days then 80% for the next 80 days then it is exhausted. These people are responsible to pay for the 20% difference. Some have private insurance that covers this difference and other don't. If they don't they pay privately for the 20%. Then the person pays 100% privately if they wish to stay after the 100 days. Average cost per month is $7,000 U.S. dollars. We also have a few beds that are public aid which is paid for 100% by the state. These residents have to had exhausted all their money, assets, etc. and can only have $1,000. We do philanthropy, a lot of fund raising for donations that comes from private people, local businesses, etc.