Hello! My name is Matt and you can join me as I go through a Long Term Care Facility pointing out key points in an ABC format.

Hello! I'm Janice, and I will be assisting Matt with the ABC part of today's adventures!

Let's get to learning!

While on the road, let's talk about what kind of facility we are going to!

There are many different types of facilities that provide care to the elderly. Some facilities provide no medical care and is just a place for seniors to interact with other seniors and other places are like where are going to today!

The facility we are going to today specifically provides care to those who are disabled or those who cannot care for themselves

We have arrived at Hunnington Assisted Living Facility.

A is for Assisted Living Facility

An assisted living facility is a facility that provides personal care, 24 hour supervision, activities (both social and recreational) and some nursing and rehab services; however they do not perform skilled care (Singh, 2021).

B is for Beneficiary

A beneficiary just refers to someone who is covered by either a private or public health insurance plan. 

Many people that live in these care facilities are known as Beneficiaries. Assisted living facilities rely on private payments due to them not being funded by the government.

Now that we're inside let's meet with one of the employees.

Hello! My name is Macey and I work here at Hunnington as a Certified Nursing Assistant (CNA).

Hi Macey! Nice to meet you! Could you tell us a little bit about what you do?

C is for Certified Nursing Assistant (CNA)

Macy is Hunningtons CNA. Her job as a certified nursing assistant is to aide nurses around the facility. A CNA has the base required trainings that is needed in order to have this position.

Some of their tasks involve providing direct care to residents whether that be through helping them with eating, bathing or grooming.

Sure thing Matt! So my job here at the facility is to aide and provide direct care to our residents. Some care that I provide is to help feed the residents, or if a resident needs help brushing their teeth or hair, I am there to assist them. 

Oh wow! That's very interesting! Thank you for telling us about all that you do! We are going to walk around the facility more and meet with more staff! Thank you Macey!

No, thank you, Matt, for coming by! 

This is the facility's dining room. Here we will meet with the facility's dietician.  

Hello! Welcome to Hunnington! My name is Shayna and I am the facility's Dietician!

Hey Shayna! Nice to meet you, my name is Matt. What is your job here at the facility as a dietician?

D is for Dietician

Shayna has a really important job here at Hunnington. A dietician's job is to provide nutritional information and any services that relate to one's diet. 

They ensure that the food that is being made at the facility meets the nutritional requirements of each resident. An example is that if a resident is allergic to eggs, Shayna's job is to ensure that the resident is given food that they can consume. 

So my main job is to ensure that the residents are being fed healthy nutritious meals. I ensure that if a resident does have a dietary restriction that I cater to their needs. 

Oh that is very interesting! It is important to ensure that these residents are getting the proper nutrients that they need. Thank you for allowing me to meet you!

No problem! Thank you for stopping by Matt!

Here Matt will meet with the CEO of Hunnington where he will talk to us more about the facility itself.

Hello! Welcome to Hunnington! My name is Mason and I am the CEO of  Hunnington. Welcome in Matt!

Thank you for having me Mason! I'm happy to be here and excited to learn about this facility and other information that you're willing to teach us about!

Hunnington is an assisted living facility. Here we provide services to those whose needs cannot be met if in a community-based setting. Community- based long term care refers to care that is: 1. less restrictive, 2. more advanced than what family or surrogates can provide, 3. there to help relieve stress from family and caregivers and 4. to either prevent or delay institutionalization.

E is for Extramural Services

Extramural services are services provided outside the person's home and usually at facilities such as adult day cares and senior centers.

Some services that these centers provide are supervision, social activities, and counseling. 

Community- based long term care services are delivered at a community locations and can either be considered intramural services or Extramural services.

All of these facilities must abide by federal regulations. In order to keep track of those regulations, F-tags are used in order to easy identify these regulations. 

F is for F-Tag

F-Tags refer to reference numbers for different federal regulations. 

Some examples of an F-Tag is F578 which is the federal regulation that the patient has the right to accept or refuse medical treatment, along with the right to participate or not in research as well as create advance directives (Singh, 2021).

G is for Gross negligence

Unfortunately, there are some residents that do experience some form of gross negligence which refers to the conscious action of being indifferent to another person's rights, safety or welfare. 

An example of gross negligence that can occur in the healthcare field, is if a doctor operates on a patient while under the influence of drugs or alcohol, or if the doctor operates on a patient without the proper training (Weycer, 2019).

It is important to have these regulations especially one that lists the rights that our residents have because Gross negligence can occur which puts the residents at a disadvantage because of someone's inability to treat some residents humanely. We can actually meet with one of the residents that experienced gross negligence at a previous facility.

My name is Mary and I am a resident here at Hunnington! I have been here for a couple months now after transferring from a different assisted living facility. 

The negligence that I experienced at the other facility I was at is something that I wish no one has to go through. The nursing staff refused to feed us as well as give us water. We sometimes went 3 days without any food and when asked for food, they would ignore us and say that they were making it, but we never got it. It was miserable. I was taken out of that facility by a family member and was able to live with them for a while until I found Hunnington.

It's stories like Mary's that reminds me that so often that these elders get mistreated because many people thing that the cannot stand up for themselves. 

There are different types of approaches that a facility may participate in when it comes to the delivery of the health care that they provide. A facility can provide evidence based care or take the holistic approach.  

Here at Hunnington, we focus on the Holistic approach to the delivery of health care that we provide. This allows us to look into all aspects of living instead of just a residents physical and mental needs. 

H is for Holistic approach

The holistic approach is a way that health care can be delivered. This approach focuses on empathizing with what makes a person whole and complete.

There are 4 main aspects of holistic caregiving: 

1. Physical: medical exams, medications and comfortable furniture.

2. Mental: ensuring that the space around the resident relieves stress and anxiety.

3. Social: socializing with those who are within the facility whether that be that staff, family, or other residents.

4. Spiritual: Someone's personal beliefs and values and the ability to practice their religious beliefs.

I is for Instrumental activities of daily living (IADLs)

The IADLs refer to activities that a person must be able to do in order to consider independent living. Some of these activities include meal preparation, essential shopping, laundry, and light housekeeping. 

The resident being able to perform these tasks ensures that they are able to live on their own and thrive.

Now we are going to talk about what causes someone to live in an assisted living facility rather than other facilities such as a nursing facility. Many of our residents cannot perform activities that are necessary for independent living. These are referred to as Instrumental activities of daily living (IADLs).

IADLs are important because they can give someone the sense of autonomy and that they are in charge of their own lives, but another thing that is important with our residents is Justice.

J is for Justice

Everyone needs to have a fair shot at being able to live on their own, and using IADLs as a scale, we are able to determine if it is safe for a resident to be by themselves. It is important to know that not everyone is capable of being able to live on their own, but having a standard that determines if someone is able to ensures justice for everyone

K is for Kidney failure

The reason that I chose to choose kidney failure to focus on for K is because it determines if someone is eligible for Medicare but it is also because it is common in the elderly community. The National Kidney Foundation 2020, tells us that Johns Hopkins University found that about 50% of those over the age of 75 have kidney disease and that kidney disease was commonly found in those over the age of 60.

Moving on, let's talk about Nursing homes. Nursing home are a long term care facility where someone can also get care. Nursing homes accept those with Medicare and Medicaid, which I can talk about later. If someone is dealing with end-stage renal disease or Kidney failure, they are eligible for Medicare. I can discuss other eligibilities. 

Now Mason, you keep mentioning long term care, but I don't think we every really defined it. Can you define it for us?

Sure thing Matt! Long term care can be defined as care services that are provided over time to those in order for them to live the most independent lives that they can.

L is for Long-term care

Long term care is something that references the care that is provided to those in order to promote their independent life style. These services are not provided all at one, but rather other a period of time and utilizes providing the best quality of care and bettering the individual's quality of life. We can look into what quality of life means later on. 

M is for Medicare and Medicaid

Medicare and Medicaid are the two most popular health insurances that people can have. Each one has their own requirements in order for someone to be eligible for the program, but I'll leave that job up to Mason to describe what those requirements are. 

It was estimated that in 2020, about 18.4% of those living in the US were covered by Medicare (Yang, 2022) and that in 2020, about 17.8% of those living in the US were covered by Medicaid (Yang, 2022). 

Hey Mason, I remember you saying that we were going to go back and talk about Medicare and Medicaid. Shall we do that now?

Yes sir! Let's get right to that! Medicare and Medicaid are two insurance plans that people can apply for. Each one has specific requirements in order to apply so we can go through those now.

Mason, thank you for all the information that you have provided to us thus far. Let's take a break and I'm going to wander around the facility and talk to other staff members that are here!

Will do! I'll be here after our break and talk to you more about long term care!

Let's see what other people we can run into here at this facility!

While walking through the facility, Matt meets Lynn. 

I'd love to! Hello! My name is Lynn and I am a Nurse practitioner here at Hunnington and basically my job here is to provide similar services that a physican would provide. 

Hi Lynn! Would you tell us what your job here at Hunnington is?

N is for Nurse practitioner

A nurse practitioner's role is similar to one as a primary care physician where they are able to assess a patient's needs, order lab tests, diagnose and prescribe treatments. 

Nurse practitioners are essentially more advanced in practices than registered nurses.

Wow! You play a vital role here at Hunnington! Thank you for your time Lynn!

My role is just as vital as Macey and Shayna's roles! Have a great day Matt!

Hmmmm... Let's see if we can find anyone else here!

Matt found his way into the Occupational & Physical Therapy room.

Hm. The occupational therapy room. This room is quite interesting. But, hello! How are you?

This room is where I help residents develop, recover or maintain their ability to do certain occupations. I'm Geana by the way and I am the occupational therapist here at Hunnington!

O is for Occupational therapy

Some residents may need occupational therapist which can help with, as Geana said, help residents develop, recover or maintain their ability to do certain occupations.

Occupational therapy can help some of our residents be able to feed themselves or bathe and get dressed on their own. 

P is for Physical therapy/ therapist

Physical therapy is important when it comes to helping those who have been injured. It mainly focuses on improvement of movement and treatments for those who may have experienced a stroke or traumatic brain injuries.