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Do I Need "Nursing Home" Care?

If an individual needs 24-hour care and supervision, a skilled nursing facility is probably the best answer. However, when a less intensive and less restrictive form of care will suffice, a mix of services and/or programs may be appropriate (such as an adult home or assisted living program).

When you are considering skilled nursing facility placement and the individual is currently at home, in order to be referred to a skilled nursing facility in New York State, an evaluation must be completed by a certified home care agency. This assessment is called a PRI (Resident Review Instrument). After the agency completes this evaluation it is your decision where you would like it to be sent for consideration for placement. When the facility receives the PRI, that gives them an idea of what medical problems the individual in question has and what level of care is needed. This allows them to determine whether or not they will be able to meet the individual's needs. When a resident is in the hospital awaiting placement, the hospital discharge planning department requests that the PRI be done and then the hospital would have it sent out to the facilities you would like to consider for placement.

For more information about our
skilled nursing care, call us at (315) 474-1561.

What is Post Surgery Rehabilitation?

Whatever the operation you have or are about to have, recovery can be maximized by quality post surgery rehabilitation. Many patients do not go straight home after surgery, but will instead go for post surgery inpatient rehabilitation, either in an acute setting if they have the stamina to participate in rehab daily, or in a sub-acute setting, typically a nursing facility that segregates their short-term patient units from long-term care units, if physical or occupational therapy is needed. Acute stays are typically between 2-3 weeks while a sub-acute stay could be for up to 100 days.

Contact James Square Health and Rehabilitation Centre at (315) 474-1561 to ask about Agility, our short term rehabilitation program.

How do I assess my aging parent's health and safety?

It is difficult, at times, even uncomfortable to bring up the conversation about safety and health concerns with an aging parent. Its important to be mindful of patterns of change. Notice when he is having more problem days because of health issues. Notice when and if he becomes more forgetful of common things or begins to place items in strange places; for example, car keys in the refrigerator. Take time to really look at your aging parent regularly. Take note of any weigh loss or gain, any signs of depression, any marked fatigue or acute changes in appetite and sleep patterns. These are important warnings that signal your parent's needs.

Areas that should be carefully looked at include:

• Medication Management
• Personal Hygiene
• Home Safety
• Meal Preparation
• Transportation
• Home Maintenance and repair

If you have questions or concerns about someone you love's health and safety call and speak to one of our care professionals at (315) 474-1561.

What Are Some Of The Alternatives?

Home Health Care: covers a broad range of services that are brought to a person in their home, including: part-time skilled nursing care, occupational therapy, physical therapy speech therapy and nutritional counseling.

Home Health Aide Services: are provided under the supervision of a professional therapist who assesses the residents needs and plans the service to be provided including assistance with bathing, dressing and meals.
Home Delivered Meals: provide nutritious meals delivered to the persons home, if they are unable to prepare their own meals.

Congregate (Group) Dining: is where a nutritious noon meal is served to older persons at sites like senior centers and schools.

Adult Day Health Care: means an organized day program of therapeutic, social and health related activities.

Telephone Reassurance Programs: provide a daily contact for persons who live alone and are anxious about their safety or security, or have chronic health problems.

Hospice: is a service by a facility or home that provides supportive care for terminally ill residents approved by their family physician.

How Will I Pay For Skilled Nursing Facility Care?

Many people are surprised to learn that their health insurance does not cover all skilled nursing facility related expenses. It is important to inquire about specific coverage with your insurance provider, since coverage varies from plan to plan.

Long term health care insurance is also growing in popularity. Some of the plans do not cover custodial care (specialized treatment for Alzheimer residents, for instance) and like other health insurance plans, it's important to have the policy explained to you very carefully.

There are also misconceptions about Medicare coverage. Please ask an admissions representative at James Square for more detailed information on Medicare and Medicaid coverage. Included below is a short definition of both.

Medicare is a federal health insurance program for persons 65 years old and older, as well as people with permanent disabilities who have met specific criteria. There are very specific guidelines for coverage in a long term care facility, as well as time limitations for the coverage (no more than 100 days).

Medicaid on the other hand is a state program implemented by each county. It does receive federal funding. Medicaid has many facets, but for long term care it pays for the necessary care that an individual may require in a long term care facility. This is available to individuals who have met specific financial criteria and is utilized when all other insurances and private funds have been exhausted.

How Does A Skilled Nursing Facility Differ From A Hospital?

First and foremost, a quality skilled nursing facility emphasizes the "home" environment. At James Square, we encourage visitors, and that means kids and pets, to come see their family and friends who live at James Square. We let them know that this is the resident's home.

Visiting hours are very flexible, from 10:30 am to 8:30 pm. And, yes, we encourage you to take residents out to do the things they've always loved to do, whether it's shopping, visiting friends or just spending time with someone special.

What About Rehabilitation And Other Specialized Services?

At James Square, we provide the assessment and therapy programs that help a resident enjoy a more functional life by living it more independently and/or with less pain. A quality skilled nursing facility provides full onsite rehabilitation therapies and special services. Our scope of services include, but is not limited to:
• Physical Therapy
• Speech Therapy
• Occupational Therapy
• Pulmonary Program

Is Family Support Available?

Making the decision to have a loved one live in a skilled nursing facility can be difficult to cope with for many people. Many needlessly experience guilt and fear. Our social services staff works with the entire family to offer guidance and counseling during what can be an emotionally trying time.

Once families get to feel comfortable with a quality skilled nursing facility, they discover that the old image of skilled nursing facilities no longer applies. Then they come to realize that they have made the right decision to have their loved one cared for in a setting that best suits their needs.

What Other Services Should We Look For In A Skilled Nursing Facility?

You should look for specific qualities that will add to your loved one's quality of life, such as these features we provide at James Square:
• 24-hour Skilled Nursing Care
• Recreation Department
• Staff Physicians on site, or on call
• Nurse Practitioners on site
• Full Range of Medical Specialists available
• Dental Services
• Community Rooms
• Personalized Nutrition
• 24-Hour Security

Preparing For The Residents Admission.

The director of admissions, or the social services director, can advise and take an active part in the residents transition into the skilled nursing facility.

To ease the transition, we encourage you to be with the resident on admission day and stay with them a few hours to help them get settled in.

After the first day, we encourage you to visit the facility as often as you can. Seeing friends and relatives can be a great boost to the residents morale.

Where To Turn For Information And General Services

• AARP (American Association of Retired People) 422-6673
• ACCORD (Action Coalition to Create Opportunities for Retirement with Dignity) 455-8634
• Alliance (Elderly Abuse) 424-1880
• Alzheimers Association 472-4201
• Catholic Charities Services 424-1800
• Elderly Support Services 424-1812
• Foster Grandparent Program 473-5017
• Gerontology Center at Syracuse University 443-5587
• Jewish Family Services 445-0820
• Meals on Wheels 478-5948
• Medicare Information (Social Security Administration) 1-(800) 772-1213
• Metropolitan Commission on Aging 425-2362
• Onondaga County Medicaid 435-2928
• RSVP (Retired Senior Volunteer Program) 474-7011
• Volunteer Center, Inc. 474-7011

Information On Home, Health And Social Care
• EISEP (Expanded In-home Services for the Elderly) 435-2362
• Home Aids of CNY, Inc. 476-4295
• Hospice 634-1100
• Onondaga County Cooperative Extension 424-9485
• Onondaga County Department of Long Term Care 435-5600
• Respire Care Program 476-4295
• St. Joseph's Home Care 458-2800
• V.I.P. Companion Care 422-4222
• Visiting Nurses of CNY 476-3101

Medical Services:
• American Lung Association of CNY 422-6142
• Aurora of Central New York 422-7263
• Better Breathing Program, St. Josephs Hospital 458-5111
• Caring Coalition 476-5552
• Community Information & Referral Service Helpline 474-7011
• Mental Health Association of Onondaga County 445-5606
• NYS Commission for the Visually Handicapped 428-4147
• Onondaga Arthritis Action Committee 451-1050 & 422-8174
• Onondaga County Department of Health 425-3355
• Telephone Life Line 458-2800

Housing Information:
• Christopher Community, Inc. 424-1821
• Housing Service for the Aging 422-3883
• Independent Living Services 452-5800
• Services to the Elderly or Handicapped Tenants in Public Housing 475-6181

Wheelchair Services:
• ABLE Medical Transport 472-3393
• Call-A-Bus 424-1212
• Suburban 437-0058
• TLC Wheelchair Service 422-0211
• Watson Wheelchair Service 668-2654

Other Resources:
• Catholic Charities 455-7096
• Elderly Support Services 424-1810
• Ida Benderson Senior Center 473-4434

A checklist of important points to consider in selecting a skilled nursing facility:

• Are they certified to participate in Medicare and Medicaid programs?

• Do they have a State license or letter of approval from a licensing agency?

• If the resident requires specialized services are they provided? (Physical Therapy, Occupational Therapy, Speech Therapy, Respiratory Therapy...)

• Is the general atmosphere warm, pleasant and cheerful?

• Do the residents look well cared for and content?

• Are the staff members cheerful, courteous and enthusiastic?

• Are the residents up and dressed every morning?

• Are the residents allowed to decorate their rooms,
pick out their own clothes and keep a few prized possessions on hand?

• Is there a place for private visits?

• Do the residents, visitors and volunteers speak favorably about the facility?

• Are there copies of the residents rights, recent Dept. of Health State Survey, Hotline numbers and ombudsman,
posted in accessible areas for everyone to see?

General Conditions
• Do they admit and provide services without regard to race, color, creed, sex, national origin or source of payment?

• Is the facility clean and orderly?

• Is the facility reasonably free of unpleasant odors?

• Is the facility well lighted?

• Are the rooms well ventilated and kept at a comfortable temperature?

Safety Considerations
• Are there smoke detectors, a sprinkler system and emergency lighting in every room?

• Are there portable fire extinguishers?

• Are the exits clearly marked and illuminated?

• Is there a maintenance staff available to provide immediate service?

Medical Services
• Is dental care available for residents?

• In case of medical emergencies is a physician available at all times, either on staff or on call?

• Is emergency transportation readily available?

• Does a qualified pharmacist maintain and monitor a record of each residents drug therapy?

Living Quarters
• Does each room open onto a hallway?

• Does each room have a window to the outside?

• Does each resident have a reading light, comfortable chair and a closet and drawers for personal items?

• Is there a curtain or screen around each bed for privacy?

• Do the bathing and toilet facilities have adequate privacy?

• Is there a resident lounge where they can relax, play games, read and watch TV?

• Does the facility have an outdoor area for the residents where they can get fresh air and sunshine?

• Are there beauty and barber facilities?

Financial Matters
• Are the costs, including extra charges, comparable with other facilities?

• Are prepaid unused days refunded?

• Are visiting hours convenient?

• Have you read the contract completely?

Nursing Services
• Is there at least one registered nurse on duty at all times?

• Is an RN on duty during the day, seven days a week?

• Are there emergency call buttons at each residents bed?

• Are trained geriatric technicians and certified nurses aides caring for the residents?

Nutritional Services
• Is the kitchen clean?

• Ask to see the meal schedule. Are at least three meals served each day?

• Are nutritious snacks available?

• Are guest trays available?

• Are the residents given enough food?

• Is the food appetizing?

• Does the meal served match the menu?

• Are the residents and family asked about special diet likes and needs?
• Is the dining room attractive and comfortable?

• Do residents who need assistance eating receive it?


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