Case Management If you are admitted to Reston Hospital Center, you will be assessed by the nursing staff for your ability to care for yourself at the time of admission and following the hospital stay. If you require additional healthcare services after time at the hospital, such as home care or skilled nursing, you will receive assistance with these arrangements from a nurse or social worker in the Case Management Department. Based on your agreement with your insurance carrier, a Case Management nurse will provide clinical information concerning the medical necessity of your admission and continued state to your particular insurance company. In turn your insurance carrier will approve or deny your hospital stay. The Case Management Department will work together with the rest of the clinical staff to provide you with a beneficial hospital stay. Our Case Management Department will provide phone numbers for private duty nursing and agencies for patients who need this type of care. It is the responsibility of the patient’s family and/or significant other to make all necessary arrangements, including payments.
A Growing Number of Options Nowadays, independent living communities, assisted living facilities, nursing homes, and the like are catering to more and more people with a variety of care needs. Home Care (see p. 32) Advance Directives Home care provides a limited amount of assistance with routine activities (such as shopping, meal preparation and getting to medical appointments) to individuals who desire and are able to live independently in their own homes, and who do not require constant medical care.
Many people today are worried about the medical care they would receive if they should become terminally ill and unable to communicate their wishes. That’s why a growing number of people are taking an active role in their care before they become seriously ill. They are stating their health care preferences in writing, while they are still healthy and able to make such decisions, through legal documents called advance directives. Before deciding what choices about your care at the end of life are best, you should talk over the issues involved with your family and your physician. You can learn more about these documents at caringinfo.org.
Independent Living and Assisted Living (see p. 18)
Often termed “congregate care,” there is a broad spectrum of independent and assisted living care options available to seniors with varying needs. “Independent living” facilities are specifically designed to accommodate social and recreational activities within a community of seniors.
Money Matters
“Assisted living” or “residential care” tends to combine independent living facilities with shared services such as dining, laundry and housekeeping— and in some cases, medication management and other personal services. They also include some shared living spaces and provide access to social and recreational activities and transportation. Unlike nursing homes, assisted living communities do not provide extensive medical care.
Nursing home care can come at a significant cost. Medicare pays for some nursing home care costs, but generally only for an initial period—not over the long-term as most people need. AARP recommends that seniors buy special insurance to help finance their long-term care, and most financial planners recommend saving for long-term care as part of retirement planning.
Intermediate Care and Nursing Homes (see p. 27)
Prescription Discounts
Intermediate care facilities provide additional assistance with daily activities beyond what assisted living provides, such as help with bathing and eating. “Board and care” homes are subsidized group living arrangements that provide help with daily activities to low-income seniors who do not require the level of care of a nursing home. Nursing homes go a step further by providing true nursing care at a full-time level once only available through hospitals. Unlike at hospitals, however, residents of nursing homes are still free to come and go as they please.
Hospice (see p. 39)
The mission of hospice care is to provide supportive, as opposed to curative, care to terminally ill patients in order to make them as comfortable as possible. It is specifically funded for those whose life expectancies are six months or less. As such, hospice combines care at medical facilities with varying degrees of home care in order to provide around-the-clock assistance and/or monitoring.
How to Weigh Your Options
Your primary consideration in selecting long-term care should be the type and level of care you need. Many facilities specialize in caring for specific health conditions, such as heart problems or dementia. You also need to consider your budget, any existing coverage you have, proximity to family and friends, and overall daily environment. Because there are so many options in a given area, it helps to collect information on several facilities and compare them. Also, be sure to visit every facility you are seriously considering in person. To help you get started, Medicare offers a comprehensive listing of U.S. nursing homes by state.
Finding discounted prescriptions may be easier now that prescriptions are considered an “essential health benefit” under the Affordable Care Act– meaning that your insurance must cover them. However, there are more ways to save. • Prescription Drug Coupons - Ask your pharmacist about pharmacy discount cards that can save you another 10 to 25 percent.
Prescription Discount Websites: virginiadrugcard.com • pparx.org rxassist.org • needymeds.org patientadvocate.org • Generics - Choosing generic drugs can be another way to cut the cost of medications. • Patient Assistance Programs - Pharmaceutical companies and nonprofit organizations offer grants and discounts to patients in financial need.
Other Practicalities Besides financial considerations, there are other important concerns. Is the nursing home in question close to friends and family who will visit often? How are certain amenities, such as pharmaceutical services, handled there? It’s also important to ask which hospitals a facility has contractual relationships with, should residents require hospitalization. See more at: www.restonhospital.com Reston Hospital Center • Resource Guide • restonhospital.com •
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