VA
Extended Care
Supplement
to the
Patient Handbook
Director: Michael Sabo
July 2006
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Welcome: |
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Introduction to Extended Care Units --------------------- |
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Our Philosophy ---------------------------------------------- |
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Our Promise -------------------------------------------------- |
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Admissions ---------------------------------------------------- |
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Bed Hold Policy ---------------------------------------------- |
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Discharging Planning --------------------------------------- |
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General Information: |
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Residents Safety Smoking Policy ------------------------- |
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Use of Restraints -------------------------------------------- |
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Mail ------------------------------------------------------------- |
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Clothing & Personal Items --------------------------------- |
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Patient Funds ------------------------------------------------ |
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Unit Resident Council --------------------------------------- |
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Family/Visitors Council ------------------------------------- |
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Care Management Program ------------------------------ |
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Helpful Services: |
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Dental Services ---------------------------------------------- |
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Education Services ------------------------------------------ |
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Nutrition & Food Services ---------------------------------- |
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Medical Services --------------------------------------------- |
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Mental Health Services ------------------------------------ |
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Nursing Services -------------------------------------------- |
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Podiatry Services -------------------------------------------- |
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Recreation Therapy Services ----------------------------- |
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Rehabilitation Therapy Services -------------------------- |
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Social Work Services --------------------------------------- |
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Volunteer Services ------------------------------------------ |
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Phone Directory -------------------------------------------- |
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Welcome |
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• Our goal is to
help residents to return to their family and community as soon a possible. We
look forward to working with the residents and their families in making your
stay both pleasant and productive.
• This guide
provides general information about the Extended Care Units, treatments
available and other services available to our residents. We hope this pamphlet
answers some of your questions and helps you become acquainted with us.
• The therapy
programs for each resident are individually designed to meet each resident’s
needs. Therapies include nursing, rehabilitation, recreation and social
programs. All residents are expected to accept responsibility for
attendance at the therapies and programs designed to meet the goals set in
order to meet their potential.
Our Philosophy:
•
We believe that aging is a developmental process within the total life
experiences of all people. In this respect, each person has a purpose in life
and a potential for growth through the fulfillment of their physical, mental,
spiritual and social needs.
•
We believe in the dignity of each individual and acknowledge needs that are
unique to each life situation.
•
We believe that our purpose is to provide care with respect for the dignity,
autonomy and individuality of each person. It is our goal to maintain a therapeutic
environment that includes skilled nursing care, appropriate medical care,
recreational and spiritual opportunities.
•
We believe through comprehensive nursing care, in an atmosphere which more
closely approximates normal living conditions, that our residents can make the
transition back to home or community.
•
We believe that care should be designed to assist each resident to maintain
integrity, self-esteem and identity through the encouragement of their
self-care abilities. Supportive care will be provided in assisting the resident
to return home or to an appropriate community setting.
•
We believe that educational opportunities and programs designed to
assist personnel in
developing the necessary skills to expand their roles as therapeutic agents are
conducive to a satisfied productive staff.
•
Through an interdisciplinary approach and participation of resident and/or
significant others, we will formulate care to meet the residents physical,
emotional, social and spiritual needs. We believe that when quality of life can
no longer be sustained, the highest value be through the humanistic
support of the placed in death with dignity.
Our Promise:
The Extended Care Unit staff is dedicated to our residents, we promise to:
► Strive to maintain a high
quality of resident care.
► Provide a home-like
therapeutic environment
► Endeavor to assist residents
in regaining and maintaining their functional status.
►
Through an interdisciplinary approach, we will strive to formulate plans
to meet the physical, emotional, social and spiritual needs of our residents.
Admissions:
• When a resident is admitted to the Extended
Care Unit, he/she will be placed on the unit that is most appropriate for
meeting his/her needs. Upon admission the resident will be oriented to the unit
and staff. A staff member will complete an in-depth assessment of the
resident’s needs and strengths. The resident will be helped in adjusting to his
new surroundings and introduced to other residents and staff that will be
working with him.
• The resident and family will be
invited to attend an Interdisciplinary Team meeting to formulate and discuss a
treatment and discharge plan. If there is something you do not fully
understand, please ASK. Our staff is happy to answer your questions. It is your
treatment you should understand it.
• Each program is different in order to meet
patient specific needs. Socialization is an important part of our program. We
welcome families and visitors to our units.
• Room
assignments will be based on several factors. Residents requiring more
assistance are usually located in a room closer to the Nurses station. In the
event eligible married veteran, eligible partners or significant others are
accepted for admission, room accommodations will be provided unless there are
medical or others limitations prohibiting such placement. Certain medical conditions
may require a single room. Rooms are usually, single or double.
Bed Hold Policy:
Extended Care Units residents who are transferred
to the hospital for an acute illness will have a bed held for them in the
Extended Care Units for up to 30 days. Unfortunately we can’t always guarantee
that the available bed will be on their original unit.
Discharge Planning:
Rehabilitation is the focus of the VA Hudson
Valley Health Care System Extended Care Unit.
• The goal of the extended care units is to
assist the resident reach their highest level of independence and to return to
the community. Therefore, it is expected that the length of stay will not
exceed 90 days and may be less.
• The treatment plan is developed to meet
this goal. All involved staff working with the resident will help him/her and
the family to prepare for this discharge.
• Special equipment is ordered as needed and
any necessary medical, nursing or social work follow-ups are planned before the
resident leaves the nursing home.
• Referrals to community resources are also
arranged and scheduled before discharge.
• Resident and family teaching is done as
needed during the course of the Extended Care unit stay to assist in providing
a smooth transition to home or contract nursing home.
• The Extended Care Unit staff remains
interested in the veteran and his /her family after discharge. The staff will
continue to be a resource for the veteran and their families as needed. The
resident will return to the hospital clinics for follow-up care by a staff
physician.
General
Information:
Residents Safety Smoking Policy:
The following items are considered to
endanger residents’ safety and are against hospital policy. These items should
not be given to a resident:
1. NO Alcohol without direct
permission from the ward physician.
2. Medications only as ordered by
medical provider. Any medications brought will be sent back home.
3. Cigarettes are permitted only for
residents who can safely and independently smoke and are able to independently
go to designated smoking areas. Lighters and matches will be retained by
clinical staff and the patients’ unit. Staff will regulate cigarettes and
lighting materials for non-independent patients.
4. Pocket knives and double edged
razors are not allowed at any time.
• All residents will be evaluated by staff as
to their capabilities to carry and handle their own smoking materials.
• Smoking cessation will be encouraged.
• Confused residents will be given close
supervision while smoking.
• Our facility
is a non- smoking institution and, while smoking is not encouraged, an outside
area for Extended Care Unit residents to smoke is provided.
• Smoking is NOT permitted in any Extended
Care Unit or hospital building.
• To ensure the safety of all, each resident
will be evaluated for other safety measures that might be required.
Use of Restraints:
A physical restraint is any device applied to
a resident that interferes with some aspect of independent movement.
• It is the philosophy of the V A Hudson Valley Health Care System that in cooperation with
our residents, we will create and maintain an environment that fosters the
least restrictive environment.
• The permission of the resident or family is
requested for a non-behavioral restraint when it is determined to be necessary.
• The need for a restraint will be determined
as an alternative to ensure the safety of Extended Care Unit patients.
• Decisions for the need for non-behavioral
restraints will be reviewed at treatment team meeting.
• A physical restraint for non-behavioral
reasons requires an order by the medical provider.
• If restraint for behavior reasons is needed
the resident will be transferred to a psychiatric unit, until behavior is stable.
• Please feel free to speak to your Medical
Provider or Charge nurse if you have any questions regarding restraints usage.
Mail:
• On the Castle Point Campus there is a U.S. Post
office substation located on the hospital grounds. It is open from Monday
through Friday and Saturday, from 8:00 AM to NOON. Stamps and other supplies
can be purchased at the post office.
• On the Montrose Campus there is a mailroom that
can assist you with your needs. Mail is picked up and delivered to the Extended
Care Units once a day, Monday thru Friday. To be delivered properly, mail
should be addressed as follows:
Your Name
Extended Care Unit
VA
Att: Castle
Point or Montrose Campus
Clothing & Personal Items:
Residents in the Extended Care Unit are encouraged
to dress in their own clothes.
• Each resident is provided with a bureau and/or a locker for their personal items.
• Laundry service is provided for personal clothing
of Extended Care Unit residents for those families who are unable to launder
clothing.
• Clothing must be marked with the resident’s name
upon admission.
• All clothing needs to be given to the nursing
staff to be marked before it is placed in the residents’ locker or bureau,
including any additional clothing brought to the residents.
• Each resident needs enough clothing to allow for
the time it takes for clothes to be laundered and returned to the unit.
• Families need to discuss clothing needs with the
nursing staff on the resident’s unit.
• The following is a list of the personal items and
suggested clothing needs for our residents:
► About 10 changes of
clothing (wash and wear) and underwear. Staff may request additional amounts
for certain needs.
► Pairs of comfortable
shoes or sneakers
► Warm sweaters or
jackets – appropriate hat for season
► Toilet articles,
toothbrush, shampoo, comb, brush, aftershave/makeup, deodorant and a utility
bag for storage.
► A
few meaningful personal possessions such as pictures and cards. (These
need to be permanently marked with resident’s name. Items may also be
displayed on the bulletin boards in each room)
► Electric razors
(labeled with resident’s name)
• It is recommended that the family take valuables
such as rings or jewelry home. • When necessary I resident clothing and effects
can be stored in the clothing room located in the hospital.
• Noise from personal radios and TV on the nursing
home units can be bothersome to residents trying to rest in their rooms.
• We ask that the volume be maintained at a low
level or that earphones are used. All radios /TV’s need
to be turned off by 11:00 PM.
Patient Funds:
A patient account can be opened with the
Agent Cashier in the VA Hudson Valley HCS.
• Upon admission, a deposit of $150.00 is
requested. This covers personal needs (haircuts, outing, clothing and grooming
articles).
• A balance of $100.00 should be kept in the
account in order to provide the resident with available funds for individual
needs and activities.
• Deposits can be made by sending bank checks
or money orders made out to the director and mailed to:
Patient Funds c/o (resident’s name)
V A
Att: Castle Point or
Montrose Campus
• The
• We suggest that only a minimum amount of
money (no more than $5.00) be kept at the bedside at any one time.
• Withdrawals from your account may be made
from the Patient Funds Clerk. Ask staff for the hours and location of patient
funds at each campus.
Unit Resident Council:
This council meets regularly on the Extended
Care Units. It discusses residents concerns, social and Extended Care Unit
activities.
• Residents are encouraged to attend.
• The Social Worker or her designee is the
facilitator of the meeting. Other
• The minutes of the meeting will be posted
on each unit’s bulletin board.
Family/Visitors Council:
This council meets regularly in the Extended
Care Unit. All families are invited to attend.
• This group is facilitated by the Extended
Care Unit Social Worker.
• This council provides families with a forum
to discuss general concerns related to the Extended Care Unit and ways to
improve the residents’ quality of life.
Care Management:
Every resident will be assigned to a
treatment team.
• Under this care management system, we will
be able to provide a well-coordinated care experience for the residents and
families and ensure that satisfactory clinical resident outcomes are met.
• In addition, the treatment team will integrate, coordinate and communicate the
activities of multiple disciplines and effectively manage length of stay and
resources.
Passes/Authorized
Patients residing in the Nursing Home
/Extended Care units may request permission to leave the premises to meet
therapeutic goals. An authorized absence pass must be requested by the
patient/family two days in advance. This request can be made at the Nurse’s
Station. The patient/family is required to provide the following information:
1) where they are going, 2) the name and telephone number of a responsible
contact person, 3) date and time of departure with the date and time of return,
and 4) the therapeutic goal (reason for the pass.) If approved per policy
111-10HV, the physician will write the order and specify medications to be
taken during the pass.
Helpful
Services:
Dental Services:
We work with residents, their families, and
the treatment team to determine the dental needs of each resident.
• Together, we develop a dental health plan
tailored for each resident.
• Our dentists and hygienist also conduct a
preventative oral health program to educate residents, their families and the
nursing staff in oral hygiene and self-care practices.
• Residents receive oral examinations
including an oral cancer screening within fourteen days of admission.
• Periodic dental check ups are usually scheduled
semi annually, and emergency or urgent care is available around the clock.
• Removable dentures provided as part of
treatment are labeled in the course of treatment. Removable dentures of
confused residents may be returned to their families or held with other
personal property to prevent loss, damage or injury to residents.
• Feel free to contact unit staff, your VA
dentist or the Dental Service with any concerns related to your dental care.
Education Services:
The individuals on the treatment team responsible
for your care are very much interested in providing you with information about
your health that is useful and appropriate to you and your family.
• Your team will develop a plan of care, with input
from you and your family that guides activities for your healing,
rehabilitation and or/recovery.
• Health education is an important part of the
plan. Resident and family health education is available to you in a variety of
ways at the Castle Point and Montrose Campuses.
• You can expect information to be provided to you
from every member of your treatment team.
• One-on-one education, as well as a variety of
written materials, video- cassettes, formal classes, displays and support
groups is available to you and your family. Please help us to provide you with
essential information by taking an active role in educating yourself about your
health and wellness.
• If at any time you or your family have questions
or concerns, feel free to speak to a member of your treatment team.
Nutrition and Food Services:
Nutrition and Food Service provides residents with
three well balanced meals per day to help achieve or maintain good nutritional
status.
• Diets may be modified if necessary to meet the
resident’s individual nutritional needs.
• Diets can also be modified in consistency for
those who have difficulty chewing, swallowing or any other feeding problem
• The dietitian assigned to the unit makes an
initial visit to all residents to assess their individual nutritional needs.
• A plan is developed and implemented to assist the
residents in meeting their goals. The dietitian works closely with the
interdisciplinary treatment team.
• Nutritional education is provided to residents
and families in classes, individual sessions and through informational
pamphlets.
• Residents are encouraged to eat in the individual
dining areas on each unit.
Medical Services:
Medical Physician and Advanced Registered Nurse Practitioners
are assigned to the Extended Care Units to provide each veteran with the care
he/she needs to reach the goals set in the treatment plan and to treat any
acute or chronic illness that require care during the residents stay.
• The physician and/or the physician extenders
(Advanced Registered Nurse Practitioner) provides a yearly physical
examinations, updates the plan of care, and attends the residents’ treatment
planning conferences.
• All areas of the resident’s needs are assessed,
both physical and mental. Recommendations for consultation with other care
providers are made by the treatment team.
• A physician is available 24 hours a day for
emergencies as well as ongoing evaluations to provide optimal health care.
• The unit physician and physical extender work
closely with all other health care services offered in the medical center to
provide total care.
• Resident/family will be invited to participate in
treatment team planning.
Mental Health
Services:
A psychiatrist is a doctor who prescribes
treatments, tests and or medication for mental/emotional disorders.
• In the Extended Care Units, the
psychiatrist works as a consultant through the request of the primary care
provider and provides the mental health care both for acute and chronic
conditions.
• Psychologists are doctoral trained mental
health professionals who also are part of the treatment team.
• They see residents on the request of the
primary care provider and treatment team.
• Psychologists provide assessments through
interview and testing. Individual and group therapy, family therapy, treatment
team consultation and patient management are available if needed.
Nursing Services:
Nursing service is dedicated to providing a
therapeutic environment in which the patient is treated in a humanistic,
comprehensive and competent manner.
• All newly admitted residents receive a
complete nursing assessment by a Registered Nurse (RN). An interim plan of care
is initiated upon admission and developed during the first 21 days of care.
After this period, an interdisciplinary team meets and formulates an
individualized plan of care to address the specific needs of the resident and
their family.
• Many nursing programs are available to
assist the resident in achieving their full potential and facilitate their
return to the community. Advanced practice nurses consult with nursing staff on
issues such as skin care and pain management.
• Nursing care is provided 24 hours a day,
seven days a week by a Nurse Manager (NM), Registered Nurses (RN’s), Licensed
Practical Nurses (LPN’s) and Nursing Assistants (NA’s).
Podiatry Services:
Podiatrists are available for consultation and
treatment of all foot care needs. Appointments are arranged at the Unit level.
Pharmacy Services:
Each resident that resides in the Extended
Care Units will have their medication reviewed by a licensed Pharmacist upon
admission and then at least once a month while on the unit.
• The pharmacist and trained pharmacy
technician also review each order for medication before it is processed and
filled.
• The pharmacist is a key member of the
treatment team who participates in all meetings
concerning patient care and offers advice on medication use in order to provide
the right care for each patient.
Recreation Services:
Recreation Therapy staff is responsible for
meeting the recreational/leisure needs of all the residents.
• The recreation therapist is a member of the
interdisciplinary treatment team.
• Upon admission, the recreation therapist completes a through assessment
on each resident. The recreation therapist asses the
resident’s strengths and weakness as well as interests and abilities.
Leisure activities and the ability to pursue them are integral parts of
resident’s recovery.
• Participation in recreation therapy
programs results in a greater independence, increased self-esteem, interaction
with others and an overall sense of well being.
• Programs are scheduled at a variety of
times including weekends and evenings to enable the greatest number of
residents to participate.