Home-based care services for Alzheimer's disease and elderly disabilities in Anchorage

Population Groups Served

This services target persons in Anchorage Municipality who are home based and suffer from Alzheimer's Disease and Related Disorders as well as individuals above 60 years of age who suffer from physical or cognitive disability. The services target mainly those who are at risk of institutional placement giving highest priority to those with the greatest socioeconomic need especially low-income minority.

Seventy percent of the clients covered by this program are persons with Alzheimer's Disease and Related Disorders at various locations in Anchorage Municipality. Their ages vary between 60 to 90 years. These individuals receive round the clock care giving; the caregivers help them live comfortably with their medical conditions. This makes in home service acceptable since all the support they already have is solidified and they can still reside in their homes while enjoying the provided benefits with increased satisfaction.

Thirty percent of the clients are individual over 60 years with varying cognitive and physical disabilities. Sixty five percent of these people have mobility problems and cannot perform basic daily activities such as bathing or dressing (ADLs), they receive round the clock care. The other thirty-five percent receive respite care as they live with family who provide necessary care to them. This service enables them perform most activities like laundry, bathing and cleaning their environment. Caregivers reduce their need for institutional placement by performing these activities.

Over all, the clients covered here are in the low-income category and meet the income and level of care eligibility to receive services under the HCB Medicaid waiver program. Fifty percent of them are minorities of native Indian origin.

Goals and Objectives

The main goal of this program is provision of home care services in homes that enable individuals and their families achieve their goal, which is to remain living in their community of choice. With the help of experienced caregivers and staff, provision of high quality service is a priority in helping clients achieves their goals.

The objectives include:

To establish and maintain an exemplary state of health and freedom for the people we serve.

To provide skilled nursing and personal care services to our clients.

To make up for or restore patients basic functional activities like bathing or walking

Description of Programs

The following are description of activities and procedures of the services provided in the program.

Case Management

Case Management includes 3 main functions that ensure the program runs appropriately.

The first is the administrative function. The main activities here include:

Case Manager ensuring strict adherence to proper policies, procedures and regulations in provision of care to home-based seniors.

Ensuring standardized training of care workers in providence of care to the elderly.

To undertake monitoring and evaluation of home care workers.

Case manager recommends required changes and improvements to the program.

He or she schedules work assignments based on home care worker's competence and experience as well as discussing any concerns with the supervisor.

The second function is coordination of case management and the main activities here include;

Set up an up-to-date, accurate and confidential reporting system for the client.

Ensuring that provision of care as required and client needs are identified and met in consultation with family members and other support.

The third function is Provision of individualized care following medical instructions as needed and consistently. The activities are as follows;

Provision of home-based care that includes general housekeeping, clients' hygiene and meals.

Help the client with workouts and physiotherapy

Check blood pressure and client's physical conditions as needed

Schedule time and resources concerning client's individual needs

Manage any uncertainties or unstable occurrences

Chore Services

Chore services assist the elderly persons living at home with one or more of the following essential activities of daily living: housework, personal care, yard work or sidewalk maintenance. The activities include;

Housework

Cleaning the floor, this might involve scrubbing and polishing

Washing windows

Some minor repair on furniture and appliances

Laundry work

Personal care

Assisting in shopping for groceries, preparation of meals and assisting in eating during meals

Assisting the client in bathing and dressing

Assisting the client in and out of bed as well as walking

Assisting in management of medication as well as toiletry transfer

Yard work

Maintenance of the yard

Limited painting

Shoveling snow and ice

Lawn mowing

Respite Care Services

This support services include social interaction, monitoring and administering of medications, housework, and personal care. This can be short or extended over many weeks or months.

The client gets companionship.

The caregiver spends quality time with the client that can include reading books, letters and shopping.

Caregiver performs housekeeping work such as cleaning the house, the client's cloths, makes the bed.

Meal preparation

Personal care that includes bathing and dressing the client as well as assisting in and out of bed.

They provide nursing care, which include a nursing plan reducing trips to the hospital.

Transportation

Administrative Structure

One full-time Director

Two full time Certified Case Managers (CCM)-Registered Nurses

One full time Chore Manager

One full time Administrative and Finance Manager

Six full time caregivers-Licensed Practical Nurses (LPNs)

Three part time volunteers caregivers

Three part time housekeeping and two maintenance

One full time budget and supply manager

One full time personnel manager

Program Structure

Director serves as the top-level manger and technical expert. The Director is responsible for;

Overall management of the project

Public relations

Fundraising

Chief administrator

Applies functional knowledge in project management

Gives guidance to staff

Care Managers are responsible for daily operations of residential care homes. They manage activities in the within the clients home to ensure quality of the care provided meets the National Minimum Standards. Care Managers report to the Director. There are two Care Managers in charge and oversee operations in the Care giving and Chore services sections.

Caregivers assist with various duties that could include meal preparation, cleanup, make beds, change linen, light housekeeping, bathing, dressing as well as vacuuming, running errands laundry and ironing. They work closely with qualified volunteers.

Administrative and Finance Manager has the Primary responsibility of;

Finalizing the monthly payroll, W-2, 1099 and all other tax documents.

Does checks and fills vouchers.

Manages petty cash,

Records mileage and other financial functions.

Assisted by Budget and Supply Manager as well as Personnel Manager

Chores Manager, manage cleaning, repair and maintenance needed to protect the health and safety of the clients. There are two assistants handling housekeeping and maintenance work.

$1,900 will be paid from the Primary Grant award

A. The Director will attend the annual Regional Conference hosted by DHSS. Air travel will cost $350, meals will cost $120 and $180 for hotel charges for two nights.

B. The two Case Managers will also attend the annual Regional Conference hosted by DHSS. Air travel for the two will cost $700 meals and hotel charges will cost $600.

Facility Expense

A. Facility Rental- Rental of office space will be a one year lease of $10,000 including heat, lights, water and sewer.

B. Communication- Local and international service as well as internet will cost $800 paid from the Primary Grant.

C. The Primary Grant will pay for renovations and repairs done on the premises costing an estimated $5,000.

D. Maintenance- Maintenance of the premises that include lawn mowing, snow shoveling, and other landscaping activities will cost $2,200 from the Primary Grant.

Supply

Will cost $3,000 paid from the Primary Grant.

A. General office supply- $1,000

B. Program Supplies- Stationary for brochures and surveys- $2,000

Equipment

A. Laptop Computers- Three laptop computers costing a total of $4,500 will be covered by the Primary Grant.

B. Office Chairs And Desk- One office chair and one desk costing $1,500 will be charged from the Primary Grant

C. Printers and Photocopiers- One printer and a photocopier machine costing $1,550 will be charged from the Primary Grant.

D. Appliances- The office will also acquire appliances totaling $1,000 from the Primary Grant.

Other Costs

A. Auditing- There will be an audit conducted on the financial documents that will cost $2,000 but and $500 will be paid for by the Primary Grant.

B. Advertisements- There will be a newspaper advertisement as an awareness campaign costing $500 from the Primary Grant.

C. Journals subscriptions- Subscription of relevant health journals will cost $400 paid by the Primary Grant

D. Insurance of office equipment will cost $2,000 paid by the Primary Grant.

Appendix i

The Programs Intended Effect

1. The program is intended to support individuals suffering from Alzheimer's Disease and Related Disorder Maintain their independence. In addition, the program is intended to provide home care services in homes so that individuals and their families can achieve their goal, which is to remain living in their community of choice.

2. The programs expectation

The program meets expectation. Service delivery is timely and progressing as expected based on Planned Service and Expenditure.

3. Programs Benefit to Clients

A 86-year-old woman living in Spenard and suffering from Alzheimer's and Chronic Obstructive Pulmonary Disease, was living alone. Due to her illnesses, she cannot be left unattended. Therefore, she gets a 24-hour live-in care service. Now she is able to retain familiarity and routine throughout her day. The program has enabled her to regain some independence living in her own home, and providing her some security as well. She enjoys the quality of life and feels more confident because of her improved hygiene and appearance.

4. Clients Input on Service

To collect and respond to clients' feedback, the clients and their family members are provided with self-administered questionnaires. The caregivers give these to them at the end of every week. They are provided with stamped return envelops for return of the questionnaire by mail.

Eighty five percent of the respondents were happy with the services. Ten percent were neither happy nor unhappy.

The results of this study are instrumental in determining the quality of service provided to the client. These survey assist in improving the services, provision of high quality service is the priority in helping clients attains their goals.

5. The program does not have a wait list for services for any reason.

6. There is has not been any staff training.