为长期护理机构中的老年人争取权益 - 修订版.pdf

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1、Advocating for Older Adults in PALTCSusan Elliott DNP,APRN,FNP-CSLU Department of Internal Medicine,Division of Geriatric MedicineSusan.j.Elliott.1health.slu.eduDisclosure StatementThis project is supported by the Health Resources and Services Administration(HRSA)of the U.S.Department of Health and

2、Human Services(HHS)under grant number Award U1Q53678 Geriatrics Workforce Enhancement Program for$1,000,000.This information or content and conclusions are those of the author and should not be construed as the official position or policy of,nor should any endorsements be inferred by HRSA,HHS,or the

3、 U.S.Government.Demo Form1.Understand ombudsmen as a resource2.Understand interdisciplinary screening options to differentiate the 3Ds of mentation3.Review Key evidence:APA(2019)CPG for the Treatment of Depression Across Three Age Cohorts,APA(2013)DSM-5,CMS(2024)State Operations Manual:Appendix PP G

4、uidance to Surveyors for Long Term Care Facilities 4.Learn about Project ACT-ON5.Use the ADVOCATE checklist and understanding of the CMS regulations in nursing homes to ask for appropriate interventionsThe 4Ms of an Age-Friendly Health System(IHI,2022)What Matters:Patient perspectiveMedications:Rele

5、vant,optimize other Ms,polypharmacy and PIM reductionMentation:3Ds(dementia,delirium,depression)Mobility:functional capability,ADLs,doing What Matters4MsThe 4Ms is not something extra,but instead a model of care which should guide all care in the care plan to ensure Goals of Care of older adults are

6、 met(IHI,2022)Requires 2 consistent actions(see IHI Figure 2)Assessing for the 4Ms all of them,which together inform care needsActing on the 4Ms in a way that fulfills What Matters and optimizes health and function4MsNationally,Ombudsmen(NLTCO,2023)Assisted residents,families and advocates more than