As we age, our healthcare needs become more diverse and complex. A well-structured continuum of care provides a range of services that can be tailored to meet the specific needs of each individual and ensures that older adults receive comprehensive and personalized support throughout their aging journey. Organizations that take a population health approach allow seniors to transition between different levels of care based on their changing needs ensure they receive the support and assistance they require as they age. With a continuum of care, there is better coordination among different healthcare providers, caregivers, and support services. When all aspects of an elderly person’s health and well-being are considered, the result is a more comprehensive and effective care plan, better health outcomes, emotional well-being, and an improved overall quality of life.
National Health Care Associates (National) operates under a population health approach so that guests at our affiliate centers receive appropriate care based on their health conditions, preferences, and limitations. The aging process often involves transitions between different levels of care, and when organizations offer their patients and residents direct access to a continuum of care, these transitions can be managed more seamlessly, reducing stress and disruption for the elderly person and their family.
Many elderly individuals value their independence and prefer to age in place or with minimal assistance. A continuum of care can offer various levels of support, allowing them to maintain their dignity and autonomy while getting the help they need when necessary. Regular monitoring and preventive healthcare measures are crucial for older adults to identify and manage health issues early on. Access to a continuum facilitates regular check-ups, screenings, and access to medical professionals who can help prevent or manage chronic conditions effectively. However, sometimes, aging can lead to feelings of isolation and loneliness. When individuals can gain access to social activities, support groups, and companionship, they can maintain an active and engaged lifestyle. Aging also brings an increased risk related to falls, cognitive decline, and other health-related emergencies. With a well-implemented continuum of care, there are staff and resources available to ensure the safety and security of older adults, whether they are living independently or in a care facility, addressing health issues early and preventing hospitalizations or unnecessary interventions.
Typically, when considering what aging adults might need along their healthcare journey, the following services are considered critical to the continuum of health:
Independent Living: Independent living communities or retirement communities offer older adults the opportunity to live in private residences while having access to social activities, communal dining, and various amenities. These communities are suitable for seniors who can live independently but want a more supportive and socially engaging environment.
Home Care: Home care services provide assistance to older adults who wish to age in place but need help with daily tasks such as meal preparation, medication management, housekeeping, personal care, and transportation.
Assisted Living/Residential Living: Assisted or residential living facilities offer a higher level of care than independent living communities. They provide 24-hour supervision and assistance with daily living activities, but residents still maintain a level of independence in their private apartments or rooms.
Memory Care: Memory care facilities are designed to cater specifically to individuals with Alzheimer’s disease, dementia, or other memory-related conditions. They offer specialized care and safety measures to support residents with memory loss.
Skilled Nursing Facilities: Skilled nursing facilities (nursing homes) provide round-the-clock medical care and support for older adults who require more intensive medical attention or rehabilitation services. These facilities are suitable for seniors with complex medical needs or those recovering from surgery or illness.
Home Health Care: Home health care services deliver medical assistance and skilled nursing care to older adults in their own homes. This can include wound care, medication management, physical therapy, and other medical services.
Hospice Care: Hospice care focuses on providing comfort and support to terminally ill individuals during their final stages of life. It can be offered in various settings, including the home, assisted living facilities, or specialized hospice centers.
Respite Care: Respite care provides temporary relief to family caregivers by offering short-term care for their elderly loved ones. This service can be useful when the primary caregiver needs a break or has other obligations.
Adult Day Care: Adult day care centers offer a safe and supervised environment for older adults during the day while their family caregivers are at work or need time for other responsibilities. These centers often provide social activities, meals, and some healthcare services.
Care Management: Care management services involve professionals who assess an older person’s needs, develop a personalized care plan, coordinate services, and advocate on behalf of the individual to ensure they receive appropriate care and support.
Each of National’s 33 affiliate centers are the gateway to an extensive continuum of care that the aging population can gain access to once they admit for a short- or long-term stay. Beyond assisted and residential care program, traditional short-term rehabilitation programs and respite stays, each National center offers advanced clinical capabilities and specialities allowing them to manage the most fragile and complex of patients. Through the organization, there are units specifically designed to manage those with acquired brain injuries, to complex trachs and even to those requiring ventilators, in addition to specialized secure memory care living units.
To coordinate discharge back home, National employs a team of Clinical Integration Nurses (CIS’s) who transition patients back to the community via telehealth discharge visits with a Passport to Home Nurse Practitioner, ensuring all equipment, home care services and medication is in place, and coordinating with the patients primary care physician for a seamless care coordination. Additionally, the CIS’s can tap into National’s extensive continuum of care organizations which includes Constellation Home Health and Hospice, Preferred Therapy Solutions, Impact Health PC, Procare LTC, NOA Diagnostics to develop the most appropriate care plan for guests to thrive once home, reducing rehospitalizations and increasing overall satisfaction with their post-acute healthcare journey.
National makes it easy by offering a 24/7 CARE line, allowing for direct admission from home or even the emergency department. For more information, you can call 877-CARE-247 or visit us online at https://nhca.com/about-passport to learn more about our approach.
Column was originally written by Christina Fleming, chief marketing officer at National. Christina welcomes the opportunity to be a resource on services for older adults and is often featured in online publications.
