Bridging treatment gaps for the elderly and the disabled

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1 Bridging treatment gaps for the elderly and the disabled

2 Issues unique to the elderly and the disabled Identifying Treatment Gaps Introduce Home and Community Services and their programs How to create partnerships with HCS and treatment services Defining Success

3 FACT: Estimates suggest that the number of substance dependent and abusing adults aged 50 or older will climb from approximately 1.7 million in 2001 to 4.4 million by This pattern of growth is echoed in admissions to substance abuse treatment, where adult admissions aged 50 or older increased from 143,900 to 184,400 (from 8 to 10 percent of all admissions) between 2001 and Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (November 8, 2007). The DASIS Report: Older Adults in Substance Abuse Treatment: Rockville, MD

4 and older referred 65 and older in treatment 65 and older in an indicator of CD "Need" WA State

5 Their mid-life drinking may become a problem as their body changes leading to full blown alcoholism Substance use can have a different effect on older people leading to more falls, fractures and car accidents Misuse presents as overdosing, under dosing, mixing contraindicated prescriptions Misuse stems from cognitive difficulties, difficulty reading the packaging and directions and the ability to accurate follow complex drug protocols.

6 Diabetes Heart Disease MH/BH disorders Obesity Dementia

7 Unfortunately, health care providers often overlook substance abuse among older adults because they don't know what to look for or they mistakenly assume that older adults cannot be successfully treated. Fredrick Blow et al (Hazelden.org)

8 Common trends with RCL population Diabetes Amputations Chronic Pain Mental Illness

9 Institution vs Residential Functionally and Financially eligible Transitional Needs Community Integration Needs

10

11 Functional Determined by the CARE assessment Must need assistance with Activities of Daily Living Coded on assistance provided during a specific look back period. Captures client s strengths and preferences Financial Looks at income, property, savings, burial, plans, cars, assets, etc. Determines if client is eligible for waiver services or just personal medical care based on income amounts and sources

12 Housing Personal Care Household items Social integration into the community Transportation Behavioral Health Services

13 Roads to Community Living Federally matched demonstration project Residential placement for complex, long term care needs Front loaded services authorized for one year from date of discharge Emphasis on client choice and community integration Wrap around services

14 Resources for challenging or complex cases involving individuals who are living in the community, but who are at risk of losing their placement.

15 Assess and evaluate for treatment Design a Therapeutic tx plan with time linked goals and objectives Direct individual treatment Training and instruction Outreach

16

17 Nursing Home caseworkers Residential caseworkers Adult Area on Aging Community Choice Guides

18 Building rapport Providing outreach in diverse settings Challenges as a treatment provider Addressing Treatment Gaps

19 Engagement and outreach services. Using motivational interviewing to create change talk Education about chemical dependency as a disease Provide various options for services

20 Defining Success for the HCS Client Success stories Better health outcomes Stronger support systems Longer placement stabilization Better community integration

21 Each client will have a different success measurement Our goal is to provide the client with an intervention that supports their care Working with variables

22 Educating social workers and care givers about program De-stigmatizing treatment Increasing understanding and awareness Disease Choice Skilled Nursing Facility attitudes

23 Barbara Bratle Region 2 North Betsy Jansen Region 2 South Jessica Price Region 1 South Laura Smith Region 1 North Susan Kaiser Region 3 North Dawn Okrasinski Region 3 South

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