Bridging treatment gaps for the elderly and the disabled
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
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 2020. 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 2005. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (November 8, 2007). The DASIS Report: Older Adults in Substance Abuse Treatment: 2005. Rockville, MD
800 700 600 500 400 300 200 2009 2013 100 0 65 and older referred 65 and older in treatment 65 and older in an indicator of CD "Need" WA State
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.
Diabetes Heart Disease MH/BH disorders Obesity Dementia
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)
Common trends with RCL population Diabetes Amputations Chronic Pain Mental Illness
Institution vs Residential Functionally and Financially eligible Transitional Needs Community Integration Needs
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
Housing Personal Care Household items Social integration into the community Transportation Behavioral Health Services
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
Resources for challenging or complex cases involving individuals who are living in the community, but who are at risk of losing their placement.
Assess and evaluate for treatment Design a Therapeutic tx plan with time linked goals and objectives Direct individual treatment Training and instruction Outreach
Nursing Home caseworkers Residential caseworkers Adult Area on Aging Community Choice Guides
Building rapport Providing outreach in diverse settings Challenges as a treatment provider Addressing Treatment Gaps
Engagement and outreach services. Using motivational interviewing to create change talk Education about chemical dependency as a disease Provide various options for services
Defining Success for the HCS Client Success stories Better health outcomes Stronger support systems Longer placement stabilization Better community integration
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
Educating social workers and care givers about program De-stigmatizing treatment Increasing understanding and awareness Disease Choice Skilled Nursing Facility attitudes
Barbara Bratle 360-756-5771 Region 2 North Betsy Jansen 206-341-7801 Region 2 South Jessica Price 509-225-4435 Region 1 South Laura Smith 509-568-3822 Region 1 North Susan Kaiser 253-476-7253 Region 3 North Dawn Okrasinski 360-664-9144 Region 3 South