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Training in Long Term Care



 
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Training in Long Term Care

Training in Long Term Care
CSULB Center for Health Care Innovation


Mrs. Smith's family is in a quandary. After residing for two years in a lovely assisted living complex, Mrs. Smith, who uses a walker, has begun to wander, particularly at night. The staff recommend moving her to a skilled nursing facility. Mrs. Smith does not want to move. The family members are undecided among themselves about how much they will pay for the additional costs of a skilled care facility.


Mr. Lee, the administrator, considers all aspects of the situation. The ethical issues include those pertaining to the right of the individual to self-determinatin, the public benefit risk of allowing the person to remain and potentially cause harm to ohter by inadvertent behavior, the family dynamics, and the judgment of the staff. He also evaluates the financial issues: the cost to the facility of marketing and filling the unit, the cost to the family and Mrs. smith of the new recommended move, and delineates estate planning consequences. Mr. Lee reviews the legal issues: the liability if Mrs. Smith is documented as unsafe to others but allowed to stay, the risk to herself of falling, the implications for licensing under the state's regulations. He also takes a quality assurance perspective and considers the overall policies and procedures used by the facility in the original admission of Mrs. Smith and in orchestrating the move. In a small facility with a small staff, the administrator is the ultimate decision-maker for business and customer issues. The administrator needs a breadth of skills and the underlying conceptual knowledge. The administrator benefits from a sound education in the fundamentals of management, as well as knowledge of the special issues of long-term care. The majority of managers in long-term care settings have not had a formal education in management. The purpose of the Management Training in Long Term Care Project is to provide administrators like Mr. Lee with the concepts, facts, and confidence that enable them to make good decisions about a variety of issues on a daily basis. The Center for Health Care Innovation is developing a multi-faceted program for Management Training in Long-Term Care. Building upon the base of the CSULB Health Care Administration Program, CHCI will develop a track in long-term care in the master's degree program and a certificate available to students and professionals of all disciplines through University Extension College and Extension Services, as well as incorporate long-term care issues into undergraduate courses. The program will strive to recognize the interdisciplinary nature of long-term care by working with faculty, students, and professionals from the disciplines of health care administration, gerontology, social work, nursing, physical therapy, health education, and others as appropriate. To ensure pragmatic relevancy, practicing administrators will be involved as members of the advisory committee, focus group participants, conference presenters, and reviewers. Connie Evashwick, Sc.D., leads the project. She is Director of the CHCI and also the Archstone Foundation Endowed Chair and Professor. The Archstone Foundation awarded an initial grant in the amount of $200,000 to support the activities required for the first year of the program, which will be devoted to the program's development. These activities include market assessment, curriculum development and marketing. The first year of the program has been devoted to market assessment and curriculum development. In addition, CHCI will prepare the second edition of its 1995 textbook on long-term care, produce an instructor's guide, develop its continuum of care slide package for on-going update and dissemination, and convene conferences on topics pertinent to long-term care. The program will endeavor to achieve national recognition through work with national professional and trade associations, as well as university programs in health administration and gerontology. Moreover, the program will be receiving important input from industry leaders and administrators for the construciton of the course curriculum, continued relevance, and evaluation of the program.


   

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