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Problems and Solutions Worksheet for Health and Wellness Work Group, Study notes of Nursing

A worksheet for the Health and Wellness Work Group to identify potential solutions to problems related to EMS services for older adults and healthy lifestyles and prevention. The worksheet includes a list of potential solutions for each problem, as well as suggestions for expanding or improving programs and services, addressing barriers and facilitators, and making potential solutions more detailed or specific.

Typology: Study notes

2021/2022

Uploaded on 05/11/2023

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Problems and Solutions Worksheet – Health and Wellness Work Group
To make your potential solutions more concrete and feasible, please think about:
1) What programs and services you would like to see expanded or improved
2) Programs or service that that you believe are at risk of losing funding
3) Barriers and facilitators that could be addressed with your solution
4) How the potential solutions could be more detailed or specific
1
Problem Potential Solutions
1. Appropriate EMS
services for older adults
2. High numbers of older
adults transported to the
hospital for falls
1. EMS works with department on Aging to implement Slips Trips and Falls
Program (prevent repeat falls).
a. Wake County received million dollar grant
b. Leave packets and info with indiv. Who fall in their own homes
c. Leave DVD showing what should/shouldn’t do in case of fall
(incorporate into in Praise of Age. Make available to churches
and other locations).
2. EMS education for caregivers
3. Appropriate protocols for EMS workers responding to calls for aging
adults
4. Educate community on when it is appropriate to call EMS
5. Roaming crisis unit with triage capabilities for responding to falls
6. LTC issue: send out ambulance for every fall. Revise protocol in LTC to
prevent always calling an ambulance and full-service EMS workers.
7. Address fear of older adults telling physicians about falls (thinking it will
involve recommendation to move out of home).
1. Healthy lifestyles and
prevention
1. Encourage other facilities to host exercise classes
2. Encourage recreation departments to put on exercise classes
3. Ensure that older adults with physical or mental problems have access to
exercise classes
4. Provide water aerobics classes for physically and cognitively challenged
seniors
a. Morning water aerobics pilot program for 12 individuals
b. Ratio of 1-4 aids to participants
c. Sportsplex in Hillsboro is underutilized pool, other possibility is
YMCA or Meadowmont with its link to UNC.
d. Partnership created with PT professor at UNC, have students do
practicum with specialized population.
e. Initially gear program towards LTC facilities and use
transportation.
5. Advertise lectures and continuing ed. classes offered at the Senior
Centers, libraries, etc.
a. Churches can market continuing education.
b. Use maps of population to focus continuing ed programs.
6. Offer continuing ed in smaller organization centers and churches.
7. Put continuing ed online.
8. Continue/ expand falls prevention programs offered at senior centers
9. Health marketing campaign to encourage Orange County citizens in their
50s to exercise for disease prevention.
10. Train volunteers to offer evidence-based programs like “A Matter of
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To make your potential solutions more concrete and feasible, please think about:

  1. What programs and services you would like to see expanded or improved
  2. Programs or service that that you believe are at risk of losing funding
  3. Barriers and facilitators that could be addressed with your solution
  4. How the potential solutions could be more detailed or specific

Problem Potential Solutions

  1. Appropriate EMS services for older adults
  2. High numbers of older adults transported to the hospital for falls 1. EMS works with department on Aging to implement Slips Trips and Falls Program (prevent repeat falls). a. Wake County received million dollar grant b. Leave packets and info with indiv. Who fall in their own homes c. Leave DVD showing what should/shouldn’t do in case of fall (incorporate into in Praise of Age. Make available to churches and other locations). 2. EMS education for caregivers 3. Appropriate protocols for EMS workers responding to calls for aging adults 4. Educate community on when it is appropriate to call EMS 5. Roaming crisis unit with triage capabilities for responding to falls 6. LTC issue: send out ambulance for every fall. Revise protocol in LTC to prevent always calling an ambulance and full-service EMS workers. 7. Address fear of older adults telling physicians about falls (thinking it will involve recommendation to move out of home).
  3. Healthy lifestyles and prevention 1. Encourage other facilities to host exercise classes 2. Encourage recreation departments to put on exercise classes 3. Ensure that older adults with physical or mental problems have access to exercise classes 4. Provide water aerobics classes for physically and cognitively challenged seniors a. Morning water aerobics pilot program for 12 individuals b. Ratio of 1-4 aids to participants c. Sportsplex in Hillsboro is underutilized pool, other possibility is YMCA or Meadowmont with its link to UNC. d. Partnership created with PT professor at UNC, have students do practicum with specialized population. e. Initially gear program towards LTC facilities and use transportation. 5. Advertise lectures and continuing ed. classes offered at the Senior Centers, libraries, etc. a. Churches can market continuing education. b. Use maps of population to focus continuing ed programs. 6. Offer continuing ed in smaller organization centers and churches. 7. Put continuing ed online. 8. Continue/ expand falls prevention programs offered at senior centers 9. Health marketing campaign to encourage Orange County citizens in their 50s to exercise for disease prevention. 10. Train volunteers to offer evidence-based programs like “A Matter of

To make your potential solutions more concrete and feasible, please think about:

  1. What programs and services you would like to see expanded or improved
  2. Programs or service that that you believe are at risk of losing funding
  3. Barriers and facilitators that could be addressed with your solution
  4. How the potential solutions could be more detailed or specific

Balance” and “Living Healthy” at least every two months at the Sr. Centers, at Senior Living environments, at churches, the VFW, etc_._

  1. Continue/ expand daily meal services at senior centers?
  2. Establish primary medical homes for older adults a. Individuals can select a primary care physician or practice as the place they go for their primary care needs. Special reimbursement associated as well as patient care benefits. Prevents fragmentation of care. Embedded care/case managers. b. Include social workers in medical homes and care managers.
  3. Coordinate transportation for older adults to attend lectures/continuing education classes?
  4. Insufficient support for caretakers
  5. Offer more caregiver support groups at Senior Centers
  6. Continue/ expand Caregiver Day Out programs at Senior Centers
  7. Expand financial consulting offered to Caregivers (regarding health insurance, LTC insurance, other areas?)
  8. Improve access to information on caregiver services and supports
  9. Expand Adult Day programs in Orange County a. Find more ways to publicize the services, the resources available to help families avail themselves of the services and the potential for all involved with the Soltys Day Health Program b. Protect the core mission of the Soltys Adult Day Health Program through sustained funding from the county and continued support from the Department on Aging and Department of Social Services c. Promote the volunteer opportunities at the Soltys Adult Day Health Program so that there is a dedicated core of dependable volunteers to help meet basic programming and general assistance needs d. Continue to develop fund raising opportunities to bolster the support needed by the Soltys Adult Day Health Program
  10. Offer caregiver support programs in rural areas through churches and/or other local organizations such as the Agricultural Extension program
  11. Increase number of Finding Your Voice Programs offered
  12. Need for more spiritual counseling and chaplaincy services
  13. Provide trainings to religious leaders in providing spiritual counseling to caregivers and older adults a. An issue for individuals with dementia. b. Church attendance is decreasing.
  14. Encourage faith-based groups to create chaplaincy services within their own organizations, using a lay leader model such as “Stephens Ministry” to meet spiritual needs for counseling
  15. UNC and Duke have great Chaplaincy Depts – people are trained in lifestyle and chaplaincy issues. Partner with them.

To make your potential solutions more concrete and feasible, please think about:

  1. What programs and services you would like to see expanded or improved
  2. Programs or service that that you believe are at risk of losing funding
  3. Barriers and facilitators that could be addressed with your solution
  4. How the potential solutions could be more detailed or specific

people who are underserved and marginalized. (ex: Piedmont services, LGBT center in Raleigh

  1. Advocating for Medicare at all levels.
  2. Advocate for any particular program or service?
  3. Increase type of health care service?
  4. Lack of workforce training to engage with and serve older adults
  5. Use Durham Tech campus to train professionals of different disciplines on aging issues
  6. Promote/ market Certificates in Aging to students at UNC
  7. Provide continuing education credits to physicians
  8. Disseminate aging program and services information to health professionals in the county, especially primary care physicians a. Emphasize nurse practitioners and physician assistance. b. Train retired physicians and nurses to train others
  9. Encourage professional networking among those who work with older adults (example: CHADERnc) Chapel Hill and Durham Eldercare Resources.
  10. Train health care providers on end-of-life issues
  11. Training for how to work with individuals with dementia.
  12. LGBT center sensitivity center hosted by SAGE for healthcare workers.
  13. Pharmacist education and training
  14. Create required trainings for social workers and nurses on working with an aging population and continuing ed on the services available in Orange County
  15. Area Health Education Centers – put on trainings. Resource
  16. Provide training to lay helpers in support of “consumer directed care” allowing people to choose who they want to provide services, when they want services provided, etc. c. Workforce training for these lay helpers (who are paid) will be different than training professionals. The helpers can provide more personalized service at lower cost.
  17. Lack of community engagement
  18. Collaborate with schools or surrounding universities to facilitate intergenerational interaction between youth and older adu.lts
  19. Encourage the Department on Aging and other organizations/ institutions to use infrastructures and buildings than can serve many generations.
  20. Increase community engagement activities and programs in LTC facilities
  21. Continue/ expand RSVP
  22. Harness the expertise of older adults to provide services and engagement to peers
  23. Engage churches in facilitating community engagement programs
  24. To increase community engagement in providing volunteer services, provide liability insurance coverage so that volunteers won’t have to

To make your potential solutions more concrete and feasible, please think about:

  1. What programs and services you would like to see expanded or improved
  2. Programs or service that that you believe are at risk of losing funding
  3. Barriers and facilitators that could be addressed with your solution
  4. How the potential solutions could be more detailed or specific

worry as much about “being sued” by the people they are trying to help. d. This may entail changes in local policy, regulation, etc. It may also require that we educate the public about the real dangers of being sued vs. the perception of those dangers

e. Insufficient Mental Health Services

  1. Maintain a list of Licensed Clinical Social Workers and licensed counselors who can provide fee-for-service counseling to older adults with mental health issues and to their families
  2. Contact Pro Bono to understand their services covered under Medicare.
  3. Educate providers on what mental health services are covered under insurance and how to go about filing for reimbursement successfully.
  4. Hire a part-time mental health counselor to provide services at the Sr. Centers one-two days each month.
  5. Make depression a regular screening program
  6. Make depression screening a part of a regular physical (in addition to dementia screening). a. Important now that Medicare is covering many preventive services.
  7. Other Programs/ services addressing dementia?
  8. Other Programs/ services for mental health problems other than dementia? a. Depression is underdiagnosed. More sensitivity and training needed for physicians b. Harder to diagnose depression in older adults because of co- morbidities.
  9. Programs and Services within Long Term Care facilities
  10. Partner with nutritionists who work in LTC facilities to offer more nutritious foods. (encourage and support nutritious foods). a. Encourage facilities to offer more food choices.
  11. Evidenced-based activity programs that meet individual needs, provides a purpose in life and cognitive stimulation for Orange County residents living in long-term care facilities
  12. **Bringing creative ideas to LTC facilities.
  13. Encouraging patient-centered care within LTC facilities.
  14. Include LTC residents in continuing ed classes and exercise classes.
  15. Provide transportation to and from senior center for activities and programs.
  16. Meeting with leadership of LTC corporations.
  17. Evidenced-based exercise programs that are specific to the needs of Orange County residents living in long-term facilities
  18. Provide palliative care and end of life care program for residents living in long term care facilities, families and staff, including a formalized program for bereavement