Chapter 10

Low cognitive functioning places an elderly person at a high risk for a. clinical depression b. functional decline c. chronic ailments d. acute ailments

The elderly do not constitute a homogeneous group; hence a. they have more chronic ailments than acute episodes b. the LTC system must be integrated with the rest of the health care delivery system c. most elderly people live independently d. a variety of long-term care services are demanded

Decline in ADLs is likely to be most pronounced in a. patients needing nursing home care b. people entering a CCRC c. people who need to be transferred to a hospital d. people needing adult day care services

Most of the expenditures for long-term care services, both community based and in institutions, is paid by a. private long-term care insurance b. employer-based health insurance c. Medicare d. Medicaid and other public sources

Which of the following plays a primary role in individualizing long-term care services to the patient's needs? a. Coordination of various services b. Physician's orders c. An individual assessment d. A discharge report from the hospital

In the delivery of long-term care, customized interventions are carried out according to a. an individual assessment b. a plan of care c. weekly evaluations by the patient's physician d. the philosophy of total care

Rational integration between long-term care and non-long-term care services a. helps individualize a plan of care b. facilitates the delivery of total care c. establishes better working relationships between the various partners of care d. helps identify the level of long-term care that is most appropriate for the patient

What is the key determinant of the need for long term care? a. A disabling accident b. An acute episode c. Presence of multiple chronic conditions d. Dependency because of inability to perform tasks of daily living

What is the main goal of long term care? a. Maintain function and prevent further decline b. Return a person to independent living c. Reverse the decline in activities of daily living d. Cope with multiple chronic conditions

Long term care should be delivered according to a. the biomedical model of health b. a person's ability to perform his or her social roles c. the holistic model of health d. the guidelines established by the World Health Organization

Which of the following can contribute positively to a person's quality of life? a. Palliation b. Assessment c. Plan of care d. Total care

What is the purpose of incorporating evidence-based practices in the delivery of long-term care? a. To determine whether a person need community-based or institutional services b. To ensure the delivery of total care c. To identify a patient's specific needs d. To improve the quality of care

Why is the assessment of psychiatric illness particularly difficult in geriatric patients? a.Mental illness cannot be ruled out b.The elderly often fake mental illness c.Psychiatric illness can be intermittent d. Commodities can obscure diagnosis

Which type of long-term care service is predominantly used in the United States? a. Informal care b. Home health care c. Nursing home services d. Respite care

Which of the following is likely to result in fewer unmet needs and better utilization of services for HIV/AIDS patients? a. hospice care b. home and community based services c. services managed by the Area Agencies on Aging d. case management

Basic assistance with ADLs is provided mainly by a. physical therapists b. licensed nurses c. paraprofessionals d. occupational therapists

Personal care a. Individualized care b. Assistance with basic ADLs c. Services that are nurse-intensive d. Long-term care provided by unpaid caregivers

Maintenance rather than restoration of function is specifically the domain of a. custodial care b. restorative care c. skilled nursing care d. personal care

Which federal agency is responsible for overseeing the programs funded through the Older Americans Act? a. Administration on Aging b. Medicare c. Medicaid d. Department of Housing and Urban Development

20. Rehabilitation therapies often form an important component of a. Health-maintenance model of adult day care b. Personal care c. Services available at senior centers d. Skilled nursing care

Which is the largest payer for home health services? a. Medicaid b. Out-of-pocket funds c. Medicare d. Private insurance

Most of the funding for meals-on-wheels is authorized under a. Section 1915(c) waivers b. the Older Americans Act c. the Affordable Care Act d. Medicaid

In long-term care case management, services of freestanding case managers are used in the _____ model. a. integrated care b. brokerage c. managed care d. consolidated

To participate in the PACE program, an elderly person must a. need only community-based long-term care services b. be a Medicaid beneficiary c. have been certified for nursing home placement d. undergo preadmission screening and resident review (PASRR)

In recent years, the prevalence of psychiatric diagnoses in nursing homes a. has decreased b. has increased c. has stayed the same d. has been unknown

In recent years, the quality of care in nursing homes a. has decreased b. has increased c. has stayed the same d. has been unknown

A long term-care facility must be certified in order to a. operate as a nursing home b. comply with national fire and safety codes c. obtain deemed status d. admit Medicare and/or Medicaid patients

A facility that is certified as SNF can a. admit only Medicaid patients b. admit only Medicare patients c. admit both Medicare and Medicaid patients d. only be a distinct part

A facility that is certified as NF can a. admit only Medicaid patients b. admit only Medicare patients c. admit both Medicare and Medicaid patients d. only be a distinct part

Hospital-based transitional care units must be certified as a. an acute care hospital b. a SNF c. a NF d. both SNF and NF

A continuing care retirement community (CCRC) a. provides only independent living options in a secure environment b. provides different levels of long-term care options in one location c. delivers no clinical services, such as nursing care and rehabilitation d. must be certified as a NF

Which part of Medicare covers SNF services? a. A b. B c. C d. D

The predominant users of long-term care services are the elderly.

Most elderly needing long-term care reside in nursing homes.

Elderly in the lowest socioeconomic status are at the greatest risk of need for LTC services.

LTC services are tailored to the needs of the individual patient.

Most people needing long-term care need it for more than 90 days

Most institutionalized long-term care patients have a diagnosis of dementia.

Therapeutic services in long-term care are rendered by a physician.

The number of informal caregivers in the United States has been gradually increasing.

Respite care includes only community-based long-term care services.

AIDS is now classified as a chronic condition.

Subacute care is designed for patients who remain critically ill during the postacute phase of illness.

Medicare does not pay for regular adult day care services.

Medicare only pays for short-term stays in an adult foster care home.

All states require assisted living facilities to be licensed by the state.

In a skilled nursing facility, Medicare covers only short-term rehabilitation or convalescence.

Nursing facilities must be certified by the state in which they operate.

Facility licensing regulations are consistent nationwide.

In certified nursing care facilities, different levels of services are delivered to Medicare and Medicaid patients based on the source of financing.

Private pay patients may be admitted to a certified nursing care facility.

In recent years, the number of nursing home beds per 1,000 elderly population has declined.

In recent years, skilled nursing facilities have been the fasted growing segment of the institutional continuum.

Most nursing home care in the U.S. is financed by Medicare.