AMBestadultdaycareWord文档格式.docx
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AMBestadultdaycareWord文档格式.docx
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AUTOMOBILELIABILITY
4
Higherifinsuredprovidestransportation.
AUTOMOBILEPHYSICALDAMAGE
--
GENERALLIABILITY
5
PRODUCTLIABILITYANDCOMPLETEDOPERATIONS
Lowerifclientsprovidetheirownfood;
higherforcentersstaffedwithvolunteers.
PROFESSIONALLIABILITY
ENVIRONMENTALIMPAIRMENTLIABILITY
WORKERS'
COMPENSATION
CRIME
2
FIREANDE.C.
3
Higherinolderbuildings.
BUSINESSINTERRUPTION
6
Immediateavailabilityofreplacementspacecritical.
INLANDMARINE
BOILERANDMACHINERY
Low1-3,Medium4-6,High7-9,VeryHigh10
SICCode
SICClassification
8052
IntermediateCare
8059
NursingandPersonalCare,NEC
8322
IndividualandFamilySocialServices
8641
Civic,Social,andFraternalAssociations
ISOCode
ISOClassification
44431
HealthCareFacilities-HomesfortheAged
44437
HealthCareFacilities-HomesforthePhysicallyDisabled/Orphans
61000
BoardingorRoomingHouses
SpecialExposures
Swimmingpools
Inadequatefoodstorage
Clientabuse
Multi-levelfacilities
Prescriptionmedications
RelatedClassifications
DaycareCenters
HospiceFacilities
NursingHomes
OutpatientHealthCareFacilities
SpeechLanguagePathologists
RISKDESCRIPTION
a170r.
Throughoutlife,wearetaskedwiththeresponsibilityofcaringforourfamilies.Aswegetolder,thatresponsibilityoftenincludescaringforaparentorspouse,orfunctionallyorcognitivelyimpairedsiblingsorchildrenwhohavereachedtheageofmajority.Illnessanddisabilitycancauseadifficultsituationtobecomeimpossible;
thestressesofeverydaylife-financialpressure,employedcaregivers,costsoffamilycare-overloadusandmaketheresponsibilityoffamilycareevenmorechallenging.Mostpeoplewhocareforinfirmfamilymembersfeelastrongsenseofobligationanddesiretokeeptheirlovedonesoutofinstitutionsandinahomeenvironment.Manypeopleinthe1990shavefoundthatoneincomeisnotenoughtosupportafamilyandthatasecondincomeisnecessary;
often,thefamilymemberwhowouldbethecaregiverhastofindemploymentoutsidethehome.Justastheneedforchildcaregaverisetothegrowthofdaycarecenterstoprovidecareforthechildrenofworkingparents,theneedforeldercareiscreatingademandforcentersthatcanprovidethesupportiveservicesnecessarytoassistworkingfamiliesinthisendeavor.Additionally,manyelderlypeoplewhoarealonebutotherwisehealthymaysufferfromlonelinessandadesiretosocializewithothers.Adultdaycarecentershavebeendevelopedtofillthisvoid.
Theneedforadultdaycarehasneverbeengreaterandwillcontinuetogrow;
meetingtheneedsoftherapidlygrowingpopulationoftheelderlyhasbecomeapriorityinthe1990s.Twentyyearsago,fewerthan100adultdaycarecentersexisted;
presently,thereareapproximately3,000adultdaycarecentersintheUnitedStatesandmoreareneeded.Thenumberofelderlyparentswithadultchildrenwillnearlydoubleby2030withfamiliesproviding80%oflongtermcare.By2010,oneoutofeverysevenAmericanswillbeover65,andthesegmentofthatseniorcitizenpopulationgrowingthefastestwillbethose85andover,includingover100,000centenarians.
Familiesattempttosolvetheiradultdaycareneedsinmanyways.Somefamiliesarrangetohaveotherfamilymembers,friends,orneighborscareforolderorinfirmrelatives;
however,thistraditionalsourceofcareisbecomingraresincetoday'
seconomyincreasinglypressuresthoseindividualstowork.Somefamilieswillarrangetheirworkhourssothatsomeoneisalwaysathome.Otherfamilieschoosefromavarietyofcommunity-basedarrangements.Somecommonarrangementsinclude:
seniorcenters,adultfostercare,continuingcareretirementcommunities,assistedlivingfacilities,respitecare,andadultdaycare.
Seniorcentersareoftenlocatedinseniorhousing,churchesorsynagogues,veterans'
halls,orschools.Theyareusuallydrop-infacilities,andthosewhoattendorganizetheirowngamesorotherprojects.Hotfoodorsnacksmaybeavailable.
Adultfostercareprovidesaprogramforseniorswhoareexperiencingincreaseddifficultylivingalonesafely.Theseprogramsworkbybringingseniorsintouchwithpersonsinthecommunitywhoarewillingtoopentheirhomesandfunctionascaregivers.Mostcaregiversprovidehousingandappropriatecareandalsoreceivetrainingandorganizationalsupportfromlocalcentersontheaging.Adultfostercareprogramsprovideroomandboardandpersonalcareservicesinaresidentialsettingforindividualswhohavefunctionalimpairmentandrequiresupervisedliving.
ContinuingCareRetirementCommunities(CCRC)createacampus-likeenvironmentwhereresidentsbeginbylivinginanapartment,thenlatermovetoanassisted-livingunitoranursingfacilityastheirabilitytocareforthemselvesdeclines.
Assistedlivingfacilities,atypeofCCRC,offers"
home-like"
residencesthatincludedailymeals,helpwithbathinganddressing,24-hoursupervision,andlimitednursingservices.Assistedlivingarrangementscanbeprovidedinavarietyofsettings,includingfree-standingfacilities;
facilitiesclosetoorintegratedwithskillednursingfacilities;
componentsofcontinuingcareretirementorlifecarecommunities;
orindependenthousingcomplexes.
Respitecareprovideshome-and/orcommunity-basedassistanceforprimarycaregiversofseverelydisabledpersons,andenablesinformalcaregivers(suchasfamilymembers)towork,whileprovidingthemwithrelieffromthestressoffull-timecare.
Adultdaycarerepresentsahybridofhomecareandnursinghomecare.Itoffersclientstheopportunitytosocialize,enjoypeersupport,andreceivehealthandsocialservicesinasafe,familiarenvironment-typically,alocalcommunityfacility.Italsoprovidesrespiteforcaregiversresponsibleforapersonwhocannotbeleftalone,butwhoalsodoesnotrequire24-hournursingcareinaresidentialfacility.Adultdaycareservicesoftenwillincludecareandsupervision;
smallgroupandindividualactivities;
nutritiousmeals;
transportation;
casemanagement;
recreationandexercise;
nursingcare;
education;
familycounseling;
assistancewithactivitiesofdailyliving;
andoccupational,speech,andphysicaltherapies.Generally,clientsareambulatoryormobile(abletomoveindependentlywiththeaidofawheelchair,walker,orcrutches).Adultdaycarecenterscanbefree-standingoccupanciesortheycanbeaffiliatedwithahospitalornursingfacility.Thisclassificationwillfocusonadultdaycarecentersfortheelderlyoperatingasindependentcentersnotaffiliatedwithotherorganizationsorbusinesses.Theexposuresdiscussedherealsomaybeappliedtotheothertypesofadultdaycarearrangementsaswell.
Adultdaycarecenterscomeintwoforms:
thesocialcentermodelandthemedicalcentermodel.Thesocialcentermodelprimarilyattemptstoalleviatefeelingsoflonelinessandisolationamongolderadults,whilefosteringgroupparticipationandfeelingsofbelonging.Servicesprovidedtraditionallyfocusonrecreationalandgroupactivities.Thesecenterscatertoadultswhosephysicalconditionisstableandwhofunctionindependentlyinactivitiesofdailyliving.Socialdaycarecenterscanbequiteinformal,astherearenoregulationsgoverningthemandnolicensesarerequired.Presently,therearenostaffingrequirements,mandatedactivities,orstaffqualifications.Medicaidusuallydoesnotcoversocialdaycarecenters,althoughsomefundscanbeobtainediftheclientisinvolvedwithaprogramthatcaterstothosewithachronicailment(e.g.,Alzheimer'
sorParkinson'
sdisease).Inthesecases,amedicalchartisoftenrequiredforclientscoveredunderthisprogram.Someinsurancecompaniesarebeginningtoofferadultdaycarecoverageaspartoftheirnewlong-termcarepolicies;
also,itmaybepossibletonegotiateforcoverageunderolderpolicies.Mostclientsinasocialdaycareprogramarefundedthroughprivatesources,suchasfamilyorindividualincome.Theratesthatcanbechargedforasocialdaycarecenteraretraditionallylowerthanthoseforamedicaldaycarecentersincefewerservicesareprovided.Centerscanbesponsoredbychurches,recreationoradulteducationdepartmentsofthelocalmunicipality,privateorganizations,and/orcorporations.
Themedicalcentermodel,ontheotherhand,provideshealthandrehabilitationservicesinadditiontorecreationalservices.Theintentisrehabilitationormaintenanceofeachperson'
shighestleveloffunctioningandindependence.Medicalmodelfacilitiesaretraditionallystaffedbyhealthcareprofessionalsandcatertothoseindividualsinneedofphysicalassistanceorstructuredenvironments.Asuggestedminimumstaffratioisonestaffmembertoeverysixclients.Fundingformedicaldaycarecentersismorevariedthanthatforsocialmodels;
aclientcanpaywithprivatefundsorthroughfundsavailablefrommedicaldisabilityprograms(e.g.,theCommunityCareProgramfortheElderlyandDisabled,oranAlzheimer'
sgrant).Medicaidpaymentscanbeappliedincertaininstances.(Medicaidpaysforhealth-careservicesfortheverypoorofanyage.Toqualify,nearlyallofapatient'
sassets
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