LTC 315 week 5 final presentation Case Study Comparison Presentation

Case Study Comparison Presentation




Names: Ruby(F) and Irving(M) Kallenbach Marital Status: Married for 72 yearsAge: 92 and 94, respectivelyReligion: Jewish, Not able to attend services, participate in a nondenominational service in their communityLanguage: EnglishTraditions: Enjoy all Jewish holidays with daughters and respect another daughter’s choice to be Christian, they celebrate Christian holidays with her family.Medical Diagnosis: Ruby is treated for mild depression and anxiety. Irving has diabetes that is controlled with oral medications. Irving has been diagnosed with moderate dementia (recently) and has been asked to participate in a research study with Mayo Clinic.Financial Resources and Insurance: Ruby purchased a life care contract at a continuing care retirement community (CCRC), however Irving did not qualify for the life care contract because of his dementia diagnosis. Ruby and Irving had enough funds for Irving to pay privately in the independent setting. They have Medicare and prescription drug coverage.

Introduction To Case

Social Support System: Ruby and Irving have lived in their CCRC for 6 years and have many friends. Ruby has made friends with the activity director (who is also Jewish) in assisted living and they have collaborated to offer annual Passover Seders for the Jewish residents that reside in the community, which is a small percentage of residents. Ruby and Irving have three daughters that reside in different states. Their oldest daughter is a Rabbi and is available to travel when necessary. Their middle daughter is a CPA and is very busy most of the year as she has her own business. Their youngest daughter is a social worker in a hospital setting.

Introduction To Case Cont.

Current living environment: The couple lives in a CCRC with multiple levels of care. Ruby feels that she has the emotional and social support that she needs to care for Irving; however, she is struggling as Irving is having more difficulty ambulating and is becoming more frustrated and agitated. Irving used to write out his day and follow the sheet of paper; however, this task has become nearly impossible. Irving is very frustrated as he was the professor of engineering at the local university. At times Ruby must call for assistance when Irving refuses to take his medications or becomes angry and unmanageable. Ruby knows that Irving could go to the memory care assisted living on campus, but she is struggling with the guilt of not being able to care for her husband of 72 years and the financial effect of the move.

Active Adult CommunitiesRetirement CommunityIndependent Living Facility

Active Adult & Senior Communities

Senior CommunitiesAssisted LivingNursing homes

the Independent seniors can not use Medicaid to help pay for the rentAssisted living, these individual need medical attention, they are able to use sources of finances to cover the cost of their rent. Such as Medicaid, Veteran Administrative , and long term care insurance

Advantages & Disadvantages

Regulations Governing Assisted Living

Department of Aging and Disability ServicesMedicaid and MedicareDifference in other states

Dementia Care ProgramsFull room and boardAssistance in various daily tasksServes patients with a range of health issues

Assisted Living Facilities Services

Common SourcesMedicaid/MedicarePrivate pay

Sources of Reimbursement for Assisted Living

AffectLower state revenuesFewer staff

Federal RegulationsOBRA (also known as the 1987 Federal Nursing Home Reform Act)Centers for Medicare and Medicaid ServicesState Regulations(vary by state)

Governing Bodies

Common SourcesMedicaidMedicare

Sources of Reimbursement for Skilled Nursing

AffectsReduction in staffLosing money

Recommendations from area hospitalsTexas Department of Aging and Disability Services (DADS)Medicare websitesWord of Mouth

Selecting an Appropriate Facility

Constantly changingApproach changes with:CommunicateSelecting a leaderProvide resourcesFlexibility and adaptability for future needs

Effects of Culture Change

Technology’s integration into Health CareUses by providers and consumersApplied TechnologyInformation TechnologyClinical ApplicationsAdministrative ApplicationsStrategic SupportProvide efficiency and support

Progress of Technology Based Living

IrvingNeeds more care for his ADLThe current facility has memory care

Best Living Environment Option

RubyNeeds less care then IrvingCan stay in the same building as IrvingCan be with her friends and people she knows

California Department of Public Health. (2016). Licensing and Certification. Retrieved from, M., & Heetebry, I. (2004). Information technology in the future of health care. Journal of Medical Systems, 28(6), 673-88. doi: Yee-Melichar, Darlene, and Flores, Cristina. Long-Term Care Administration and Management : Effective Practices and Quality Programs in Eldercare : Effective Practices and Quality Programs in Eldercare. New York, US: Springer Publishing Company, 2014. ProQuest ebrary. Web. 9 July 2016.


Botek A.M. (2016) Retrieved from: and-assisted-living-168142.htm Center for Medicare advocacy Retrieved from: // facilities-remains-high-for-2010-despite-reductions-in-overpaymentsMollica R. (2009) National center for assisted living American health care association Retrieved from: eport.pdf

References (2016) Residential Care | Caregiver Center | Alzheimer’s Association. Alzheimer’s Association. Retrieved from: facilities.asp on July 9, 2016.Connell, Linda H. (2004). Nursing Homes and Assisted Living Facilities : Your Practical Guide for Making the Right Decision. Naperville, IL, USA: Sphinx Publishing, an Imprint of Sourcebooks, Inc., 2004. Retrieved from: on July 9, (2016) Medicare Program. Retrieved from: program.html on July 9, 2016.Texas Department of Aging and Disabilities. (2016) About the Agency (DADS). Retrieved from: on July 9, 2016.