Adult day-care centers follow very specific intake procedures as outlined by the state agency that licenses the center. The minimum requirements may be specified by the state health department, social services, mental health services or a specific licensing agency responsible for inspecting and awarding licenses to adult day-care centers. From this assessment process, the center's team develops a plan of treatment.
Psychological Assessment
Most states require a licensed nurse to conduct the psychological assessment portion of a patient's intake process. One of the most common assessment instruments used is the Folstein Mini-Mental State Examination (MMSE). The MMSE is a quick assessment of the cognitive state of an adult patient. The instrument screens for impairment in cognition, estimates the severity of impairment at a specific point in time (intake) and can be used to reassess and follow changes in the individual's mental state over time or to document changes that happen as a result of therapy or applied therapeutic support services. The nurse also should obtain copies of formal psychological evaluations that have been done of the patient within the past 10 years.
Physical Assessment
State minimum standards outline what sorts of physical evaluation are needed. Standard tests, of course, include height, weight, blood pressure, respiration and temperature. A nurse also obtains and reviews the patient's medical history from his doctor and follows up with questions about specific conditions that impact the patient's care plan. At this time, the patient's family and the nurse develop or make a copy of the patient's advance directive, which lays out the patient's wishes in case extraordinary medical intervention is needed to keep him alive.
Leisure Interest Inventory
The center activity director (AD) conducts a leisure/recreational interest inventory of the patient. The inventory is a check-off list of recreational activities that the person either enjoys or does not enjoy to varying degrees. By identifying recreational interests of each new patient, the AD can structure an activities program so that activities not only meet physical, mental and social needs in a therapeutic way but also engage the patient.
Nutritional Assessment
The center's consulting nutritionist looks at the care plan drawn up by the center treatment team and incorporates the patient's special dietary needs into the center's meal and snack menus.
Risk Assessment
As part of the intake process, the treatment team considers physical, social and mental limitations faced by the patient, special needs, flight risk, fall risk, seizure potential or other possible risks in providing care to the patient. The team weighs risks, develops strategies and addresses risk factors to be incorporated in the patient's treatment plan.
Financial Plan
The family meets with the bookkeeping staff, assesses family financial resources, insurance, Medicare, Medicaid and other social service resources and develops a care contract and payment plan. At this time, the staff usually provides a copy of the center's family handbook to the patient's caregivers with center policies and procedures as well as general information about operations, hours, types of services offered and terms of service.
Treatment Plan
The treatment team, usually composed of the nurse, center director, activities director and nutritionist, develop a treatment plan from the assessment data according to state licensing standards. A state's minimum standards are the guidelines for developing the assessment protocols and treatment plan process.
Tags: treatment plan, treatment team, care plan, day-care centers, intake process