How to Meet the Needs of Younger Populations in
Long-Term Care
June 10, 2016
Voyce Conference – The Changing Landscape of Long Term Care
Learning Objectives:
 Identify strategies to meeting the social, emotional, and
health-related needs of younger populations
 Identify best practices to managing the challenges of
younger residents in long-term care including behavioral
management issues, past medical history, escalating costs
and staff turnover.
 Learn how to prepare staff to care for younger residents.
Young Adult Population In Nursing
Homes
 Ages 31-64 makes up 14%
of the population in the
Nursing Home Community
Shapiro, J. (2010, December 9). A New Nursing Home Population: The Young. Retrieved May 24, 2016, from
http://www.npr.org/2010/12/09/131912529/a-new-nursing-home-population-the-young
2000 Missouri Long Term Care
Residents Age Groups
2014 Missouri Long Term Care
Residents Age Groups
40
35
35
30
30
25
25
20
20
32.5
34.6
15
34
15
25.8
10
17.8
10
15.6
14.7
5
5
9.7
7.5
6.5
0.7
0
0.1
0.7
0-21
22-30
0
0-30
31-64
65-74
75-84
85-94
95+
31-64
65-74
75-84
85-94
95+
2014 United States Type of
Certification
32.4
31-64
6
Age Groups
14.8
2.5
22-30
0.1
0.3
3
0-21
0.1
0.1
0
5
10
15
20
25
Percentage of Residents
Medicaid
Medicare
Medicare & Medicaid
30
35
United States Percentage or Nursing
Home Residents 64 or Younger
15.6
15.5
Percentage of Residents
15.4
15.3
15.2
15.1
15
14.9
14.8
14.7
2011
2012
2013
Years
2014
Not Just For The Elderly
 According to the Centers for Medicare and Medicaid, the
under 65 year old patients in nursing homes have
increased to 22 percent in the last eight years.
 Due to state’s budget cut, it is cheaper for young adults
facing a disability or illness to live in an assisted living or
nursing home, than to pay for home health care.
 Young adults with a psychiatric background are being sent
to a nursing home as well, due to the state shutting down
mental disability facilities.
 Combining young adults with wise adults develop
depression within the younger adults
L, S. (2015, August 17). Young Disabled Adults in Nursing Homes. Retrieved May 24, 2016, from http://hubpages.com/health/Why-are-YoungPeople-Ending-up-in-Nursing-Homes
Who are these individuals? What is
their diagnosis
 Multiple sclerosis
 Chronic mental illness
 History of drug addiction
 Huntington’s Disease
 Brain injury
 Spinal cord injuries
 Stroke
 Obesity with contributing co-morbidities
Who are these individuals?
 Parents
 Students
 Recently retired/on disability
 Lived in the community
 Living independently – on their
own, with family, friends, their
parents, their children
Financial Considerations
 Younger populations tend to have more payments
(paying on a house, auto, children)
 They typically have limited or no assets (savings,
retirement pensions, trusts, still owe on items)
 If they have a debilitating disease, it is 2 years after the
incident before they can apply and qualify for Medicare
 Longer stays than older residents
 Medicaid pending for most because they must be
disabled for 6 months before they can apply for Medicaid
Financial Considerations
 Cost of medical care (medications, hoyer lifts, air
mattresses, electric wheelchairs)
 More inclined to be bariatric (specialty beds, wheelchairs,
hoyer lifts, slings for those lifts)
 Medicaid will not reimburse for PT, OT, ST but SNF must
do what’s right for the patient so the center will be
responsible for the cost
 Medicaid transportation is limited and the patient must
qualify
Financial Considerations
 The younger resident may have mobility issue’s so more
inclined for skin breakdowns thus wound care
 Without a payer source, the SNF is responsible for the
cost of meds, wound care supplies, psychiatric services
 Depression can be a huge issue with younger residents
again all meds and psychiatric services will be at the
expense of the SNF if no payer source is in place
 The younger residents eat more food than seniors and
have more specific food choices like fresh fruit,
vegetables, gluten free, lactose intolerance
Financial Considerations
 Medicaid requires a monthly haircut/style that SNF’s must
provide but they are not reimbursed for
 The younger resident has more “electronic and
technology needs” so free Wi Fi, headphones for volume
control and Powercords (we use a power strip that costs
$104.00 per unit)
 Strong likelihood that the younger population will live
longer, face considerably more health challenges over the
years and increased cost
 Typically this population will not have a prepaid funeral
Health-related considerations
 Emotional
 Depression
 Anger issues
 Sexual desires
 Behavioral budget
 Physical
 Mobility
 Risk of falls
 Health issues (specific diagnosis considerations)
Meeting the social needs of younger
populations
Younger residents do not tend to enjoy
the things that your “typical” long
term care residents would enjoy. You
often here “I am bored”, “This is not
of interest to me”, or “that is for old
people”.
Social needs
 Family and friends-more family




involvement and children tend to be
younger and can be more
demanding.
Exercise
Transportation – cost, availability
Dietary interests (food, microwave…)
- Picky about food choices and want
different foods (i.e., more fried foods,
raw vegetables instead of the typical
soft vegetables).
Sleep schedule-They want to go to
bed much later and sleep later in the
mornings.
Activities that you will see younger
residents engaging in at centers
 Movies - more modern day
theme
 Happy hours-with real alcohol
 Community outings-enjoys
going shopping, out to eat, to
the movies, theater shows,
etc.
 Computer access (social
media, internet sites) they
often have their own
computers, tablets, smart
phones, etc.
How do you plan an activity calendar
with younger residents in mind
 Find common activities that you can engage them in such
as gardening, reading clubs (have them lead it), card
games, live entertainment, etc.
 Provide activities into the later part of the evenings or
have them start movie groups at night.
Preparing the Healthcare Team:
Challenges & Opportunities







Turnover
Experience
Expectations (use of social media, boundaries)
Opportunities
Communicating with residents
Resident to resident interaction
Training





Physical
Emotional
Communication
Community organizations
In-services on disease-specific information
Q&A
Panel Discussion
 Lester, lives with MS (via video)
 Todd, brother-in-law lived with Huntington’s Disease
Community Resources
See Handout
Thank you
Suzanne Carron, OTR/L, MSOT
Director of Community Partnerships & Programs
National MS Society
1867 Lackland Hill Parkway
St. Louis, MO 63146
[email protected]
314-446-4169
Jennifer Frazier
Activity Director
NHC of Town & Country
13995 Clayton Rd.
Town and Country, MO 63017
[email protected]
636-227-5070
Catherine Hicks
Executive Director
Golden Living Center #2380
415 Sidney St.
St. James, MO 65559
P:1-573-265-8921
[email protected]