DISCUSSION QUESTIONS

PART I: The following are the Discussion Questions found at the end of this chapter along with answers to those questions.

1. What are community-based services?
What is home health care?
What is hospice care?
What is adult day care?

2. Who provides community-based services?
Who provides home health care?
Who provides hospice care?
Who provides adult day care and in what settings?

3. What are the patient services most commonly provided by each of the services discussed herein (home healthcare, hospice care, adult day care)?
Services most commonly provided by home health care organizations:
Services usually included in hospice care:
Services that may be provided at adult day care centers:

4. How are each of the community-based services financed?
How is home health care financed?
How is hospice care financed?
How is adult day care financed?

5. What are some of the human resource issues confronting community-based services providers?
Human resource issues confronting home health care providers:
Human resource issues confronting hospice care providers:
Human resource issues confronting adult day care providers:

6. What are some of the legal and ethical issues facing community-based services providers and consumers?
Legal and ethical issues facing home health care providers and consumers:
Legal and ethical issues affecting hospice care providers and consumers:
Legal and ethical issues facing adult day care providers and consumers:
Community-Based Cases:

7. In reference to the home health care case at the end of this chapter, consider the following:

a. Should Joan and Jerry have applied for home health care sooner, and, if so, who should have made them aware of the benefits of home health care?
b. Given what you have learned about the accessibility and financing of home care services, are such services as readily available to other consumers as they were to Joan and Jerry?

8. In reference to the hospice care case described in the chapter, consider the following:
a. The doctors were pretty sure that Pierre had less than 6 months to live, so he fell well within the guidelines for hospice coverage. Should hospice coverage be limited to those with 6 months or less to live, or should others be covered? Why?
b. Volunteers played a large part in Pierre's care, even staying with him overnight toward the end. How can the hospice's management adequately supervise volunteer workers in such situations and assure that they provide safe, appropriate care?

9. In reference to the adult day care case at the end of this chapter, consider the following:
a. Although Wilma is clearly benefiting from day care, so are Lorenzo and Karen. Should society (Medicaid) be paying for something that benefits them, when they are not poor?
· Arguments against:

b. If there was not a day care center available for Wilma, do you think she would be able to continue living with Karen and Lorenzo? If not, to what type of long-term care facility would she likely be admitted?

PART II EXERCISES:

The following exercises relate to Part II of the text. Completing them will help you to more fully understand the material covered in that part.

Exercise 1.

This part of the text focuses on the providers of long-term care. Some of them are institutional in nature, some are noninstitutional, and some are a combination of the two forms. One of the most enduring and difficult questions facing the system is how to balance the use of institutional and noninstitutional services.

A. How should the long-term care system balance institutional and noninstitutional forms of long-term care?
B. What factors should be taken into account?