Table 1.
Site/service | Patient description (‘One-Liner’) |
---|---|
1. Independent Living | Eight six-year-old woman with diabetes and hypertension who lives independently and would like to continue doing so, while having access to social groups and activities in her community. |
2. Assisted Living Facility | Ninety-two-year-old woman who is looking to live somewhere where meals are provided, and assistance is available for bathing and dressing. She manages her own finances. |
3. Home with services (Visiting Nurse Agencies, Area Agencies on Aging/Elder Services) | Seventy-five-year-old previously functionally independent community-dwelling man with diverticulitis status post end colostomy wanting assistance with colostomy care as he returns home. |
4. Post-acute care (Skilled Nursing Facility/Sub-Acute Rehab) | Eighty-four-year-old previously functionally independent community-dwelling woman status post hip fracture repair who needs strengthening before she is ready to return home. |
5. Programs of All-Inclusive Care for the Elderly (PACE) | Sixty-year-old woman with diabetes, hypertension, CHF, aortic stenosis, stage 4 CKD and osteoporosis who continues to live safely in her community and is dually eligible for Medicare and Medicaid. |
6. Long-term care (Skilled Nursing Facility/Nursing Home) | Eighty-five-year-old man with advanced Alzheimer’s dementia and diabetes who needs assistance with iADLs and several ADLs, 24 hour supervision and medication management. |
7. Hospice | Seventy-two-year-old man with metastatic colorectal cancer and expected prognosis less than 6 months. |
Legend: ADL = activity of daily living; CHF = congestive heart failure; CKD = chronic kidney disease, iADL = instrumental activity of daily living.