Transitions of Care: Dementia Part 2
Presented by Cathy Wollman
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This course will continue to highlight nursing interventions to improve outcomes for skilled nursing facility (SNF) or nursing facility (NF) residents with cognitive impairment or dementia. The focus will be on education and discharge planning for those returning home following their SNF or NF stay. The course will also focus on the importance of advance care planning, as most dementias or neurocognitive disorders are progressive terminal diseases. Individual roles of the interdisciplinary team will be examined to improve transitions and prevent unnecessary hospitalizations. Unique resident and family goals, including options for palliative or hospice care, will be discussed. The course will conclude with a case study of a complex resident with dementia.
Meet your instructor
Cathy Wollman
Dr. Wollman has been an educator and clinician for more than 35 years. She has worked as a gerontologic nurse practitioner at multiple sites of care across the health care system. She also served as director of senior health for a large health system and the coordinator of the nurse practitioner program for more than ten…
Chapters & learning objectives
1. Education and Discharge Planning for the Resident With Dementia or Cognitive Impairment
This chapter will focus on the role of the nursing staff and other members of the interdisciplinary team to enable residents and/or their caregivers to manage care if they return home. Additional focus will be on appropriate interventions to prevent acute care hospitalizations since those events are often overwhelming for residents and can result in delirium, compromised function, longer-than-average hospital stays, and poor post-discharge outcomes.
2. Individual Resident and Caregiver Goals Related to Prognosis and Potential for Rehabilitation
This chapter will focus on individual resident and/or caregiver goals based on the resident's prognosis and potential for rehabilitation. The importance of advance care planning, hospice, and palliative care will be included, with a discussion of guidelines for hospice qualification.
3. Interactive Case Study
The case study will summarize and synthesize the learning related to the high-risk resident with dementia in the NF. Interactive technology will allow the learner to use his/her knowledge and skills to provide quality care and prevent unnecessary hospitalization for a complex resident with dementia.
