You are working in a long-term care facility with your cli…
The main question at hand is how to ensure equitable and high-value care for Mr. M, a client who has experienced a stroke resulting in paralysis on one side and expressive aphasia. Given that his long-term care insurance coverage is limited to 180 days per calendar year, it is essential to effectively coordinate services to facilitate his discharge before reaching this limit. However, the evaluation and measurement of Mr. M’s progress have proven challenging due to multiple problems, resulting in his readmission to the long-term care facility. As the care coordinator, it is crucial to be well-informed about the events and interventions taking place across all settings to optimize Mr. M’s outcome.
To address this question, it is important to consider the concept of equitable care. Equitable care refers to the fair distribution of resources and services based on individual needs, regardless of the person’s race, ethnicity, socioeconomic status, or other demographic factors (Fiscella & Epstein, 2008). In the case of Mr. M, equitable care means ensuring that he receives services and interventions based on his specific needs to maximize his recovery and overall quality of life.
One aspect of equitable care involves comprehensive assessments and evaluations. To provide high-value care, it is crucial to accurately measure Mr. M’s progress and adjust interventions accordingly. In the context of stroke rehabilitation, various standardized assessment tools can be utilized to evaluate physical function, cognitive abilities, communication skills, and overall quality of life (Duncan et al., 2005). Examples of these assessment tools include the National Institutes of Health Stroke Scale (NIHSS), the Functional Independence Measure (FIM), and the Boston Diagnostic Aphasia Examination (BDAE).
Using these assessment tools, the healthcare team can gather objective data to monitor Mr. M’s progress over time. Regular assessments can identify areas of improvement, stagnation, or decline, allowing for appropriate modification of intervention strategies to optimize his recovery. Additionally, baseline assessments at the time of admission can serve as a reference point to measure the effectiveness of the interventions implemented throughout the course of Mr. M’s care.
However, it is important to acknowledge the challenges in the evaluation and measurement of Mr. M’s progress that have been experienced thus far. These difficulties may be related to various factors, such as the complex nature of expressive aphasia and the limitations of existing assessment tools. Expressive aphasia, characterized by difficulty speaking and expressing oneself through language, can pose challenges in accurately capturing changes in communication abilities (Pedersen, Vinter, & Olsen, 2004). Furthermore, the existing assessment tools may not fully capture the intricacies of Mr. M’s condition, especially if they primarily focus on physical function rather than communication abilities.
To overcome these challenges, a comprehensive and multidisciplinary approach is essential. Collaboration among healthcare professionals, including speech therapists, occupational therapists, and rehabilitation nurses, can provide a holistic understanding of Mr. M’s capabilities and challenges. This multidisciplinary approach allows for a more comprehensive assessment that considers not only physical function but also communication abilities, cognitive skills, and psychosocial factors (Miller, 2010).
Implementing a person-centered approach is another crucial aspect of ensuring equitable and high-value care for Mr. M. Person-centered care involves tailoring interventions and support to meet the individual’s unique needs, preferences, and goals, with a focus on promoting autonomy and dignity (McCormack & McCance, 2017). In the context of stroke rehabilitation, person-centered care can be achieved through shared decision-making and goal-setting processes, where the client’s input is valued and incorporated into the care plan (Kuluski et al., 2017). This approach ensures that the care provided aligns with Mr. M’s personal goals and aspirations, enhancing his overall experience and outcome.
In conclusion, to ensure equitable and high-value care for Mr. M, it is crucial to implement comprehensive assessments and evaluations, utilize appropriate assessment tools, and adopt a multidisciplinary and person-centered approach. These strategies will enable the healthcare team to accurately measure Mr. M’s progress, tailor interventions to his specific needs, and promote his autonomy and dignity throughout the care process. By prioritizing equitable care, Mr. M’s outcome can be optimized, and his chances of unnecessary readmissions can be minimized, ensuring that his long-term care is both effective and efficient.