Kungani Ukuhlaziya Izakhamuzi Ezenzekayo Kubaluleke Kangako Ezihlinzekweni Zokunakekela Abahlengikazi Abaqeqeshiwe
Abaningi abahlengikazi abanamakhono abahlengikazi baqhuba izilinganiso zabakhona izakhamuzi ngaphambi kokuba bazivumele ukunakekelwa, kungakhathaliseki ukuthi kungokwesikhathi esifushane sokuvuselela kabusha , ukunakekelwa kwesikhashana noma ukunakekelwa kwengqondo. Lezi zicelo zangaphambi kokungeniswa zingasiza ekunqumeni izidingo zomuntu futhi ziqinisekise ukuthi indawo ihlomele kahle ukubhekana nalezi zidingo. Ukukhomba ukuthi yiziphi izingxenye zokuhlola, nokuqonda ukuthi kungani ukuhlolwa kokungena ngaphambi kokungenwa kubaluleke kakhulu, kungenza kube lula ukuthuthukiswa kwamasevisi weMediare & Medicaid Services (CMS) izinyathelo ezinhlanu zekhwalithi kanye nokwaneliseka komhlali.
Izigaba zokuhlola
Izibalo zabantu
Lolu lwazi lubandakanya igama, usuku lokuzalwa, ubulili, nekheli.
Umlando Wezokwelapha Oyisisekelo
Lokhu kufaka phakathi ulwazi olunjengokuphakama nesisindo, imithi yokwelashwa noma ukudla, kanye nohlu oluphelele lokuxilongwa. Kufanele ubuyekeze umlando wamuva kanye nomzimba ukuze uthole isithombe esihle sezithombe zezokwelapha zalesi ohlala khona. (Umlando kanye nomzimba kuyadingeka ukuvunyelwa, ngakho ukuyibuyekeza ngaphambi kwesikhathi kubalulekile.)
Uma kudingekile, cela ukuthi ngabe kube yini ukunakekelwa kwe-hospice noma ukunakekelwa kwezinwele okubandakanyekayo ekunakekeleni kwakhe, njengoba lokhu kuzothinta uhlelo lwakhe lokunakekelwa kanye nokukwazi ukuhlinzekwa kwe-Medicare.
Umshuwalense, Izimali, nokukhokha
Qinisekisa ama-Insurances
Qoqa imininingwane yomshuwalense ukuze ubone ukuthi ukutholakala kuyatholakala. Umshuwalense, okufaka phakathi i-Medicare, i-Medicaid, umshuwalense wokunakekelwa yesikhathi eside, kanye nezinye izimpahla zokuzimela ezizimele zonke zidinga ukuqinisekiswa ngenqubo yokuhlinzeka kanye nezinqubo zokugunyazwa.
I-Medicare noma i-Medicare Advantage Plan Prior-Authorization
Izinhlelo Eziningi Zenzuzo zidinga ukuba indawo ithola imvume ngaphambi kokukhokhelwa ukuvuselelwa okuncane. Lokhu kusho ukuthi uhlelo lomshwalense luqinisekisa futhi luvuma ukumboza lowo muntu ngezinsuku ezithile. Ukufakwa okuqhubekayo ngalezi zinsuku zokuqala kuvame ukunikezwa kepha kusekelwe ekuhlaleni ulwazi ngemuva kokuba umuntu ehlala esikhungweni sakho izinsuku ezimbalwa.
Izidingo kanye nokuhlelwa kwesikhathi zivame ukuhlukana kwezimbambiso ezihlukahlukene, ngakho-ke uzofuna ukuqinisekisa ukuthi uyazazi lezo zinto.
Ukusabalala kweMithi yesintu akudingi noma yikuphi ukugunyazwa kwangaphambili, kodwa uzofuna ukuqinisekisa ukuthi lowo ohlala khona angafaneleka ngokomuthi we-Medicare Part A, ukuze lapho uqhuba ukuhlola kwakho okuncane okungaphansi kweDatha (MDS), awumangazi izinga lakhe lokunakekelwa.
Ukufaneleka okuKhokhelwayo noma okuMedicaid
Uma umuntu ohlala khona ehlela ukuhlala esikhungweni sakho futhi athole izinsizakalo zokunakekelwa isikhathi eside, thola ukuthi kukhona yini izimali zangasese ezitholakalayo noma uma ezokwazi ukuthola ukuhlinzekwa kweMedicaid kumakhaya asebekhulile. Kubalulekile ukubuza imibuzo eyanele yokwazi ukuthi ngabe usuvele uvunyelwe yini ukuze uthole i-Medicaid, uma efake isicelo seMedicaid futhi isicelo sakhe sisalindelwe, kungakhathaliseki ukuthi cishe sizovunyelwa, futhi uma sinikezwe imali (imali ehlukanisiwe) engavumelekile noma kumbambezele ukuba angamukeli imvume ye-Medicaid.
Izinga Lokuhlolwa Lokunakekelwa Kwezempilo
Uma ukungena kwakho okungenzeka kungena esikhungweni sakho kusuka ekhaya futhi uhlela ukuhlanganiswa ne-Medicaid, qiniseka ukuthi ungahlolisisi kahle izinga lakhe lokunakekelwa ngeThuluzi likaMbuso we-Medicaid.
Ngenkathi ungenakufaka lokhu kuhlola ohlelweni lweMedicaid ngaphambi kokuba umuntu avunyelwe esikhungweni sakho, udinga ukwazi ukuthi i-Medicaid izokwenzela ukunakekelwa uma ihlala ohlala endaweni yakho. I-medicaid idinga kokubili ukufaneleka kwezezimali nezempilo.
Ngokuyinhloko, uhlola ukuthi ngabe ngubani ozohlala khona unezidingo zokwanele okwanele ukuze uMedicaid azinakekele esikhungweni sakho. Noma, ingabe kudingeka ngandlela-thile athole izinsizakalo ezengeziwe ekhaya lakhe ngoba "enhle kakhulu" ukumbozwa yi-Medicaid esikhungweni sokunakekelwa isikhathi eside?
Uhlelo lomndeni kanye nokweseka
Ukuhlola kwakho kumele kubone amagama kanye nolwazi lokuthintana nabo abamele umndeni nabakhileyo, okufaka phakathi uma kukhona amandla ommeli wezempilo noma ezezimali , kanye nokuthi umgcini wezomthetho ukhethwe enkantolo.
Kubalulekile ukucacisa ukuthi kukhona abanye abangakwazi ukusekela ohlalayo uma amalungu omndeni engatholakali.
Ikhono lolimi nokuxhumana
Thola ukuthi ulimi oluyinhloko lomhlali lungabonakala yini uma kuzodingeka umhumushi. Kudingeka uqinisekise ukukhulumisana okwanele nomhlali.
Ngaphandle kolimi, kubalulekile nokuhlola ikhono lomhlali lokukhulumisana nezidingo nokuqonda ukuxhumana kwabanye. Ukuxilongwa njengesifo se-Alzheimer kungaba ukukhawulela kokubili ukukhulumisana nokukhulumisana okuhle.
Ikhono lokuhlala lomuntu ongakwazi ukukhuluma nalo lingathinteka nokukwazi kwakhe ukuzwa nokubona.
Uhlu lweMithi kanye ne-Pharmacy Cost Estimate
Qiniseka ukuthi ubuyekeze uhlu oluphelele lwemithi enqunyelwe umuntu okhulunywe ngaye. Udinga lokhu ngezizathu ezimbili.
Owokuqala wukuthi unakekele kahle umuntu. Uhlu lwezokwelapha olugcwele luyadingeka ukuze uvume umuntu endaweni yakho ngemigomo. Udinga ukwazi wonke umuthi wemithi, ngakho buza ukuthi kukhona yini izinto zemvelo noma izithako ezithathayo.
Isizathu sesibili sokubukeza imithi sihlobene nemali. Uma uhlelo lwe-Medicare A noma lwe-Medicare Benevantage ngumthombo oyinhloko wokukhokha, lesi sikhungo siyadingeka ukukhokha yonke imithi yalo muntu. Lokhu kungenxa yokuthi izindleko zemithi ifakwe esilinganisweni samalanga onke esikhokhwa ngaphansi kwe-inshuwalense yokuvuselela i-inshubhe, kodwa lelozinga alilungiswa ngokususelwa kulokho imithi enqunywe khona.
Ezinye izimo zibuhlungu kakhulu ngoba umuntu okhulunywe ngaye udinga ukwelapha iziguli futhi ungakwazi ukuhlangabezana nezidingo zakhe, kodwa kungenzeka abe nemithi ebiza okungaphezulu kakhulu kwansuku zonke isikhungo sakho sizokhokhwa ukuze simnakekele.
Izinsiza Zezokwelapha Ezingapheliyo
Iziphi izidingo zokusebenza ezikhona? Isibonelo, ingabe i-oxygen? Ingabe usebenzisa i-walker noma isitulo sabakhubazekile ukuze azungeze? Ingabe ulala nomshini we-CPAP ngenxa ye- apnea yokulala ? Nakuba ezinye zalezi zicucu zingase zifike ngokufakwa okusha, ezinye (ezifana ne-oksijeni) kuzodingeka ziqalwe lapho zifika esakhiweni sakho.
Ukwengeza, ezinye izinto zokwelashwa ezihlala njalo zingabiza, ngakho izindleko zemishini zingathinta isinqumo uma isikhungo sakho singakwazi ukunakekelwa ngokwezimali ngomhlalaphansi.
Ulwazi lwe-MDS
Uma umuntu ohlala esikhungweni sokunakekelwa isikhathi eside esuka kwenye indawo kuya kwesinye, ungacela ulwazi oluthile oluthile lokubeka idatha (MDS) . Lokhu kufanele kukunikeze isithombe esihle sesidingo sakhe, ukuze ukwazi ukuqinisekisa ukuthi uyakwazi ukuhlangabezana nazo.
Izidingo Zomsizi
Uma ungenayo ukufinyelela kwe-MDS noma ukuhlolwa kokusebenza komzimba noma okusebenzayo, kudingeka ubuyekeze amazinga osizo oludingekayo.
Isibonelo, ingabe udinga usizo lomuntu oyedwa noma ababili ukudlulisa? Ungakwazi yini ukuhamba embhedeni ngokuzimela noma udinga usizo? Ingabe udla ngokuzimela noma udinga usizo? Kuthiwani ngekhono lakhe lokuhamba? Ingabe udinga usizo ngokugqoka? Ingabe i- continent yesibindi nesisu , ingabe isebenzisa imikhiqizo ethile ukusiza ukuphatha lokho, noma ingabe idinga ukuhanjiswa ngezikhathi ezithile zosuku? Lonke lolu lwazi lungakusiza ukuthi uqonde isithombe esiphezulu sokuthi ungamnakekela kanjani lo ohlala khona esikhungweni sakho.
Umlando we-Falls
Hlola ukuthi ngabe ukhona yini ukuwa kwamanje. Uma kunjalo, buza nini futhi kwenzekani, ukuze ukwazi ukusebenzisa lolu lwazi ukuze usebenze ngokunakekelwa kwezokwelapha kanye nokuzama ukunciphisa ukuwa kwakhe .
Isimo sesikhumba
Kubalulekile ukwazi uma othile eza kuwe nganoma yiziphi izindawo ezivulekile, njengengcindezi enkulu . Udinga ukwazi lokhu ukuhlola ikhono lakho lokunikeza ukunakekelwa okudingekile kanye nokubhala ukuthi uza kuwe ngaleyo ndlela ebuhlungu, kunokuba uthole lokho okubi emva kokungena kwakhe futhi engakwazi ukufakazela ukuthi unakho ngaphambi kokuba eze kuwe . Kumele uqaphele izindleko zokwelashwa ezibekiwe kunoma yikuphi ukucindezeleka okukhulu.
Kubalulekile futhi ukubuza mayelana nanoma yikuphi ukulimaza , kuhlanganise ukuvuthwa kwamanje kanye nomlando wokulimala kalula ngenxa ye-anticoagulants njenge-Aspirin noma ezinye izinto eziyingozi.
Ukusebenza kokuqonda
Uma uhlola umuntu ohlala emphakathini, kubalulekile ukuthola isithombe senqubo yakhe yokusebenza kwengqondo. Ngaphansi, ungabuza imibuzo mayelana nenkumbulo yakhe kanye nokwenza izinqumo. Uma uhamba ukuze umhlole yena, ungasebenzisa i- BIMS , SLUMS noma i- MoCA ukuyihlola ngokuningiliziwe, uma uzizwa ukuthi kufanelekile.
Izinga lokunakekelwa kwe-Dementia liyadingeka
Uma umuntu ohlala khona ene-dementia, cabanga ukuthi udinga i- unit of dementia evikelekile noma ngabe uzophepha ephepheni elivulekile. Ukubona ingozi yokuhlunga kubalulekile ngoba uma uvuma ukuthi uhlala endaweni yakho, unesibopho sokuphepha kwakhe, kubandakanya ukumvimbela ukuba angaphumi emnyango.
Izidingo Zomzwelo Nezifo
Ukuthola noma yikuphi ukugula kwengqondo noma ukuhlola izifo zengqondo ukuthi ngubani ohlala khona futhi uqinisekise ukuthi unamandla okuhlangabezana nalezi zidingo. Lokhu kuhlanganisa ukuxilongwa okunjenge-schizophrenia kanye nesifo sokucindezeleka ngemuva kokucindezeleka.
Ukukhathazeka Kokuziphatha
Thola ukuthi yikuphi ukukhathazeka kokuziphatha okwamanje. Lokhu kungenzeka ikakhulukazi kulabo abaphila nokuphefumula komqondo. Esikhundleni sokubuza umbuzo ojwayelekile mayelana " nokuziphatha okunzima ," buza ukuthi uthola ukukhathazeka noma uthukuthele lapho ethola ukunakekelwa, uma ezama ukuphuma endlini, noma isizathu esithile esithola ukuthi uthola imithi yokwelashwa . Uma ucabangela ukuhanjiswa esibhedlela, qiniseka ukuthi ubuza ukuthi ngabe ukhona yini "umhleli," "ilungu elilodwa," noma ukuqapha okwenziwe ngenxa yokuziphatha.
Ukuhlukunyezwa kwezinto
Uzodinga ukwazi uma kukhona umlando wokusetshenziswa kwezidakamizwa noma ukuxhashazwa, kungakhathaliseki ukuthi yizidakamizwa zomthetho noma ezingekho emthethweni. Ukukhathazeka okubonakalayo kule ndawo kuzoba nomthelela ohlelweni lwakho lwezokwelapha kulo mhlali.
Amalungiselelo okuPhambi kokuPhila
Ukuze iziguli zokuhlala kabusha zesikhathi esifushane, cacise ukuthi ziphi lapho zihlala khona kuze kube manje, futhi uma izilungiselelo zabo zokuhlala zibavumela ukuba babuyele lapho ngemuva kokuthola ukuvuselelwa esikhungweni sakho.
Izinhlelo zokuKhipha
Ngokufanayo, ukuhlelwa kokuhlelwa kufanele kuqale ngaphambi kokuba umuntu ohlala njalo ebeka unyawo emnyango wakho. Kubalulekile ukuhlonza izinhlelo zabo nezifiso zakho ukuze uhlose ukuhlola ukuphepha kwalawo macebo futhi uhambele kubo.
Imibuzo Nokuvakasha
Vumela isikhathi somuntu ohlala khona futhi ophetheyo ukubuza imibuzo mayelana nendawo yakho bese ubakhuthaza ukuba bavakashele ukuze baqiniseke ukuthi kufanelekile. Ungase ube nesifiso sokugcwalisa imibhede yakho, kepha ukunika isikhathi sokuba lezi zinyathelo zingaphinde zisindise isikhathi esilandelayo.
Okuhlangenwe nakho Okungalungile Kwangaphambili
Uma umuntu othakazelayo enethemba lokudlulisa kusuka kwesinye isikhungo esifanayo, mbuze ngokuzithoba ukuthi ngabe uzokhathalela yini ukwabelana ngezizathu zakhe ukuthi kungani angathanda ukuhamba.
Ngenkathi kunezikhathi lapho ukuphathwa okulula (njengendawo yesikhungo) kungahle kwenzeke ushintsho, kungase kube nezinye izimo lapho kube khona inkinga enkulu ekunakekeleni umuntu okutholakele kwenye indawo. Ukuqaphela lezi zimpikiswano ngaphambi kokungeniswa kungakusiza ukuthi uxoxe ngokuthi indawo yakho ingabaphatha kanjani futhi unikeze umhlali onokuqonda ukuthi ngabe usafuna yini ukuthuthela endaweni yakho. Ibuye ikuvumele ukuba uthole ulwazi mayelana nokulindela kwakhe futhi anqume uma ungawahlangabeza.
Ukubaluleka kokuhlolwa kwangaphambi kokungena
Ukuhlolwa kwangaphambi kokungenwa kuthatha isikhathi sokuqhuba, kodwa ngokuvamile kusetshenziswe kahle. Nazi izizathu ezimbalwa zokuthi kungani zibaluleke kakhulu.
Okokuqala, uma uvuma ohlala kuzo, unesibopho ngokugcwele ukunakekelwa kwakhe. Ukwazi ukuthi yini okudingekayo ukunakekelwa kuyadingeka.
Ngaphezu kwalokho, imithethonqubo ye-CMS yenza kube nzima ukukhipha umuntu ngokuzibophezela-ukuvikelwa kokunakekela nokuhlala kahle komhlali. Ngakho-ke, uma izinto zingahambi kahle noma kunezinga eliphezulu lezidingo ongazange wazi, awukwazi nje ukuthumela lowo muntu kwenye indawo.
Ukuhlolwa kwangaphambi kokungeniswa nakho kuyasiza ekulawulweni kwezinhlekelele. Ukwazi izikhalazo ezihlala kuzo kusengaphambili kwenza kube lula ukuthi abasebenzi bakho bangasebenza ukubhekana nabo.
Njengoba kushiwo ngaphambili, umthelela wezezimali wokungena kubalulekile. Nakuba ukugxila kwabantu abaningi abasebenza esikhungweni sokunakekelwa nokuhlengikaza ukukhathalela izakhamizi zabo, inhlangano yakho kufanele ihlale ikwazi ukukhokhela imali ukuze iqhubeke nokuhlinzeka lezo zinsizakalo kulabo abadinga.
Ukuhlolwa kwangaphambi kokungenwa kubalulekile njengoba kuhlobene nesigaba se-CMS izidingo ezimbili zokubamba iqhaza-ikakhulukazi, lokho kokuhlolwa kwesakhiwo kanye nezakhono zabasebenzi. Ukuhlolwa kwesikhungo kubonisa ukuthi iziphi izidingo zezokwelapha ezidingekayo ukuhlangabezana nazo, kanti izidingo zamakhono zibhekene nezidingo zokuqinisekisa ukuthi abasebenzi bakho (ngesinye isinye) bangakwazi ukuhlangabezana nezidingo zabo ngokunethezeka futhi ngokuphumelelayo.
Izwi elivela
Ukuqhuba ukuhlolwa kwangaphambi kokungeniswa kwangaphambili kunezinzuzo eziningi, kokubili isikhungo kanye nekhwalithi yokunakekelwa komhlali. Ekugcineni, kungakusiza ukuba uhlangabezane nomgomo wokuqinisekisa ukuthi inqubo yokungena iyaphumelela ngokuphumelelayo nangempumelelo kulabo abathintekayo.
> Imithombo:
I-Delaware Impilo Nezenhlalakahle. Uhlu Lokuxilongwa Nezokwelapha. Ukuhlolwa kokuqala kokungeniswa (PAE) Ithuluzi lokuThatha isikhathi eside-001. http://clpc.ucsf.edu/sites/clpc.ucsf.edu/files/Delaware%20Pre-Admission%20Evaluation.pdf
> Scott & White. UDS-Pro. Ukuhlolwa kokungena ngaphambilini. http://www.sw.org/resources/docs/patient-forms/uds-pro-premission-assessment.pdf