Adult Residential Day Care, A Program Development and Operations Guide, Cohen, McDermott, Smith, and Loomis. Boise, Idaho, Mountain States Health Corporation, 1984, 204 pages, softcover spiral bound.
This manual is the result of a demonstration grant from HHS focusing on adult residential day care, both in the client's own home and in the home of the care provider. The teamwork of nursing and social work in using lay providers for such care is highlighted.
The manual describes the project in Idaho, so anyone else using the manual would have to exercise caution from a legal standpoint. For example, some states may require a chauffeur's license to transport for hire a client around town or may prevent the care of someone in a provider's home.
The manual describes how to set up a residential day care program, including financing, administrative staff, marketing for clients, recruitment and training of lay care providers , caseload , supervision, and quality control. Several forms - eg, provider selection, intake, functional assessment, care plans, invoices, etc - are included in the manual.
Job descriptions for administrative staff are also included, but are very sketchy, especially on educational background of the recommended GNP and social worker. One would also question the author's proposal that a case manager also could be the agency manager. The job descriptions of these individuals are such that the jobs should not be combined, especially with a growing caseload. Because of her clinical skills, a GNP is recommended if the program can only support one administrative staff person.
The nursing care plan given as an example has some less than desirable points; eg, use of macrodanti as a UTI preventive, lack of use of accepted nursing diagnoses, and poor nursing problem identification. Therefore, tasks identified for the fay care provider to carry out may not provide the interventions necessary to resolve or prevent the problem or meet the goals of care.
A sketchy curriculum guide for the training of the lay providers is included. Unfortunately, the authors state that their curriculum focus is the medical model, and this is evident in the guide, especially in the case vignettes. Too bad that some of nursing's workable theories were not used in the development of this guide. Expected outcomes are too broadly stated, so measurement of these outcomes would be difficult. The suggested quizzes require essay answers - not always a good choice with this level of workers.