Critical Path Network-Center for Case Management CareMap® Tool for deconditioned frail elders
The Deconditioned Frail Elder CareMap® Tool is designed to reflect the postacute continuum of care for patients experiencing deconditioning as a result of an acute medical event (i.e., pneumonia, CHF, etc.). (See excerpts of the CareMap® Tool, pp. 88-90.) These patients require time-limited support to return to a previous level of functioning in the least restrictive environment. This support may occur in that environment or in an inpatient facility. This decision is dependent upon the individual's needs, support systems, resources, and wishes. Regardless of where care is provided, the outcomes remain consistent.
The tool is intended to be individualized to reflect the patient's unique needs and requirements. Signature and date at the bottom of the intervention/outcomes section and initials next to the interventions in the appropriate day indicate completion of interventions or achievement of outcomes. If an outcome is not achieved, it may be circled and arrowed to the next 48 hour segment. If the patient is still unable to achieve the outcome, this signals the need for a patient/ family/health care team meeting to reassess the appropriateness of the plan for this patient.
Editor's note: This month's Critical Path Network appears courtesy of the Center for Case Management in South Natick, MA. It is reprinted by permission. For more information, contact the Center for Case Management at (508) 651-2600.