About Frank

 

Age:  39

Diagnosis:  Mild MR, Anger Management

Medical:  None

History:  7 years at 66th

About Bob

Age:  52

Diagnosis:  Moderate MR, Dyslexia

Medical:  Nothing significant

History:  13 years at 66th

About John

 

Age: 55

Diagnosis:  Mild MR

Medical:  Seizure Disorder

History:  13 years at 66th

Situation

  • Men have lived together for a long time at the 66th St. home
  • 1 staff 4:30 – 10:30 pm, sleep staff 10:30 pm – 6:00 am, then awake 6:00 – 8:00 am
  • Overnight staff costs = 7.5 hr/night X $7.25/hr X 365 nights = $19,846.87 + 25% T&B = $24,808.59/yr
  • When tracked for 3 months, there were no instances of overnight staff called to duty
  • Provider  has another four person home, Broadway 2 blocks away with an awake staff and a sleep staff on duty during the overnight
  • Each gentleman has six-plus hours of alone time

  • Able to make simple snacks

  • Independent in most ADL’s

  • Independently get up and ready for work
  • Frank smokes and gets up during the night occasionally to have a cigarette

  • Need assistance with money management, meal planning and medication administration

  • John and Bob have medications they need before going to work
  • Bob and Frank want more independence and have talked of wanting own apartment

  • John likes his home and living with Bob and Frank, no expressed preference for greater independence

  • Provider under pressure to reduce costs

The Plan for Overnight Supervision

  • Use technology to remove overnight staff at 66th
  • The awake staff at Broadway acts as response staff and receives the overnight alerts
  • If/when an alert comes, the awake staff awakens the sleep staff at Broadway to monitor that house
  • At the end of the Broadway staff shift (7:00 am), staff goes to 66th to pass meds and assure all get off to work 

Cost

  • Sengistix monthly SENS – $299.95/month = $3,599.40/year
  • Note:  if Active Monitoring was needed 7.5 hours/night, add $10,129/year

The Outcome of Overnight Supervision

  • First week – Broadway staff was called to go to 66th seven times (three in one night) all for Frank “out of bed”
  • Second week – six alerts, adjusted timing of monitor to give Frank more time (15 minutes) to come back in
  • Third week – no alerts
  • In the past three months:
    • Two alerts for front door opening
    • One alert for patio door
    • One pendant
  • All three gentlemen report liking the fact they are home alone at night
  • All three – but especially Bob and John have shown increased initiative in doing more for themselves generally and increased assertiveness
  • The men are all getting their own breakfasts