OSF SENIOR WORLD Adult Day Services Guidebook

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OSF SENIOR WORLDAdult Day Services Guidebook

Welcome toOSF SENIOR WORLD ADULT DAY SERVICESOSF Senior World is an outpatient service of OSF HealthCare SaintFrancis Medical Center. Started in 1981, it is the only certified adult dayservices program in Peoria, Tazewell and Woodford counties.OSF Senior World offers programming to seniors who are frail, disabled,memory impaired or socially isolated. Serving seniors who are not yet readyfor long-term care, but who are in need of supervision, OSF Senior Worldallows caregivers respite from their daytime responsibilities. Services areoffered to individuals age 60 and older, but also are available to people whoare in their 40s and 50s, as long as they meet admission criteria.OSF Senior World operates during daytime hours Monday through Friday(hours vary by site). Seniors may attend one or more days per week, butmust commit to a regular schedule. OSF Senior World staff will makeevery effort to work with caregivers’ work schedules. Advance notice for anincrease in time is necessary for staffing purposes.Participants may pay privately to attend or may receive funding that will payfor all or a portion of the time spent at OSF Senior World. Transportation isavailable from many areas upon request and is discussed with the individualand family during enrollment.We hope you and your loved one can benefit from our program.This handbook will answer most questions regarding our services, but pleasecontact us if you need further explanation.Thank you for your interest in our program.

TABLE OF CONTENTSMission. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6What We Do . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Program Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Admission Process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Admission Criteria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Funding Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Attendance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Late Pickup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Arrivals/Departures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Transportation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Transportation Provider Phone Numbers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Closings and Winter Weather. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Medical Emergency. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12POLST. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12AED. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Medication Administration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Illness Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Flu and Pneumonia Vaccinations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14ARA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Participant Updates and Care Plan Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Incontinence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Emergency Showers and Sponge Baths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Meals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Parties, Special Events and Outside Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164

Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Money and Valuable Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Donations and Memorials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Safety Drills. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Security and Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Cellphones. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Pictures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Outer Clothing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Discharge Policy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Hours of Operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Caregiver Groups. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Community Involvement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Cancellations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23OUR STAFFOSF Senior World staff includes gerontologists, socialworkers, nurses, patient care technicians, physical therapistsand activity coordinators. OSF Senior World meets themandated federal and state staff-to-client ratios.5

MISSIONIn the spirit of Christ and the example of Francis of Assisi, the Mission ofOSF HealthCare is to serve persons with the greatest care and love in acommunity that celebrates the Gift of Life.WHAT WE DOOSF Senior World is a day program that provides a safe, therapeuticenvironment where older and disabled adults participate in social, cognitiveand spiritual activities. By meeting the nursing and personal care needs ofour participants, we help decrease premature institutionalization by meetingthe nursing and personal needs of our participants and offering caregiverssupport and respite.SERVICES Development of a participant care plan Assistance with daily-living activities Therapeutic activity program Daily exercise program Sensory stimulation Spiritual activities Nursing services, medication administration Reassurance and emotional support Transportation arrangements Nutritious meals Secure, supervised environment6

PROGRAM GOALSWe seek to keep participants in their home setting by giving familymembers and caregivers emotional support, education and respite.We strive to prevent social isolation and promote participation, working withparticipants to maintain and improve: communication skills self-esteem and self-confidence physical health and mobility nutritional status emotional health cognitive functioningADMISSION PROCESSOSF Senior World adult day services offers programming to individuals age60 and older, but also will assist individuals in their 40s and 50s as long asthey meet admission requirements and criteria.Potential participants and their family should tour OSF Senior Worldto determine whether the program and facility meet their needs. Theresponsible person will sign a release, so Senior World nurses can acquirethe potential participant’s health and physical records, medication list,allergy list, and a diet order from their physician prior to being approved forenrollment in the program.After all the above information is received, an assessment visit is scheduled.This visit introduces the potential participant to the program and enablesOSF Senior World staff to assess the individual’s strengths and functionalabilities.If it is determined that enrollment in the program will be beneficial,then enrollment paperwork will be provided. This paperwork needs to becompleted and returned by the first day of attendance.7

ADMISSION CRITERIAEach OSF Senior World participant must be able to meet one or more of thefollowing criteria: O ne or more (physical, nutritional or social) diagnoses that would benefitfrom a structured environment. A need for socialization due to inability to initiate involvement incommunity settings. O ne or more medical diagnoses that require assistance, support orsupervision from others for activities of daily living.All participants must meet the following criteria: Be free from communicable disease. N eed no more than one-person assistance for toileting and personal careneeds. Be sufficiently oriented and cooperative. Be able to participate in group activities without one-on-one assistance. H ave an active responsible person who can assist with initial paperwork,annual review and medical updates as needed. W ithin the six months prior to enrollment, be cleared by a primary careprovider to participate in a community setting.8

FEESFees are determined by attendance. Half-day and full-day rates areavailable. OSF HealthCare mails out invoices every 30 days, and fullpayment is expected. If you do not receive an invoice, please contact OSFSenior World.OSF Senior World reserves the right to withhold services until payment ismade.FUNDING OPTIONSOSF Senior World receives funding from the Illinois Department onAging’s Community Care Program, the Department of Veterans Affairs,the Office of Rehabilitation Services and the Central Illinois Agency onAging. Currently, no Medicare coverage for adult day services exists, butsome long-term policies will reimburse an individual for adult day servicesexpenses. T he Illinois Department on Aging Community Care Program is forindividuals age 60 and older who meet the eligibility requirements asdetermined by a case manager. This program pays for services based onliquid assets and income. D epartment of Veterans Affairs is for veterans who can benefit from adultday services as determined by physicians at the local VA Clinic. O ffice of Rehabilitation Services is for individuals age 59 and youngerwho meet eligibility requirements as determined by the Home ServicesProgram counselors. There is no cost for those eligible for this funding. C entral Illinois Agency on Aging is for caregivers of adults age 60 or olderwho need respite.Please note: If a participant receives funds from one of the above servicesand they exceed the number of hours authorized, OSF Senior World willcharge privately for the extra time a participant spends at the facility.9

ATTENDANCEOSF Senior World requires that each participant commits to a minimum ofone day per week for a minimum of four hours. The amount of time spent atOSF Senior World is determined by the individual, family or funding source.Establishing a routine is key to the success of the program. Adult dayprograms provide many benefits for participants with dedicated attendance.We understand that emergencies, illnesses or unavoidable appointmentsoccasionally occur on the day you are scheduled, and we will work with youand your family to make adjustments as required.When participants are registered for OSF Senior World, the Consent/Agreement form details their assigned days and hours of attendance. Ifthe need arises to make a change, please notify OSF Senior World at least24 hours in advance. If you must cancel on a day you are scheduled, pleasenotify us no later than 9 a.m. to avoid charges. Participants must arrive nolater than 11 a.m. on scheduled days and go home no earlier than 1 p.m.LATE PICKUPOSF Senior World participants must be picked up by closing time. If pickedup after closing time, an additional fee of 10 for every five minutes will becharged. If a participant is not picked up by closing, OSF Senior World willcall the emergency contacts until a party is reached. If no party is reachedwithin 30 minutes, we will notify the police and Adult Protective Servicesfor The Center for Prevention of Abuse.If an alternative pickup time has been scheduled and the participant’s rideis late, OSF Senior World will call the emergency contacts until a party isreached. Additional daily fees may apply.ARRIVALS AND DEPARTURESWhen a participant arrives at the center, OSF Senior World staff expectsthe family or caregiver to bring the participant into the building. We willthen escort the participant into the main activity room.When a participant departs from the center, OSF Senior World staff willescort the participant to the front door. OSF Senior World staff maintains10

a list of people who are authorized to transport each participant. If someonewhose name is not on that list arrives to transport the individual, or if staffhas not been informed of any changes, we will place a phone call to theprimary caregiver for permission to send their loved one home with theperson at the center. We also may request a photo ID of the person who istransporting the participant.TRANSPORTATIONOSF Senior World participants have access to alternative transportation ifthe family or caregiver is unable to transport them to and from the center.CityLift (City of Peoria and East Peoria), CountyLink (rural PeoriaCounty), We Care (Tazewell and Woodford counties) and Miller SeniorCitizens Center (Pekin) provide our seniors with transportation. Cost variesdepending on the provider, but those who receive funding to attend OSFSenior World will have the cost for transportation incorporated into theircare plan.The vans run on regular routes and pick up many people each day.Participant pickup and return times are determined by the individualaddresses; therefore, scheduling flexibility may be limited.Once a participant becomes an established rider, it is extremely importantthat they or one of their family members call the transportation provider tocancel a ride if they are unable to attend OSF Senior World. Cancellationsor scheduling changes must be made 24 hours in advance. In specialcircumstances, such as the onset of illness, cancellation must be made nolater than two hours before the scheduled pickup time.11

TRANSPORTATION PROVIDER PHONE NUMBERSCityLift – (309) 999-3667CountyLink – (309) 999-3667We Care, Inc. – (309) 263-7708Miller Center – (309) 346-5210CLOSINGS AND WINTER WEATHEROSF Senior World is closed on the following holidays: New Year’s Day,Memorial Day, Independence Day, Labor Day, Thanksgiving Day andChristmas Day. There may be additional dates, but sufficient notice will beprovided. If one of these holidays falls on a Saturday, OSF Senior World willclose on the Friday before the holiday. If the holiday falls on a Sunday, OSFSenior World will close on the Monday after the holiday.On very rare occasions, OSF Senior World may cancel its program for theday due to extremely bad weather, usually because vans and staff are unableto get to our facility. In the event of bad weather, tune to WMBD radio,or watch WEEK-TV, WHOI-TV or WMBD-TV for a cancellation notice.Staff will attempt to contact each family directly to inform them that theprogram will be closed for the day.MEDICAL EMERGENCYIn the event of a medical emergency, OSF Senior World will provide basicfirst aid, including CPR if necessary, and call 911. The family or caregiverwill be notified immediately (a working caregiver phone number is required).If necessary, the ambulance will transport the participant to their hospitalof choice. The participant or family is responsible for the medical orambulance bills that result.POLST (PRACTITIONER ORDER FOR LIFESUSTAINING TREATMENT)OSF Senior World honors participants’ POLST orders. The POLST is anorder that is signed by a physician authorizing actions to be done if a personis or is not in cardiopulmonary arrest. Families are responsible for notifying12

OSF Senior World about the existence of a POLST and other advancedirectives. Please provide a copy of all advance directives, and keep staffnotified of any changes. A copy of the physician-signed POLST must be atOSF Senior World in order to comply.AED (AUTOMATIC ELECTRONIC DEFIBRILLATOR)Cardiopulmonary arrest, a disruption in the heart’s normal beating pattern,is responsible for thousands of deaths each year. An AED (AutomaticElectronic Defibrillator) is a device that delivers a shock to the heart tohelp restore the heart to a normal beating pattern. Since survival from acardiopulmonary arrest is dependent upon how quickly a person receiveslifesaving care, OSF Senior World is proud to report that an AED isavailable onsite for immediate emergency use.MEDICATION ADMINISTRATIONThe nurses of OSF Senior World can administer medications with aphysician’s order. The medication must be brought to the facility in aprescription container that is labeled and not expired.The container must be labeled with the following information: Patient’s full name The doctor’s name Prescription number Name of medication and dosage Date of issue for the medication Name, address, and phone number of pharmacyOSF Senior World asks that family members provide a one-month supplyof the prescribed medication the nurses are to administer. A one-monthsupply equals the amount of medication needed for the days a participant isscheduled to attend OSF Senior World within a given month. OSF SeniorWorld program nurses cannot administer vitamins, over-the-counter drugsor other supplements not prescribed by a doctor.13

ILLNESS POLICYIf the participant is experiencing any of the symptoms listed below, we ask thatthey remain at home until the symptoms disappear: Fever of 99.9 degrees or above Nausea or vomiting Excessive coughing and sneezing Chills or headache Diarrhea Discharge from the nose of a yellow, green, or tan color Coughing up phlegm of a yellow, green, or tan color Conjunctivitis (pink eye) that has not yet been treated with antibioticsfor at least 24 hours Communicable disease (i.e. shingles) Bed bugs or scabiesIf your family member has any of the above symptoms while at OSF SeniorWorld, staff nurses will assess the situation and notify a family member orcaregiver to request that someone come to OSF Senior World to transportthe participant home.FLU AND PNEUMONIA VACCINATIONSWhile OSF Senior World does not require its participants to be vaccinatedagainst flu or pneumonia, we strongly encourage all participants to bevaccinated.COMMUNICATIONIf the participant’s family member or caregiver will not be reachable at theirregular phone number, an alternate phone number should be provided. Ifthere are any changes in your loved one’s health, behavioral or functionalstatus, OSF Senior World staff will keep caregivers informed.14

Please feel free to contact us at any time with questions regarding theparticipant. Please also keep staff informed of any and all changes with theparticipant at home or when a hospitalization may occur.AUTHORIZATION/RELEASE/AGREEMENT TO PAY (ARA)At the beginning of each month, OSF HealthCare requires that theAuthorization/Release/Agreement to Pay (ARA) be signed for eachparticipant. This form allows us to provide on-site care and bill theappropriate funding source. This form can be signed at the OSF SeniorWorld facility or can be mailed home and promptly returned.PARTICIPANT UPDATES AND CARE PLAN REVIEWOSF Senior World staff will ask you or your family to update medical andpersonal information annually during the care plan review (see note below).The care plan highlights a plan of action to provide care to the participantwhile at OSF Senior World and sets person-centered goals. During thecare plan review, you or your family will be given an opportunity to updateinformation regarding changes in address, phone, caregivers, hospitalpreference, physicians, medications, allergies and health changes.Please note: Notify OSF Senior World staff immediately when there are anychanges in personal information or health information. Do not wait for thecare plan review.INCONTINENCEIncontinence is not an issue with OSF Senior World as long as theincontinence can be managed or controlled. If the participant regularlyneeds incontinence supplies (Adult diapers, wet wipes, etc.) and a changeof clothing, please bring those items labeled with the participant’s name toOSF Senior World to be stored. Upon discharge from the program, OSFSenior World asks that you take any unused supplies and clothing home withyou. Items may be claimed up to seven days after discharge.15

EMERGENCY SHOWERS AND SPONGE BATHSOSF Senior World does not regularly shower or bathe its participants, but ifan emergency arises, staff will provide a shower or sponge bath as needed. Ifthere is interest in a shower for your participant while at OSF Senior World,there will be an extra charge. Please contact us to discuss.MEALSEach participant must have a physician-ordered diet on file at OSF SeniorWorld. Currently, meals at OSF Senior World can accommodate general,diabetic, low fat or low salt, mechanical soft, pureed, vegetarian and otherspecial diets. A registered dietitian plans OSF Senior World menus andprovides ongoing consultation to the program.Limited substitutes may be arranged for those with dietary restrictions orfood allergies. We are unable to meet every preference.PARTIES, SPECIAL EVENTS AND OUTSIDE FOODOSF Senior World staff acknowledges the birthdays of each individual on ornear their actual birth date. If a participant wishes to bring in a treat for theirbirthday, please notify staff one week in advance to discuss the number andtypes of treats to be brought into the facility. All treats must be purchasedfrom a licensed food entity.Throughout the year, OSF Senior World will celebrate a variety of events,birthdays and holidays with participants. During these occasions, specialsnacks associated with the event may be provided by the facility. Manyparticipants have special diets and allergies, and OSF Senior World staff ismindful of the restrictions when bringing in outside food. Participants musthave a physician order for special-occasion desserts.Please note: Due to special diets and allergies, participants are not to bringin treats (gum, chips, candy, soda, etc.) to share with other participantsparticipants, except when approved in advance for birthdays, as describedabove.16

ACTIVITIESPerson-centered activities are provided throughout the day. OSF SeniorWorld adapts each activity to the individual’s functional abilities. Eachactivity is provided to promote cognitive stimulation, self-worth and physicalmovement in a failure-free atmosphere. Activities calendars are sent homeeach month.MONEY AND VALUABLE ITEMSParticipants do not need money while at OSF Senior World, unless theywould like to purchase a soda. We recommend that purses or wallets shouldbe brought to the facility only when necessary and should contain onlyidentification and very little money.OSF Senior World recommends personal items of value not be broughtto the facility. If a participant’s condition puts valuable items (such asglasses, dentures, hearing aids or prosthetics) at risk for misplacement, werecommend those items not be brought to the facility. For any lost items,the participant or their responsible party will assume full responsibility andwill fully and forever release and discharge OSF Senior World, its employeesand agents from any and all claims, demands, damages, rights or actions, orcauses of actions, present or future, resulting from any loss.DONATIONS AND MEMORIALSOSF Senior World accepts donations to provide participants with extraamenities. Suggested donations include the following: Bingo prizes,decaffeinated coffee, diet caffeine-free soda and craft supplies.A memorial tribute for a loved one is one of the most meaningful gifts aperson can contribute.OSF Senior World accepts memorials.For information, please contact us at (309) 495-4530.17

SAFETY DRILLSEach month, OSF Senior World staff conducts fire drills with all staff andparticipants. OSF Senior World staff go through a variety of drills, includingtornado, bomb threat and power outage. OSF Senior World staff is preparedto react in the event of an emergency.SECURITY/SAFETYAll participants wear a nametag with the OSF Senior World facility name andphone number so they may be recognized as a participant of the program.All outside doors have an installed lock system or alarm devices to prohibitwandering from the facility.The entrance to the facility is controlled by an electronic key system and isclosely monitored by staff.CELLPHONESWe understand the need for cellphones, but we ask that all phones be puton silence or vibrate while at OSF Senior World. When cellphones ring, theycause distraction to other participants in the main activity area, and we wantto respect the needs of others during their activity time. Also, due to privacyconcerns, all calls must be taken out of the main activity area. We can arrangea private area for calls if necessary. OSF Senior World staff is available toassist participants with local calls using our landline, and family members maycall the landline to check on their participant.18

PICTURESAll new OSF Senior World participants will have their picture taken fortheir electronic medical file. On occasion, OSF Senior World will takepictures or videos of the seniors engaging in various activities for educationalprograms or for publicity purposes. No names are used without the writtenpermission of the family or caregiver. OSF Senior World employees,student affiliates, and volunteers do not release any confidential informationrelating to our participants, employees or the program.OUTER CLOTHINGPlease mark all outer clothing with the participant’s name so OSF SeniorWorld staff can easily identify clothing for specific participants. OSF SeniorWorld staff will mark a participant’s clothing that is not properly marked.DISCHARGE POLICYWhen a participant’s functional or behavioral level improves or deterioratesto the point that OSF Senior World services no longer adequately meetthat participant’s needs or the needs of the family or caregiver, or if aperson no longer can be safely cared for in the program setting, our staffwill discuss discharge with the participant and the family or caregiver. OSFSenior World staff also will notify any case manager or social worker who isinvolved.OSF Senior World staff will provide information about alternative resourcesand will make appropriate referrals to those resources if the family orcaregiver requests such assistance. No referrals will be made without asigned release of information.Whenever possible, OSF Senior World will provide a 30-day notice prior todischarge so that appropriate arrangements can be made. If the participant’sbehavior or medical condition suddenly deteriorates to the point that hisor her participation at OSF Senior World is a danger to the participantor others, OSF Senior World reserves the right to terminate servicesimmediately. If the behavior or medical condition appears to be temporary,the participant may be suspended temporarily, pending medical evaluationand resolution of the problem.19

Listed below are specific reasons why a participant may be discharged fromOSF Senior World:1. T he participant no longer appears to need or benefit from adult dayservices. The individual’s functional level or social skills greatly exceedthose of other OSF Senior World clients; more appropriate opportunitiesexist elsewhere in the community.2. The participant exhibits combative, aggressive or belligerent behaviorthat is self-threatening or threatens the safety of other OSF SeniorWorld participants or staff.3. The participant needs full-time, one-on-one supervision, continuousassistance or attention from a staff member throughout the day.4. T he participant is a high risk for choking and does not follow physicianorders for a therapeutic diet at OSF Senior World.5. Inadequate arrangements exist to care for the participant at home in themorning prior to coming to OSF Senior World and upon returning homefrom OSF Senior World.6. T he participant violates the no-smoking policy, which extends to all partsof the OSF Senior World facility.7. T he participant or authorized representative is non-compliant withprovision of services specified in the care plan.HOURS OF OPERATIONPeoria Location Monday through Friday, 7 a.m – 5:30 p.m.Morton Location Monday through Friday, 8:30 a.m. – 4:30 p.m.20

CAREGIVER GROUPSOSF Senior World offers caregiver education groups to our families andthe community. We also offer informal coffee-chat programs. OSF SeniorWorld encourages all caregivers to attend. Please contact us at Peoria(309) 495-4530 or Morton (309) 263-1157 for more information.COMMUNITY INVOLVEMENTOSF Senior World is dedicated to ensuring involvement within ourcommunity and incorporates many different community

OSF Senior World is an outpatient service of OSF HealthCare Saint Francis Medical Center. Started in 1981, it is the only certified adult day . services program in Peoria, Tazewell and Woodford counties. OSF Senior World offers programming to seniors who are frail, disabled,

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CIE IGCSE Business Studies Paper 1 Summer & Winter 2012 to 2015 . UNIVERSITY OF CAMBRIDGE INTERNATIONAL EXAMINATIONS International General Certificate of Secondary Education MARK SCHEME for the May/June 2012 question paper for the guidance of teachers 0450 BUSINESS STUDIES 0450/11 Paper 1 (Short Answer/Structured Response), maximum raw mark 100 This mark scheme is published as an aid to .