FAQs Regarding Complex Care Nursing Patients
Admission to Bet Hadar is facilitated through the health insurance fund’s (Kupat Holim) representative at the hospital where the patient is currently hospitalized or through the patient’s primary care physician. The health insurance fund will forward the necessary medical documents for the patient’s transfer.
Co-payment depends on the patient’s status and rights with the health insurance fund. If applicable, payment is made through the health insurance fund, not Bet Hadar.
Typically, patients with “rehabilitation” or “ventilation” status do not require co-payment, while those with “complex nursing care” status may require co-payment, determined by the health insurance fund. “Nursing” and “mental health” statuses have eligibility determined by the Ministry of Health.
Hospitalization is based on Form 17, issued according to hospitalization days. Since notification of discharge is sent to the health insurance fund, re-application is necessary for admission to Bet Hadar. Therefore, bed reservation is not available during hospitalization elsewhere.
Visiting hours are from 8:00 AM to 9:00 PM.
Please note:
– Morning hours involve extensive nursing and medical activities; visitors may be asked to wait outside the department.
– We kindly request respecting patients’ privacy, especially during morning care and rest periods.
Personal hygiene assistance is provided as needed. Full bathing is done at least three times a week (alternating days). Shower or bed bathing is done based on medical and nursing discretion.
Patients are helped to sit according to their individual ability and multidisciplinary team recommendations. If not contraindicated, patients receive assistance to sit outside their bed twice daily.
Hospitalization duration varies individually based on the patient’s condition and treatment needs. Discharge decisions are made in multidisciplinary team meetings with the patient’s health insurance fund.
Mobility aids are for in-department use only. We recommend renting equipment from organizations like Yad Sarah or Ezer Mitzion for outside use.
Recommended items include:
– Closed shoes for fall prevention and physical safety
– Comfortable clothing (e.g., tracksuits)
– Personal hygiene products (e.g., soap, shaving kit)
– ID and health insurance card
– Medical report and illness summary
– Ministry of Health referral form (if applicable)
– Dentures/hearing aids/glasses
– Family photos and personal items for room decoration
• Undergarments
• Socks
• Seasonal outfits
• Closed shoes
According to the Patient Rights Law, you can receive a full copy of the medical record. The patient or their guardian must contact the Medical Information and Registration Department (Medical Records) at Bet Hadar, sign a waiver of medical confidentiality, and present a valid court order proving guardianship.
FAQs Regarding Occupational Therapy
Occupational therapy is a paramedical profession that aims to enable individuals to participate in meaningful activities. It takes a holistic approach, considering the relationships between the person, their activities, and their environment.
The uniqueness of this profession lies in the holistic approach that takes into account the relationship between the person, his occupations, and the environment in which he operates. In occupational therapy, an “activity analysis” tool is used. This weighs all the factors that influence performance: a person’s abilities (physical, intellectual, mental, cultural) – the requirements of the desired activity (physical, intellectual, mental, cultural) – the environmental conditions for performing the activity (human and physical).
After analyzing the causes, the treatment relies on many fields of knowledge such as: anatomy and physiology, neurology, neuroscience, psychology and more.
The treatment focuses on improving skills (physical, intellectual, behavioral) that will enable the performance of the function chosen together with the patient as a significant occupation for him.
As part of the treatment, we will make or recommend making changes in the environment that will enable optimal performance.
Occupational therapy focuses on activities that enable individuals to participate in daily life, supporting their health and quality of life.
The process involves assessing cognitive, physical, and emotional abilities and addressing them through tailored interventions.
The intervention process is holistic and breadth-related, and the treatment addresses the physical, cognitive, mental and spiritual aspects of the person, including reference to his immediate environment.
An inseparable part of the treatment is instructing the patient and his family on how to enable maximum participation in occupations that are important to the patient and his immediate environment.
The process begins with an assessment of motor, sensory, and functional abilities. The patient then undergoes exercises to improve mobility, with a focus on functional improvement, such as using the affected hand for daily activities.
The patient also learns compensation techniques or uses assistive devices to achieve partial or full independence.
Cognition refers to mental abilities like attention, perception, language, learning, memory, awareness, and judgment. Cognitive decline indicates a disturbance in one or more of these areas, which can be measured through cognitive tests and may explain functional decline.
Cognitive decline can impact basic and complex functioning, such as daily activities, mobility, and participation in meaningful activities. Occupational therapy assesses cognitive abilities, sets treatment goals, and helps patients and their families adapt to cognitive changes, promoting independence and quality of life.
Cognitive decline can impact basic and complex functioning, such as daily activities, mobility, and participation in meaningful activities.
The deficiencies will, of course, also affect more complex functions (IADL – Instrumental Activities of Daily Living, AADL – Alberta Aids to Daily Living); use of gas and electricity, taking medication, use of money, mobility in various environments (in the mall, crosswalk), driving, etc.
The participation of the individual in leisure occupations that were important and meaningful for him, and in connection with his environment, may also be affected, caring for grandchildren, spending time outdoors, solving crossword puzzles, playing bridge, reading a book, using a computer and television, and more.
Occupational therapy assesses cognitive abilities, sets treatment goals, and helps patients and their families adapt to cognitive changes, promoting independence and quality of life.
The level of impact on functioning depends on the severity of the cognitive impairment. When the individual is aware of his impairment and his limitations – this may also affect his self-image and his sense of capability – and thus affect the emotional aspect. Sometimes the person, and even close family, members deny or hide cognitive decline for fear of harm to dignity, independence and connection with the environment.
In occupational therapy, we perform a comprehensive assessment of the cognitive components and set treatment goals to improve or maintain these components, according to the patient’s previous functioning, and according to his preferences and those of his family members.
We will practice with the patient the functioning itself in the natural environment or simulating a natural environment. We will also provide guidance to the patient and his family on how to deal with the impairments affecting his functioning. For example, adapting the activity and the environment – organizing the environment in such a way as to facilitate his participation and promote independence, using various strategies (external and internal) in order to circumvent the impairment.
Memory decline is common with aging, especially short-term memory loss. To prevent potential hazards and ease adaptation, consider these strategies:
1. Cooking: Use an electric stove to avoid gas-related risks. Utilize timers or alarm clocks to remember to turn off appliances.
2. Medication: Use a pillbox or medication organizer, labeling each compartment with the day, time, and medication.
3. Shopping: Keep a permanent shopping list on the fridge, categorize items, and mark them off as you collect them.
4. Appointments and Events: Use a calendar or planner to record upcoming events, including locations and times.
Falls are common among older adults. Causes include vision impairment, attention issues, balance problems, muscle weakness, and unfamiliar environments.
Tips To prevent falls:
1. Remove tripping hazards (rugs, cords)
2. Secure electrical wires and phone cords
3. Install handrails for support
4. Install raised toilet seats and grab bars
5. Use non-slip mats in bathrooms
6. Consider showering instead of bathing using a corded showerhead for easy temperature control
7. Utilize shower chairs with backrests and handles
8. Consider getting a “shower bench/bath board” from “Yad Sarah” for safe seating in the bathtub.
9. Place a lamp and telephone near the bed.
10. Keep the bathroom and pathway lit at night.
11. Consider using a bedside urinal or commode to avoid getting up and walking at night
Kitchen Modifications
Place frequently used items and tools within easy reach to avoid unnecessary bending or climbing.
Individuals with a history of falls, especially those living alone, should:
– Install a panic button.
– Wear a wristband with an emergency call button.
Lesser-Known Occupational Therapy Areas at Bet Hadar
1. Cognitive Assessment and Rehabilitation
2. Capacity Evaluation for Decision-Making
3. Scar Management
4. Visual Function Rehabilitation
5. Driving Rehabilitation
6. Home Modification
7. Coma Patient Care (detecting responses, creating stimulation programs)
8. Post-Orthopedic Surgery Rehabilitation (lower limb)
Absolutely. If the surgery was due to a fall and fracture, the occupational therapist will investigate the cause of the fall and provide guidance accordingly.
Occupational therapy helps patients adapt their environment, practice safe functioning, and prevent future falls.
After elective surgery due to joint wear, patients can receive guidance on energy conservation and promoting health.
Assistive devices can aid with dressing, such as long-handled shoehorns or reachers.
Frequently Asked Questions in Social Work
If you haven’t received home care hours from the National Insurance Institute before hospitalization, you’re eligible for 50 hours of caregiver assistance from the Holocaust Survivors’ Fund. The social work department will handle the necessary paperwork.
If you’ve already received home care hours, you can submit a letter from the hospital to the National Insurance Institute to request reassessment.
The Long-Term Care Insurance Law allows the National Insurance Institute to provide caregiver hours at home. The social work department will guide you through the application process.
To hire a foreign worker, you’ll need to obtain a permit from the Ministry of Interior. You’ll also need to meet the National Insurance Institute’s dependency criteria.
A guardian is appointed by the family court to manage the affairs of someone unable to care for themselves.
There are two types: medical and financial guardians.
Frequently Asked Questions in Physiotherapy
Our physiotherapy team is experienced in various geriatric specialties, including post-stroke rehabilitation, brain injuries, spinal surgeries, neurological diseases, joint replacements, prosthetics, balance disorders, functional decline, and more.
Our physiotherapy institute is well-equipped with modern, specialized equipment for various treatments and rehabilitation needs.
Every patient who can benefit from physiotherapy receives an assessment, and a personalized treatment plan is created.
Treatment frequency depends on the reason for hospitalization, patient condition, treatment goals, department, and physiotherapist recommendations.
Our Physiotherapy Department operates: Sunday-Thursday, 7:00 AM-4:00 PM, and Friday, 8:00 AM-1:00 PM.
In some cases, yes. Please coordinate with the treating physiotherapist.
Wear comfortable clothing and sports shoes.
Yes, please coordinate with the treating team.
Yes, patients will receive guidance in their discharge letter.
Yes, we’re happy to assist patients after discharge.
Frequently Asked Questions About Nutrition
There are a number of questionnaires and indicators according to which it is possible to identify and diagnose characteristics of malnutrition or the patient’s chances of entering malnutrition. The questionnaires relate both to signs that can be diagnosed by external impressions and at the level of conversation, such as: weight loss, loss of appetite, decreased food intake, and also by parameters that are diagnosed through blood test indices and the presence of wounds that are difficult to heal.
Weight fluctuations:
When the patient has lost 2 kg or more in a month, regardless of his weight
When a patient has lost 10% of his weight in 6 months, regardless of initial weight.
Weight fluctuation which, according to the medical staff or dietician, necessitates a nutritional treatment plan.
It is important to understand what has caused the decrease in food intake.
Common causes and solutions:
1. Fungus or sores in the mouth – their appearance causes pain and avoidance of eating, as well as a change in the sensation of taste. The nutritional treatment will address changing the texture of the food or its components in order to reduce pain while eating.
2. Decreased senses (taste, smell and vision) – can be caused by natural physiological changes in old age or as a result of the use of medication or treatments (chemotherapy, radiation, dialysis, surgery).
The nutritional treatment will relate to the use of foods with dominant colors, herbs and added flavor and aroma through spices (even those considered less healthy, such as salt and sugar) in order to give the food a bold look and a strong smell.
3. Various degenerative diseases that cause forgetfulness and problems in chewing and swallowing, including strokes that have damaged the swallowing mechanism. The nutritional treatment will be carried out together with a speech therapist, determining food texture and recommending the level of fluid thickening.
4. A decrease in functioning that has led to a decrease in independent food intake; the nutritional treatment will be combined with providing help in eating or encouraging independent eating.
The normal weight range in the population over 65 is higher than in a younger population. Weight loss, whether intentional or not, in the absence of regular physical activity, comes mainly from muscle mass loss and is therefore not recommended. If there is a need to reduce weight, it should be done in a controlled manner, with nutritional consultation and monitoring. Determining nutritional status according to BMI values – normal weight: 23-29.9, underweight: BMI <23, overweight: BMI > 30.
Not in an all-embracing way. An elderly person is not required to adhere to a diet low in fat and cholesterol unless there is a medical instruction to do so as a result of diseases related to high levels of cholesterol or fat in the diet (for example, as an initial treatment for an inflammation of the gallbladder or pancreatitis, until a gradual return to a regular diet)
It has been found that low cholesterol levels are an indication of malnutrition and a risk factor for death.
In many cases, the elderly person reduces his food intake and any additional restriction in his menu will lead to a further decrease in food intake and as a result malnutrition.
Signs of a swallowing disorder:
Coughing while eating or drinking, moist snorting originating in the lungs, choking after swallowing.
Swallowing disorders can appear as a difficulty in the ingestion of liquids or when eating solids or a combination of both (mixed texture: soup, watermelon, fruit rich in juice).
It is important to identify the phenomenon and involve a speech therapist and a dietician. At Bet Hadar, the nutritional treatment for a person with swallowing problems will be based on adjusting food texture and thickening fluids. A patient with swallowing problems will be re-evaluated by competent parties and, if possible, progress will be made, and changes will be made to the texture of the food.
At Bet Hadar the texture of the food cooked in the kitchen and served in the wards is adjusted according to the recommendations of dieticians and the speech therapists, while taking into account the patient’s preferences.
The menu is determined according to the nutrition procedures of the Ministry of Health, which relate to the size of the portion of food served as well as variety of dishes throughout the week and month. As part of quality assurance of the nutrition field in Bet Hadar, periodic checks are conducted on the composition, taste, various textures, calculation of nutritional values, and the frequency of serving the food is monitored. In addition, inspections of the raw materials and kitchen equipment are also carried out.
On a regular basis, observations are made, and conversations are conducted with patients, in order to collect information about the satisfaction of the hospitalized patients in order to improve the menu and adapt it to the residents.
At Bet Hadar the food is cooked on site by a staff who have been trained and certified for that purpose. There is full communication and cooperation between the kitchen staff and the team of dieticians and speech therapists.
The dietician is responsible for the nutritional evaluation of the patients in Bet Hadar, for setting an individual nutritional treatment plan and monitoring the nutritional status of the patients. In general, the dieticians are responsible for building the menu and monitoring its implementation; they are partners in the writing of internal nutrition procedures together with the multidisciplinary staff, and in the training of the multidisciplinary staff in areas related to nutrition. Our dieticians are also involved in guiding nutrition students that come to Bet Hadar.
Many patients are at risk of weight loss and reduced dietary intake owing to acute and chronic illnesses as well as physical and mental problems.
The provision of appropriate nutrition, which includes all the nutrients and is served to the patients with a suitable variety and in a suitable combination, according to his preferences and according to his health condition and his ability to eat, prevents malnutrition and improves the patients’ health and quality of life.
The nutritional treatment at Bet Hadar is coordinated by the dieticians and there is full cooperation between the dieticians and all professionals in the multidisciplinary team, starting with the referral of the patient to a dietician and up to the implementation and monitoring of the execution of the nutritional treatment plan.
The nutritional treatment includes an evaluation of nutritional status, according to which a nutritional treatment plan is determined and carried out in cooperation with the multidisciplinary team.
A nutritional treatment plan includes identifying the patient’s nutritional needs, according to which an alternative nutrition and/or feeding plan suitable for the patient is written.
Subsequently, the nutritional status of the patients is monitored, and the recommendations are implemented.
Sometimes nutritional treatment will also include the use of nutritional supplements and adjustment of designated foods such as, enrichment powders or fluids given to the patient as part of the medicinal treatment, in addition to food consumed orally.
Feeding through a tube will be considered by the multidisciplinary team in cooperation with the family members and/or the guardian and/or the patient himself.
If the patient’s digestive system is functioning but he is unable to consume more than 50% of the recommended food intake according to the dietician’s assessment.
When there are swallowing difficulties or other reasons that prevent the patient from eating orally.
The food provided through a feeding tube includes a designated food, for full nutrition, that is approved by the Ministry of Health and adapted for each patient individually by a dietician, according to background diagnoses, absorption capacity, blood tests and accurate calculations of the content of the components in the feed.