An older client is being discharged from the hospital to a sub-acute unit. The client says to a nurse, "I am not sure I understand the difference between a sub-acute unit and a nursing home. Can you help me understand?" The nurse considers which of the following in formulating a response:

A. Semiprivate room.

Explanation: Medicare can cover the cost of a semiprivate room during a qualifying hospital stay or skilled nursing facility stay.

B. Hospice care.

Explanation: Medicare provides coverage for hospice care for individuals with a terminal illness and a life expectancy of six months or less.

C. Custodial care.

Explanation: Custodial care, which involves assistance with activities of daily living (ADLs) such as bathing, dressing, and feeding, is generally not covered by Medicare. Medicare primarily covers medically necessary and skilled care, such as hospital stays, certain nursing home stays, hospice care, and some home health care services. Custodial care, which focuses on assistance with routine personal care, is considered non-medical and is typically not covered by Medicare.

D. Skilled care.

Explanation: Medicare covers skilled care, including services provided by healthcare professionals such as nurses and therapists, when deemed medically necessary. Skilled care is typically required to improve or maintain a person's condition.

A. Stroke under the chin in a downward motion.
Explanation: Stroking under the chin in a downward motion is not considered a standard technique for managing dysphagia. It's important to focus on strategies that promote safe swallowing and prevent aspiration.

B. Keep pulse oximeter ready at all times.
Explanation: While monitoring oxygen saturation is important in certain situations, having a pulse oximeter ready at all times may not be a routine instruction for feeding a client with dysphagia. Monitoring for signs of distress and ensuring a safe feeding environment are key aspects of care.

C. Avoid rushing the client or force feeding her.
Explanation: Rushing or force-feeding a client with dysphagia can increase the risk of aspiration. It's important to allow the client to eat at their own pace and take adequate time to chew and swallow safely.

D. If facial weakness is present, place food on the impaired side of the mouth.
Explanation: Placing food on the impaired side of the mouth can help compensate for facial weakness and promote more effective chewing and swallowing.

E. Alternate solid and liquid boluses.
Explanation: Alternating solid and liquid boluses can help with the overall coordination of the swallowing process. It can also facilitate the movement of food and liquids through the digestive tract.

F. Have the client sit at 90 degrees during all of oral intake.
Explanation: Ensuring that the client sits at a 90-degree angle during oral intake helps promote an upright position that aids in swallowing and reduces the risk of aspiration.