Session 5

Chapter 8 :

Major Themes

• Though the majority of consumers of long-term care services are older adults, long-term care is used by all age groups from infants to older Americans
• Ideally, long-term care services should be characterized by comprehensiveness, flexibility, and coordination of services along a continuum, reflecting continuously changing medical, social, personal, and financial needs.
• The expanding population of chronically ill elderly is increasing demand for long-term care services as well as concern about its costs to individuals, families, insurers, and government.
• Until the post-WWII period of social reform, almost all long-term care was provided either by families at home or by community charities.
• Nursing homes and other types of congregate care facilities proliferated after government funding became available through Medicare and Medicaid in 1966.
• During the 1970s, major professional and regulatory reforms in the long-term care and nursing home industries followed widespread reports of severe inadequacies in care quality and of humanitarian abuses.
• Hospice, providing palliative services to the terminally ill at home and in institutions, has become a major component of the long-term care continuum.
• Evolving recognition of the value of informal long-term care provided by family and friends, accessible respite care, paid employer leave and other assistance to those maintaining the disabled or frail at home
• Cost and quality concerns in Medicare-funded home health care services prompted major initiatives by the Centers for Medicare and Medicaid Services to thwart abuses by suppliers
• Payment methods for long-term care services entail primarily personal resources and Medicaid. State and local efforts to promote citizen purchase of long-term care insurance policies have been largely unsuccessful.
• Innovative long-term care services such as “aging-in-place” (PACE and NORCs) and life care communities are attempting to provide a seamless continuum of services with flexibility to adapt to changing life needs.

Power Point Slides