Trends in Long-Term Care and Associated Implications
explanatory Essay
1651 words
Long-term care (LTC) covers a wide range of clinical and social services for those who need assistance due to functional limitations. These limitations usually result from complications associated with age related chronic conditions, from disabilities related to birth defects, brain damage, or mental retardation in children; or from major illnesses or injuries suffered by adults (Shi L. & Singh D.A., 2011). LTC encompasses a variety of services including traditional clinical services, social services and housing. Unlike acute care, long-term care is much more complicated and has objectives that are much harder to measure. Acute care mainly focuses on returning patients to their previous functional level and is primarily provided by specialty providers. However, LTC mainly focuses on preventing the physical and mental deterioration of an individual and promoting social adjustments to suit the different stages of decline. In addition the providers of LTC are more diverse than those in acute care and is offered in both formal and informal settings, which include: hospitals, physicians, home care, adult day care, nursing home care, assisted living and even informal caregivers such as friends and family members. Long-term care services have been dominated by community based services, which include informal care (86%, about 10 to 11 million) and formal institutional care delivered in nursing facilities (14%, 1.6 million) (McCall, 2001). Of more than the 10 million Americans estimated to require LTC services, 58% are elderly and 42% are under the age of 65 (Shi L. & Singh D.A., 2011). The users of LTC are either frail elderly or disabled and because of the specific care needs of this population, the care varies based on an indiv... ... middle of paper ... ... Aging Services. Nelda McCall (2001). Long Term Care: Definition, Demand, Cost, and Financing. Chicago: Health Administration Press, pg. 19. Nelson, Bill (2013). The Senate Special Committee on Aging: The Future of Long-Term Care Policy: Continuing the Conversation. Aging.Senate.gov. Shi L. & Singh D.A. (2011). The Nation’s Health. Sudbury, MA: Jones & Bartlett Learning. Stone, R.I & Wiener, J. M. (2001). Who Will Care For Us? Addressing the Long-Term Care Workforce Crisis. The Urban Institute. United Hospital Fund (2013). New York’s Nursing Homes: Shifting Roles and New Challenges. Medicaid Institute at United Hospital Fund. University of California (2006). An Aging U.S. Population and the Health Care Workforce: Factors Affecting the Need for Geriatric Care Workers. University of California, San Francisco, Center for California Health Workforce Studies.
In this essay, the author
- Explains that long-term care covers a wide range of clinical and social services for those who need assistance due to functional limitations.
- Explains that the population of disabled individuals has substantially increased over the past decade due to advances in medical care that have led to a decline in mortality and better quality of life.
- Explains that the frail elderly represent older individuals with multiple comorbidities who require assistance with activities of daily living due to mental and/or physical deterioration.
- Explains that ltc services are costly and inevitable, but there is a substantial lack of individual planning and saving for the procurement of services.
- Explains that the average retirement savings is approximately $75,000, but a single year of nursing home care can cost over $80,000, and social security is only sufficient to provide income for basic living expenses.
- Explains that nursing homes are a major component of the ltc system, but they have recently demonstrated slow rate of growth and low occupancy rates. the number of beds in assisted living has increased 97% in the last twelve years.
- Explains that age-in-place organizations give the frail elderly the ability to join communities with mechanisms that provide support service. new care settings that are well integrated into government funded services/programs are crucial for directing cost savings.
- Explains that the number of nursing home admissions from hospitals increased from 83% in 1996 to about 90 % in 2010.
- Cites calmus, d. the long-term care financing crisis, the heritage foundation, center for policy innovation discussion paper, #7.
- Cites chernof, b., and warshawsky, m. (2013). commission on long-term care before the u.s. senate special committee on aging.
- Cites the institute for the future of aging services (2007), the long-term care workforce: can the crisis be fixed?
- Describes nelda mccall's long term care: definition, demand, cost, and financing.
- States nelson, bill, the senate special committee on aging: the future of long-term care policy: continuing the conversation.
- Explains shi l. & singh d.a. (2011). the nation’s health.
- Describes stone, r.i., and wiener, j.m. (2001). who will care for us?
- Cites united hospital fund (2013), new york’s nursing homes: shifting roles and new challenges.
- Cites the university of california (2006), an aging u.s. population and the health care workforce: factors affecting the need for geriatric care workers.
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- Long-term Care Utilizing Nurse Practitionersopinionated essayLong term care (LTC) settings provide a vast variety of services that range from convalescent care, respite stays and skilled rehabilitation services which includes: skilled nursing, physical, occupational or speech therapy. LTC includes a broad spectrum of services that are designed to meet the varying needs of geriatric individuals and other adults with functional restrictions. The services rendered in this setting are designed to support individual needs from assistance with activities of daily living, medication management, cognitive and behavioral health support and limitations secondary to acute to chronic medical conditions. The care bestowed not only assists individuals with maintaining or improving their physical functioning, it enhances their quality of life. According to the Centers for Disease Control and Prevention (CDC) in 2013, there were 16,100 nursing homes in the United States (U.S.); over 1.7 million adult persons required placement in one of those long term care settings (CDC, 2013). Medical care within these settings has evolved from the traditional physician model with the introduction of the nurse practitioner (NP). The NP views the client as a whole, and considers how the individual’s condition or symptoms impact their overall well-being (e.g.: medically, physically and mentally). With the growing geriatric population in the United States, one has to ponder does the role of the nurse practitioner improve outcomes for the elderly clients?
In this essay, the author
- Explains that long-term care (ltc) settings provide a broad spectrum of services that are designed to meet the varying needs of geriatric individuals and other adults with functional restrictions.
- Explains that the centers for medicare and medicaid services (cms) has authorized nurse practitioners to provide services to long-term care residents.
- Analyzes stolee's study of the nurse practitioner role in three long-term care facilities. findings indicated the np had a positive impact on practice activities and staff assessment skills.
- Explains that the nurse practitioner's role in the long-term care setting can facilitate the concept of person-centered care. this concept embraces seeing the patient as an individual, how their current conditions affect their outlook and quality of life.
- Explains the impact of medicare reimbursement, medicare guidelines, and state governance on nurse practitioners in the long-term care setting.
- Explains that nurses are a tremendous asset to any organization, especially in the long term care setting. they can provide prompt assessments on the resident, coordinate and manage chronic ailments, and facilitate patient-centered care.
- Opines that nurse practitioners are perceived to be more readily available for the client and their family needs.
- Opines that nps' ability to connect with clients, their families, and the ltc staff is critical in enhancing the quality of life and improving outcomes for residents in the long term care setting.
- Cites mcainey, haughton, jennings, farr, hillier, and morden, p. a uniquepractice model for nurse practitioners in long-term care homes.
1022 wordsRead More - When talking about Medicaid, “the program allows for the coverage of long term care services through several vehicles and over a continuum of settings, institutional care and home and community based long term services and supports.” (Long Term Services and Support) I ...
In this essay, the author
- Cites frum, david. financial times, london, england. retrieved on march 31, 2014.
- Cites knudson, jeannie. medicare and medicaid coverage for assistive care.
- Explains that scott, lewis, & ferraro, llc, july 29, 2013. retrieved on march 30, 2014.
- Explains that the elderly needing care and attention from others will grow and be a demanding need.
1154 wordsRead More - Encompassing coronary heart disease, myocardial infarctions, and heart failure, cardiovascular diseases are the leading cause of death in the United States, accounting for approximately 1 in every 4 deaths1,2. Coronary heart disease (CHD) is caused by atherosclerosis which occurs when the build-up of cholesterol in the arterial wall limits the travel of oxygen-rich blood in the body3. This can lead to serious problems, including heart attack, stroke, or death. CHD is a chronic and potentially fatal condition. The consequences of the disease affect the lifestyle of individuals diagnosed and greatly impact the health care system at large. As of 2010, the estimated direct and indirect cost of CHD in the US exceeded $108 billion annually4. CHD results in substantial healthcare needs and may affect where people choose to live as they age.
In this essay, the author
- Explains that cardiovascular diseases are the leading cause of death in the united states, accounting for approximately 1 in every 4 deaths1. coronary heart disease is caused by atherosclerosis.
- Explains that residential care facilities (rcfs) have been an important component of housing and long-term care for older adults since the 1990s.
- Explains kochanek, xu, murphy, minino, a. m., and kung, h.-c. national vital statistics reports deaths : final data for 2009.
- Describes the national vital statistics reports deaths: final data for 2010.
- Cites heidenreich, p. a. et al., forecasting the future of cardiovascular disease in the us: a policy statement from the american heart association.
- Explains that caffrey, sengupta, park-lee, eunice ph.d. moss, abigail rosenoff, emily m.p.a., harris-kojetin, l.
- Explains stevenson, g., and grabowski, c. sizing up the market for assisted living. health aff.
- Explains the 2012 metlife market survey of nursing home, assisted living, adult day services, and home care cost.
- Cites gimm, ph.d., kitsantas, p. & cantiello, j. health services utilization of residents in assisted living communities.
- Explains the design and operation of the 2010 national survey of residential care facilities.
- Explains the katz index of independence in activities of daily living.
- States that the 2010 national survey of residential care facilities (nsrcf) seeks to fill a gap in the literature about long-term care facilities and their residents.
1354 wordsRead More - Overview of the Senior Citizens Demographic in Americaanalytical essayIn the United States, after World War II (particularly the period between 1946 and 1964), the birth rate rose due to the excitement of the end of the war and the return of overseas soldiers. This period is notoriously known as the “Baby Boom” and still affects our country today (Unit 3, Greene 36). “Baby boomers” are now reaching the age of retirement where they can begin reaping Social Security benefits and other government aid; this has become known as “The Graying of America”. In recent censuses, results have concluded that adults “65 and over make up 12.5% of the U.S. population” due to the “Baby Boom” and advances in medicine (Greene, Unit 3: Demographic Changes 31). Therefore, the retired and elderly make up a large portion of the American population, who need increased support and financial care from the government as well as from the rest of the general population, as well as retirement benefits. The elderly require increased health care due to disabilities and diseases. The elderly also need appropriate living arrangements, which may require stay at home care or admission into nursing homes, with more long-term care nurses and attendants. With the increased federal and state spending, on the proportion of those over the age of 65, brings increased financial pressure, economic decline, and further socioeconomic, racial, and ethnic inequalities among the proportion.
In this essay, the author
- Explains that the birth rate rose in the united states after world war ii due to the end of the war and the return of overseas soldiers.
- Explains that as the large, retired portion of america exits the workforce, many states' gdps will decline due to less productivity and workers.
- Explains that 3.5 million americans over 65 are impoverished and many other elderly drift slightly above the poverty line making them "near poor."
- Explains that "the graying of america" is considered a pressing, social problem. it shows psychic and material suffering in terms of increased financial burdens on the retired and elderly, as well as their family members.
- Opines that policies should be adapted to the demographic change in terms of federal finances, education, and private sector labor policies.
- Analyzes the inadequacy of the current federal retirement and health care systems through a sociological lens or perspective.
- Analyzes haas, mark l., "a geriatric peace? the future of u.s. power in a world of aging populations."
1352 wordsRead More - The Role of Certified Nursing Assistants (CNA)explanatory essayNursing assistants work in many types of settings including nursing homes, hospice, mental health centers, assisted living residences, home care agencies, hospitals, rehabilitation and restorative care facilities (Sorrentuino & Remmert, 2012). There are many types of Long-term care centers. For this paper, I will focus on the long-term care centers often referred to as nursing homes. These LTCs are "licensed facilities that provide extended care for individuals who do not require the acute care provided in a hospital but who need more care than can be given at home" (U.S Department of Health And Human...
In this essay, the author
- Explains the role of certified nursing assistants in long-term care centers and their importance as a member of the health team.
- Explains that certified nursing assistants perform delegated nursing tasks under the supervision of a licensed practical nurse or registered nurse. they are trained and certified to provide basic quality of life care.
- Explains that nursing assistants work in many settings including nursing homes, hospice, mental health centers, assisted living residences, home care agencies, hospitals, rehabilitation and restorative care facilities.
- Explains that nursing assistants monitor vital information about the residents' conditions, which is reported to the nurse or other members of the health team. frequent contact with residents means they act as the supervising nurses eyes and ears.
- Explains that nursing assistants observe physical changes in residents, but they also observe the residents' emotional state, which is an important part of resident care.
- Explains that nursing assistants play a role in the residents' social interaction and support.
- Explains that nursing assistants are an important member of the health team. they are on the forefront of basic resident care in long-term care centers.
810 wordsRead More - Coronary Heart Disease in Older Adults Living in Residential Care Facilities: 2010 National Survey of Residential Care Facilitiesexplanatory essayWe also evaluated the proportion of residents requiring assistance in their activities of daily living (ADLs) according to the KATZ scale. Within our cohort of residents ≥65 years old, the majority of residents with CHD needed assistance with 3-4 ADLs (p=0.18) (Figure 1). However, this was found this to not be statistically significant.
In this essay, the author
- Explains kochanek, xu, murphy, minino, a. m., and kung, h.-c. national vital statistics reports deaths : final data for 2009.
- Describes the national vital statistics reports deaths: final data for 2010.
- Cites heidenreich, p. a. et al., forecasting the future of cardiovascular disease in the us: a policy statement from the american heart association.
- Explains that caffrey, sengupta, park-lee, eunice ph.d. moss, abigail rosenoff, emily m.p.a., harris-kojetin, l.
- Explains stevenson, g., and grabowski, c. sizing up the market for assisted living. health aff.
- Explains the 2012 metlife market survey of nursing home, assisted living, adult day services, and home care cost.
- States gimm, ph, d., kitsantas, p. and cantiello, j. health services utilization of residents in assisted living communities.
- Explains the design and operation of the 2010 national survey of residential care facilities.
- Explains the katz index of independence in activities of daily living.
- Evaluates the proportion of residents requiring assistance in their activities of daily living (adls) according to the katz scale.
806 wordsRead More - The Importance of Assisted Livinganalytical essayTaking care of the individuals that are getting older takes many different needs. Most of these needs cannot be given from the help of a family. This causes the need of having to put your love one into a home and causing for the worry of how they will be treated. It is important for the family and also the soon to be client to feel at home in their new environment. This has been an issue with the care being provided for each individual, which has lead to the need of making sure individuals have their own health care plan.
In this essay, the author
- Explains that taking care of older individuals takes many different needs, which cannot be given from the help of a family. it is important for the family and the soon-to-be client to feel at home in their new environment.
- Explains that assisted living is an effective type of care facility programmed towards helping older individuals with increasing disabilities. positive aging is important since it leads individuals to have a happier and more fulfilling life.
- Analyzes how the quote illustrates the situation most effectively, namely, "independence with adl's", which aids in making the person appear and feel more independent.
- Argues that a nursing home's well-being and other characteristics should be taken into account when selecting an assisted living home.
- Explains that nursing homes with nonprofit status may be viewed as higher quality and, therefore, more desirable to consumers. this illustrates that certain assisted living facilities are more competitive than others.
- Illustrates how open and flexible communication with workers can ensure that an older person is getting the best care to help achieve successful aging.
- Explains that consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their own situation.
- Explains that it is important to look at the health of your loved one when choosing an assisted living home. the type of care your parents are provided should make a big impact on your decision.
- Explains that functional independence influences satisfaction among assisted living residents. bauer m, nay r. improving family-staff relationships in assisted living facilities.
- Cites abrahamson, bradley, morgan, fulton, and bauer m. improving family-staff relationships in assisted living facilities: the views of family.
1174 wordsRead More - Nonprofit and For-Profit Hospitalscomparative essayAfter reviewing the current state of the long-term care policy from the United States, it
In this essay, the author
- Explains the differences between nonprofit and for-profit hospitals. nonprofit entities, including hospitals, function under special provisions of corporation law in each state.
- Describes three major trends that have occurred with the hospital sector, including the trend of building smallerhospital facilities. urban offices have closed in the last twenty five years due to financial and competitive pressures.
- Explains that changes in the number of americans, technological innovation, and financial pressures from payers have led to an increasing proportion of medical care being provided on an ambulatory basis.
- Opines that operating at a moreefficient level of occupancy restrains the ability to respond to normal fluctuations in utilization, but also significantly impacts hospitals' response to critical communities.
- Explains the role of hospitals and nursing homes in providing long-term care. the first example will be the types of people each program accepts. extended inpatient care is for people who are so sick or functionally disabled that they require ongoing nursing andsupport services.
- Explains that hospitals require the technological and professional intensity of a hospital. hospitals provide psychiatric, rehabilitation, orthopedics, chronic disease, and long-term care.
- Compares the number of patients seen at the hospital or nursinghomes. the average length of stay has decreased over the past 30 years.
- Compares medicare ormedicaid and how they are used in each facility. medicaid pays for 47percent of all nursing facility care, while residents and their families pay for one-third.
- Criticizes the current state of long-term care policy in the united states, stating that public policy is not likely to provide any over-arching continuity.
917 wordsRead More - Long-Term Care Case Studyexplanatory essayI will discuss how LTC contributes to the U.S. Healthcare System, the targeted clients, employees that work within the long-term setting, the benefits and services offered within LTC, and the expected outcomes for individuals in a long-term facility. I will discuss the legalities and regulatory issues faced within the LTC setting along with ethical issues that may impede successful facilitation of a long-term facility.
In this essay, the author
- Explains that in the u.s. healthcare system, there are different levels of healthcare; long-term care, integrative care and mental health.
- Explains how ltc contributes to the u.s. healthcare system, the targeted clients, employees, benefits, and expected outcomes for individuals in a long-term facility.
- Explains that ltc is a paradigm of services offered for an extended period of time. these services inspire individuals to regain their independence.
- Explains that individuals in a ltc setting are debilitated to the point that they are unable to accomplish their activities of daily living, or instrumental activities of daily living.
- Explains that ltc recipients are individuals over 65, if they are younger, they usually have a chronic illness such as kidney failure or they have been involved in an accident. another percentage is required due to the normal process of maturity.
- Explains that the length of time needed for long-term care is factored by factors such as family/relative’s participation and support, the extent of the illness, disability, or injury (is it a rehabilitative sickness, and is it chronic or acute injury).
- Explains that ltc facilities are comprised of diverse healthcare professionals that aim to provide optimum care for long-term care residents. rehabilitation is targeted to restore mind, body, and soul
- Explains the benefits offered in a ltc facility range from assistance with adl's and iadl’s to full care. each facility differs based on the revenue it brings in.
- Explains that the expected outcome in long-term facilities varies by the individual. the main goal is to promote independence and/or regain this independence so the resident can complete adl's, iadl’s or even return home.
- Explains that ltc facilities face several challenges that affect the delivery of care, including legal and regulatory issues, ethical issues and social issues.
- Explains that while long-term facilities are designed to support individuals with disabilities, residents in ltc settings are often victims of unethical practices conducted by healthcare employees.
- Explains that legal and regulatory issues affect the delivery of healthcare service in a vast way, since the health care system is constantly changing.
- Defines long-term-care as assisting individuals with adl's or iadl’s whether it is physical or mental assistance. ltc plans and goals are based on the individual’s disability and/or sickness.
948 wordsRead More - Argument for Universal Healthcareopinionated essayAs a worker in the healthcare industry, I have witnessed first hand the issues facing not only our elderly, but of the young and middle-aged. They have to make decisions that no family should face: to buy medication or pay for groceries.
In this essay, the author
- Argues that the time to overhaul the american healthcare system is now. as the baby-boom generation becomes older, the stress that will be placed upon our healthcare industry will become unprecedented.
- Opines that many of you already enjoy medicare as their government-sponsored program that will pay for your medical coverage for the next ten, twenty, or thirty years. does your fellow human beings not deserve the same benefits?
- Opines that medicare beneficiaries rely on the monetary injection into the system by the current workforce.
- Opines that medicaid is being used by people who can afford to pay their way, but instead have their assets transferred to a family member or spend down their wealth so they can qualify for state medicaid benefits.
- Explains why the richest nation cannot afford to provide good healthcare coverage to its most vulnerable citizens. by focusing on prevention, the cost of surgical procedures alone would save the government tens of millions of dollars.
402 wordsRead More