Long-Term Care system
Instructions: The long-term care system is in a rapid period of change, with the need for long-term care services growing as more and more baby boomers enter retirement. Additionally, as children diagnosed with developmental delays like autism in the 1990s finish school, long-term care service options will be needed. Complete the following for this assignment:
Define the current long-term care (LTC) system, including how it was developed and the key strengths and weaknesses in the system.
In your paper, define the term continuum of care, and show how it applies to LTC today.
Identify the consumers and providers of LTC, along with defining institutional and non-institutional care and the strengths and shortcomings of each approach.
Add findings showing the changes taking place in LTC today.
Solution.
Long-Term Care
Definition
Long-term care is defined by Rowles and Teaster (2016) as the “personal care, social support and health delivered on a continuing or recurring basis to persons who have lost or never acquired some degree of functional capacity” (p. 10). Evashwick (2005) add to his definition “with the goal of maximizing their independence” (p. 4). Long-term care inherently recognizes that a persons condition may be untreatable ad may deteriorate over time, thus its distinct difference from acute care, whose goal is a cure.
How It was Developed
Long-term care is neither a novel idea nor the creation of a very recent past. Since the colonial beginning of the United States, welfare advocates, government authorities, family members, medical experts, and the infirm and old themselves have all endeavored to define and create proper long-term care. The first formal example of long-term care can be found in the English Poor Law of 1601. This law decreed that families ought to provide for the needs of their relatives; kin were to take in the infirm or old; and the elderly were to be sheltered alongside their offspring (Gordon, Grant, & Stryker, 2003, p. 6).
Strengths and Weaknesses
The strengths of the long-term care system are such as:
- Response to changing needs
- Uniquely American nature
- Dedication of caregivers
- Increasing focus on customer service
- Development of innovative types of care
- Integration efforts (Pratt, 2016, pp. 25-27)
The weaknesses of the system are:
- Reimbursement-driven system
- Fragmented and uncoordinated system
- Mix of health and social services
- Multiple entry points into the system
- Overshadowed by the acute system
- Poor public image
- Inadequate support for informal caregivers
- Confusing and user-unfriendly system (Pratt, 2016, pp. 28-32)
Continuum of Care
Continuum of care can be defined as a client-oriented system comprised of both integrating mechanisms and services that tracks and guides clients over time via a comprehensive array of heath, social services, and mental health services spanning all levels of intensity of care (Evashwick, 2005, p. 4). The concept of continuum of care extends beyond the traditional long-term care definitions. A continuum of care comprises a coordinated, comprehensive system of care designed to meet the needs of people with ongoing and/or complex problems effectively and efficiently. Until recently, however, most long-term care was provided by informal caregivers, such as friends and family.
Consumers and Providers
Long-term care consumers, unlike in the acute care system, are not typically defined by a single condition or disease. Instead, they need services because of functional disabilities. Although consumers of long-term care are primarily elderly, they represent a wide variety of people who rely on the system for assistance.
In essence, as pertains providers of care, the health, and social systems should not be treated as separate as they both have an immense impact on how well long-term care works. Focus is however placed on the health aspect as it is the most directly related to the system. The number and types of long-term care providers are a direct result of three factors: demand, need, and financing. Examples of some providers include nursing facilities, subacute care facilities, assisted living/residential care, elderly housing options, and community-based services.
These providers are either categorized as institutional or noninstitutional. Assisted living care, nursing care, subacute care, and housing services are usually considered to be in the former since most of their care is provided within facilities built for that purpose. Hospice care, adult day care, and home acre are typically provided in the consumer’s home. Hence they are considered noninstitutional/community-based care. I believe that the institutional care vs noninstitutional care argument is unreasonable, as there is enough, differentiated demand for long-term care services to go around. Community-based care may be beneficial to consumers who can majorly care for themselves with minimal support. On the other hand, institutional care provides the supervision, security, nursing/medical oversight, and practical assistance required by consumers who are unable to function adequately and safely with minimal support.
References
Evashwick, C. J. (2005). The Continuum of Long-Term Care (Third ed.). Clifton Park, New York: Thomson Learning.
Gordon, G. K., Grant, L. A., & Stryker, R. (Eds.). (2003). Creative Long-Term Care Administration (Fourth ed.). Springfield, Illinois: Charles C Thomas Publisher, Ltd.
Pratt, J. R. (2016). Long-Term Care: Managing Across the Continuum (Fourth ed.). Burlington, Massachusetts: Jones & Bartlett Learning.
Rowles, G. D., & Teaster, P. B. (2016). Long-Term Care in an Aging Society: Theory and Practice. (G. D. Rowles, & P. B. Teaster, Eds.) New York: Springer.
