Long-Term Care in the United States
Elderly Americans comprise the only group of the American population whose healthcare is globally insured as an entitlement. The majority of the country’s poor people and those who cannot afford primary care rely on Medicaid, a federal/state program to attain the kind of service necessary for their wellbeing. Nonetheless, the elderly demands for long-term care receive much less coverage. The federal program in place for the elderly and disabled, Medicare, covers for the majority of the acute medical needs and tangent coverage for some long-term services. However, the variety of services individuals can receive under Medicaid varies among states. Despite receiving little attention from U.S. policy than healthcare commands, long-term care matters for all populations and ages and affects public program spending. Researchers and stakeholders strive to provide a long-term care program that addresses the demands of the elderly people. Accordingly, it is critical to evaluate the primary strategy themes in long-term care strategy subjects, such as, employing and maintaining a gifted and competent long-term care task force, financing strategies, migration towards home-based care from institutional-based care, and community involvement, alongside integrating auspicious emergent trends including cultural migration, integrating social care in service delivery, and different community residential services that enhance service delivery in a home-like environment.
Long-term care policy comprises a range of federal, state, and local policies that define the responses to demographic changes such as the growing older adult population, diversion from infectious to chronic conditions, and greater longevity. Long-term care is an intricate patchwork of various services and professionals instead of an all-inclusive system. Long-term intervention involves integrating multiple providers, including institutional-based care, in-home assistance, community care, and material programs. It also includes informal aids by friends and families that offer a range of care for the elderly.
Long-term care continues to receive significantly little attention among policymakers, media, families, older adults, and social workers than healthcare needs do. Partly due to wishful thinking, most of the aging population contemplates long-term care when health issues result in continuous aid (Favreault, 2021). Although advocacy groups are rallying older adults together to exert substantial radical pressure on politicians who influence the community security assistances, only few commit significant efforts toward attaining reforms for long-term care through a political approach. Void of the occasional scandals that draw public attention, the media has selectively sidelined long-term care strategy. Consequently, long-term intervention service has factually fallen under the policy bar in the U.S.
However, recently, researchers and politicians are beginning to recognize the significance of designing long-term treatment strategies that ensure appropriate and adequate services for the growing elderly population. Scientific investigation shows that the current state of long-term care is lacking, considering that four among every five adults above 50 years is diagnosed with a chronic illness (Favreault, 2021). This statistic indicates that most older adults in the U.S. need some form of help or may not rely on their families for necessary care. Besides, the demographic fluctuations produce a sense of earnestness for reforms in long-term care before a crisis erupts. The surge in the population of elderly persons is attributable to the aging baby-boomer population, who significantly influenced public policy and institutions, including long-term care, when they begin to register physical, mental, and cognitive deficiencies that are often associated with advanced age.
Significant Themes in Long-Term Care
In pursuing a comprehensive long-term maintenance approach, policymakers and researchers introduce questions surrounding three sections; inadequate workforce, migration from institutional to community-based services, and financing. Workforce shortage focuses on employing and maintaining qualified care providers, especially direct care professionals such as home health aides and certified nursing assistants. The demand for these providers is set to increase with the growing population of older adults calling for drastic responses to the dramatic increase that is set to expand by 2% yearly until 2050 consistently (National Institute on Aging, 2021). The challenges for sustaining a talented and qualified pool of care providers are partly due to the lack of benefits and low pay. The higher turnover rates are attributed to a lack of insurance covers or pension. Experts identify the main challenges are lack of benefits and low income, difficult working conditions, heavy workloads, stigmatization by society and undervaluation by employees, and lack of qualified applicants resulting in many institutions settling for warm bodies employment rather than a dedicated workforce attending to older adults.
Financing long-term maintenance is a sensitive subject for healthcare stakeholders. The current state of affairs calls for designing a funding system that attains a stability between private and public funding to accommodate the rising costs of care. The current trend highlights the fragments and intransigent state of long-term care strategy in the U.S. largely ignored in the Medicare and Medicaid programs that offer communal subsidy for treatment homes, home-health providers, and other long-term care provisions (RAND, 2021). Despite Medicaid providing cover for critical care and long-term maintenance that requires skilled nursing care or rehabilitative intervention, individuals needing custodial care and other chronic conditions do not qualify. These disparities call for incentivizing the American plan to balance public and private financing framework for long-term care needs.
Over the last two decades, healthcare delivery has shifted from nursing homes towards community-based maintenance. Treatment homes remain the preference for most older adults consuming at least 75% of Medicaid long-term care allocation (National Institute on Aging, 2021). The significant challenges for lower-level care for older adults include absence of harmony on the appropriate settings for disease and disability, lack of community resources, and restrictive state regulations. Although both Medicaid and Medicare have augmented funding for homebased and public-based care recently, most spending caters to mental conditions and developmental disabilities. Policymakers are enhancing the goal of providing home-like environments by integrating cost-effective strategies to increase the quality of care and life for service users to honor the preferences of aged persons.
Promising Approaches for Long -Term Care
A cultural change movement aims to redesign the organization and delivery of long-term care. Proponents of a cultural shift call for integration of mind, body, and spirit, involving clients in decision-making, taking risks as part of the process, perceiving clients and staff as core elements, and better treatment of staff will ensure more outstanding patient outcomes. Besides, enhancing the care and life quality for older adults calls for improving staff employment and retaining through providing better working environments (Friedman & Tong, 2020). This cultural migration calls for significant migration of attitudes and management behavior and direct care staff to improve life quality for all persons involved.
Service integration encompasses connecting different elements of the healthcare system, for instance, acute care, with social service components, such as education, training, and psychosocial services. Service integration also focuses on coordinating different resources and types of services, such as combining Medicare with Medicaid (Nursing Home Abuse Center, 2019). These developments involve replacing acute care approaches with chronic care services for patient self-management and interdisciplinary teams and clinical information programs. Proponents of integration emphasize more excellent quality of care, which is the motivation behind these efforts.
A significant advance in long-term care for elderly populations is the surging demand for public residential care, including collection housing and other support and health programs. Community-based approaches provide greater privacy and autonomy than institutional care while maintaining more efficient economies of scale than individual home care. Community residentials serve a less incapacitated community than in nursing homes, which may call for aided living and adult substitute care for highly impaired individuals.
Designing healthcare strategies that will result in satisfactory and apposite care delivery for the increasing figure of older adults is cumbersome yet, achievable. The existing policies have evolved during the 20th century reacting to the demographic changes, regulations, and policy demands. Although these strategic innovations of providing long-term care offer potential answers to vital hindrances in service delivery, they do not intervene for the lack of an inclusive long-term care program vested in the ideologies and objectives to inform future strategies. The future programs must be founded on extensive research and planning and incorporate perspectives from a vast scope of professionals and stakeholders. Besides, future long-term care programs should integrate guidelines that seek to avert the quantity of older adults needing long-term care with strategies that offer ample community and therapeutic aid to those in need.
Favreault, M. (2021). Long-term services and supports for older Americans: Risks and financing, 2020 research brief. ASPE. https://aspe.hhs.gov/reports/long-term-services-supports-older-americans-risks-financing-2020-research-brief-0
Friedman, E., & Tong, P. (2020). A framework for integrating family caregivers into the health care team. https://doi.org/10.7249/rra105-1
National Institute on Aging. (2021). What is long-term care? https://www.nia.nih.gov/health/what-long-term-care
Nursing Home Abuse Center. (2019). Facts and statistics about U.S. nursing homes. https://www.nursinghomeabusecenter.org/informative/facts-statistics-nursing-homes/
RAND. (2021). Long-term care. RAND Corporation Provides Objective Research Services and Public Policy Analysis | RAND. https://www.rand.org/topics/long-term-care.html