...Discussing long-term care options is a difficult topic because there are so many options and it may very difficult for a patient or/and family member to understand the different choices that are available to them. Working as an AGNP in an internal medicine clinic would typically include adult patients only with many of the patients having chronic and complex health conditions. My first response to this important question is to ask the patient if he/she has any family members that are involved in his/her care and/or has any involvement in helping to making this type of decision? From my clinical experiences, I have witnessed the importance of involving all of decision makers including the patient’s family members. I would also ask the patient if he/she prefers to discuss long-term care options with their family members present or not? Prior to beginning: it would be important to me as AGNP to have reviewed the patient’s health history and performed a comprehensive geriatric assessment to be...
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...Relational Care Lupanch Gupta - 86510 Coleman University Relational Care Several countries have diverse point of views when it comes on taking care of their family especially when they get old. People in several countries feel that taking care of their elders should be obliged. They choose to please themselves by letting an institutions or long-term facilities to take care of their loved ones. In the Philippines where I was born and grew up having too many children is acceptable, the mothers as well as the fathers believe that having many children will give them a chance not to end up staying in a interpersonal facilities or homecare when they get old. They think that their children will take good care of them once they get older. But in reality having many children will not guarantee the parents that when they get older their children will take care of them. Where will we go when we get old? This is one of the questions that some old people ask themselves when their kids start to leave them to start their own lives. In United States very few children will be taking of their parents when they grow old. There are a lot of reasons why they do not take care of their parents when they grow old and one of it is health condition. “The most widespread condition affecting those 65 and older is coronary heart disease, followed by stroke, cancer, pneumonia and the flu. Accidents, especially falls that result in hip fractures, are also unfortunately...
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...When it comes to finding factors to drive competition in the long-term care market, one must stop and thing how far back this goes. The factors may not been looked at years ago and no competition for the long-term market needed to be looked at. Today, looking at long-term care we think about the rising cost of health care, who will provide the coverage, and if we must look at what type of care one is needing. “Although Medicare and Medicaid are still the most significant buyers of long-term care services they are no longer the only buyers. Managed care has become a buyer with considerable influence in all of health care” (Pratt, 2010). A few years ago one looked at long-term care facilities as being in nursing homes. Today facilities are opening up that is not a setting for nursing home though that is what others thinks. With the government involved today it has restraints with the pricing and the quantity of service one provides. When the government gets involved with making decision on health care they divert resources away from one provider and looks at another. “to be competitive, long-term care providers have to know where they stand in the market. That means that they need to know how they compare with their competitors and their relative strengths and weaknesses” (Pratt, 2010). Most providers does not look at the strength and weaknesses of other facilities since this was not a big factor before. One must do research to find out the pricing and check the competition...
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...services and supports known as the Community Living Assistance Services and Supports program (CLASS Act). The CLASS program is designed to expand options for people who become functionally disabled and require long-term services and supports. The CLASS program is effective on January 1, 2011. Working adults will be able to make voluntary premium contributions either through payroll deductions through their employer or directly Adults with multiple functional limitations, or cognitive impairments, will be eligible for benefits if they have paid monthly premiums for at least five years and have been em[ployeed for 3 of those 5 years Adults who meet eligibility criteria will receive a cash benefit that can be used to purchase non-medical services and supports necessary to maintain community residence; payments for institutional care are permitted. The amount of the cash benefit is based on the degree of impairment or disability, averaging no less than $50 per day CLASS is financed by voluntary premium contributions paid by working adults, either through payroll deductions or direct contributions • HOW DOES CLASS INTERACT WITH MEDICAID? CLASS will generally be the primary payer for individuals who are also eligible for Medicaid. The CLASS program gives working adults the opportunity to plan for future long-term care needs by providing a basic cash benefit to those who meet work requirements and have either functional or equivalent cognitive limitations...
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...Long-term care can have a different definition for each individual. Before taking this course my understanding of Long-Term Care was a community that the elderly would live in when not being able to take care of themself or not have a caretaker. However, having been able to obtain more knowledge on the subject, Long-Term Care can vary from Adult Day Care to Assisted Living. There are different options to choose from when having to choose a Long-Term Care facility for you loved one. An Adult Day Care is similar to a child day care. It is a facility where one can drop off a loved one while they are at work and can then pick them up at the end of the day. These facilities offer the amenities to socialize with one another and do activities that can strengthen their minds and increase mobility on their motor skills. During my college years, I had to participate in one of these facilities for an assignment and it was a great experience. Members would play dominoes, sew, and do plenty of arts of crafts. Another form of Long-Term Care is an Assisted Living Facility, this consist of a facility that can be mostly associated with an apartment complex. It can offer services as a regular living community with medical attention for those who require it. When comfortable with your living settings and are able to be fully independent, residents are able to upgrade their living arrangements. Only those who are able to independent with their ADL’s are able to living in this type of facility...
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...everything and most of the time people may not consider the extent of this or how it will affect others such as what the changes will have on the aging population. Changes may include the effects of his or her medical benefits, employment options, retirement, social security, housing, and most important who will provide care for the aging family members. Since entering into the new millennium, The United States has been challenged with the meeting of many demands that our aging population requires. For example, the increase there has been in the health costs, financing and delivery of health care for the older population, and the worries about health care quality is a serious challenge for health care. Health care is researched, and this is needed to help the aging population benefit from the advances in clinical, biomedical, and behavioral research. Aging adults face the challenges of chronic diseases that contributes to the diminishment of life, disability, and the increase that is seen with the cost of long-term health care. The number of older individuals is expected to increase always over time because somewhere someone is aging, and this will affect the penalties for public health, delivery systems, health care financing, informal care giving, and pension systems. Furthermore, other Countries around the world have been known to pay much more attention to the aging population, and an extensive number of these individuals and growing amount of chronic disease will place...
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...When it comes to long-term care, it is widely known as a field of work that has a very high worker turnover rate. Many studies have been done in addition to extensive research to seek out what is causing this phenomenon and what can be done to fix it. Taking history into consideration, closing the gap in worker turnover and aiming to get higher retention rates will be an upward battle and will take new tactics and strategies to change the minds of those already in this particular field of work as well as make it more appealing to those not yet in it. According to research, the turnover rate in long-term care is a substantial problem, with rates ranging from 55% to 75% for nurses and aides and sometimes over 100% for aides alone. There are numerous sources of statistics indicating that there are many costs connected with turnover, comprised of “increased hospital readmission rates, high employee replacement costs, loss of productivity, poorer quality of care, a decrease in staff and resident morale, increased work stress, job dissatisfaction, increased accident and absenteeism rates, increased overtime costs, and resident and family dissatisfaction” (Mcconnell, 2010). Although new strategies and programs will mainly value and benefit the workers as an aid in increasing employee retention, it is also a good thing for employers to do to increase overall employee satisfaction. This will work together to uphold a stable workforce by decreasing employee turnover through better benefits...
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...Funding Health Care Services Dr. Johnican HSA 500 Health Services Organization March 3rd, 2014 Funding Health Care Services Ambulatory services are the services offered to patients if they are to be accommodated within the compounds of the healthcare institution under professional nursing care because of the severity of their health or because of the recommendations of patients’ physician or surgeon (Williams, S. & Torrens, P. 2010). The patient is only there for a day and then is discharged for the facility. There are services that be provided in a day starting from registering the patient to providing them with medication. There many different kind of services that falls under ambulatory care such as outpatient clinics, urgent care centers, emergency rooms, ambulatory or same-day surgery centers, diagnostic and imaging centers, primary care centers, community health centers, occupational health centers, mental health clinics, and group practices. There has been an increase in the ambulatory care because it is inexpensive and more appropriate health care setting. It is hard for the health care personnel and patients to adjust because of the changing technology and complex reimbursement systems. There are spending costs involved in health care like money paid to health care providers in hospitals, outpatient centers, Veterans Affairs and other clinics, doctor and dentist practices, physical therapists, nursing homes, home health services and on-site care at places...
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...contains three empirical papers on important health policy issues. The first paper looks at the effect of changes in levels of Medicare home health care services on the informal care use of disabled, older adults. I estimate two-part models of informal care use, where the key independent variable is a measure of Medicare home health payment restrictiveness. Individuals who lived in states with less Medicare home health care services increased their use of informal care, although this effect is only observed among low-income individuals. The second paper assesses the effects of changes in employment incentives on the supply of informal support from adult children to their disabled, older parents. This study focuses on one specific form of informal support, co-residence with a disabled parent. I compare changes in co-residence patterns between 1990 and 2000 across groups of middle aged women whose co-residence patterns were arguably comparable, and who experienced very different changes in employment incentives. Results from difference-in-difference models provide support to the hypothesis that increasing employment incentives reduces the supply of informal support to disabled parents. The third paper looks at the effect of education on health status. This paper builds on the extensive research literature on this topic by measuring health in terms of the number of Quality-Adjusted Life Years experienced by individuals over an extended period of time. This measure captures overall health...
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...Home health care was developed with the benevolent intention of providing a cost-effective alternative to existing forms of long-term health care, while permitting beneficiaries to receive needed short-term, posthospitalization, acute care in their own homes. However, the home health care segment of Medicare recently sustained an unprecedented and explosive growth in program cost. As a result of this alarming expansion, home health care has become the fastest growing expense of the overwhelmingly complex Medicare program and is in danger of spiraling out of control. This article begins with a review of the current structure and administration of the home health care program under the Health Care Finance Administration (HCFA). Mr. Davis details the requirements of Home Health Agencies and their patients to qualify for full Medicare reimbursement under the home health care program. Current practices, based on lenient administrative and judicial interpretations of these qualifications, have resulted in growing demand for home health services and the resulting increase in program cost. Mr. Davis explores the primary limitations on the home health care program, including the overemphasized potential for fraud and abuse, billing and budget inefficiencies, the overavailability of services, the ease of entry into the home health care market, the lack of meaningful physician or patient involvement, and the lack of any insurance copayment or deductible. Mr. Davis critiques contemporary...
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...Continuum of Care- Long-term Care Long-term care has and is continuing to become an important part of the continuum of care. Years ago Long-term care (LTC) was considered only to be for the elderly, but as time passes it is for anybody and everybody who needs it. Barton (2006) stated, “Regardless of the length of time (i.e., from weeks to years), long-term care is an array of services provided in a range of settings to individuals who have lost some capacity for independence due to injury, chronic illness, or condition” (p. 367). According to Barton (2006), it states that the services long-term care provides help the consumer with basic needs and shows the individuals how to do daily living activities, along with therapy and being able to manage their conditions. Today long-term care is serving consumers of all ages in home, community, and institutional settings (Barton, 2006). Long-term care has contributed to the continuum of care tremendously because it is offering an array of services for consumers in different places and not just focusing on one specific population. In the last few years long-term care has become more of a need for more than 12million people in the United States, and out of these 12 million people, five million of them are nearly disabled (Barton, 2006). Barton (2006) stated, “a significant proportion of people needing long-term care-nearly half –is younger than 65: 40 percent are working age adults and about 3 percent are children younger than age 18”...
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...Abstract This paper will explore the long term care system in the United States focusing on the elderly. Understanding aging and the effects it shall have on the long term care industry is important for our society, as the numbers of the elderly are increasing. This paper shall also identify problems in the current long term care system that can cause risk to the elderly such as financial burdens and inadequate care. It will address the long term care professions and job opportunities available as well as give information needed for long term planning. Changes and needs to the long term care delivery systems will be addressed. In conclusion this paper will educate on the elderly needs for long term care and the best way to plan for their future. Long Term Care Systems in the United States When one contemplates the long term care system in the United States, the first thing one must do is understand the importance of aging. In the not so distant past, it was not uncommon for infants to die due to poor nutrition and infectious diseases, nor was the life span as high as it is today. The increasing number of elderly in our society, due to the “baby boomers and longer life spans,” and the changing patterns of activity among them, have led to new assumptions on how their needs and wishes govern the organization of long term health care. When thinking about long term care we must evaluate our rate of growth of the elderly. Statistics show that the population of 80 years or older...
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...their concerns can be over looked. They have a voice and need to be heard. In this paper I will describe the a. Organization that interest me b. How this organization will help to contribute to my professional knowledge and ability c. How this knowledge and ability can affect my career successfully Organization In choosing an organization, Catholic Charities of Louisville came to my mind. My career choice is to become an ombudsman in a long-term care facility. Catholic Charities is the organization that supports the ombudsman and assigns the cases to the workers. Ombudsman is simply citizen’s representatives, who handles complaints, provide information and assistance for the aging (American Heritage Dictionary4). They also advocate for system and legislative changes. (NASUA April 26, 2005). They help aging citizens obtain the dignity they deserve. I have always believed I was the person to be the voice for the silent ones or those that get looked over. Contributing knowledge and ability Working in health care for over a period of thirteen years, has helped me come to realize where I want my work life...
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...A variety of health care services in the United States provides continuum of care for health services. The need for long-term care is growing as the average life span of Americans continues to lengthen. The Centers for Medicare and Medicaid services estimates that about nine million men and woman over the age of 65 in the United States will need long-term care. Long-term care is a range of medical and social services designed to help people who has disabilities or chronic care needs. Services may be short or long-term and may be in a personal home in the community or in a residential facility. Long-term care facilities such as nursing homes provide care for the elderly or people who are unable to take care of them selves. The important of this paper is to discuss the continuum care of long-term care and examine the future trends of long-term care. Long-Term Care In defining long-term care there are several points. Long-term care is low tech, although it has become more complicated because many elderly patients with complex medical needs are being discharge into long-term settings. The age groups that mostly require long-term care are those who are 85 and older. This age group will double by 2030 and double again by 2050. Long-term care facilities are facilities that provide 24- hour skilled nursing assistance with activities of daily living, health services, and a number of activities. Many people would prefer not to be placed in a long-term care facility. However, some...
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...According to Barton (2010) Long-term Care “emphasized continuous care over a period of at least 90 days for a range of acute and chronic conditions. Regardless of the length of time (i.e., from weeks to years), LTC is an array of services provided in a range of settings to people who have lost some capacity for independence because of an injury, a chronic illness, or a condition” (pg. 349). This is the description of someone who may have been in a debilitating car accident, an elderly person with Alzheimer’s and dementia, a person diagnosed with chronic mental illness, and individuals who are developmentally delayed or “disabled.” People who are placed in these type of long-term care facilities are usually screened using two different measures, Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Those individuals have problems or concerns with completing their (ADLs), such as bathing, cooking, cleaning, and grooming. When we think about long-term care, we think that the elder population are the ones who would be more likely to need help with performing ADLs due to illnesses associated with old age. However, this could be further from the truth. There is a great portion of individuals who are in need of long-term care and over 40 percent of them are of working age, with 3 percent being children (Barton, 2010). This percentage of the population who requires LTC, are those who have mental illness or who have developmental disabilities. A lot of...
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