What is Long Term Care |
Trends in
the Field | Long Term Care Overview
Long Term Care Overview
What is Long Term Care?
"Long-term care is a set of health care,
personal care, and social services delivered over
a sustained period of time to persons who have lost,
or never acquired, some degree of functional capacity,
as measured by an index of functional ability.”
-American Association of Retired Persons
"... Long-term care includes subacute,
rehabilitative, medical skilled nursing, and supportive
social services for people who have functional limitations
or chronic health conditions and who need ongoing
health care or assistance with normal activities
of daily living.” -American Health Care
Association
“[Long-term care can be defined as]
coordinated medical, nursing, rehabilitation, maintenance,
and support services provided in the home, community,
or institution for an extended period of time to
patients of all ages with severe chronic diseases
or disability, involving substantial functional
impairment, regardless of diagnosis. The primary
goal of long-term care is to maintain the patient’s
maximum functional independence.” -Healthcare
Financial Management Association
The Long Term Care Continuum
The following is a general overview of the types
of services that comprise the long-term care continuum,
from low-intensity services through post-acute care:
- Chore services:
Volunteers buy groceries, mow lawns, vacuum, run
errands...
- Senior centers:
Social activities, dances, bus tours...
- Adult day
care:
Daytime activities, lunches, therapy, games...
- Home Health
Care:
In-home services by nurses, physical therapists
and dietitians...
- Rehabilitation
programs:
Provide extensive physical therapy, occupational
therapy and speech therapy)...
- Respite care:
Individuals provide relief to aid primary caregivers...
- Retirement
housing communities:
For independent elderly, individual units, building
security and social activities...
- Continuing
care retirement communities:
Provides a continuum of care ranging from retirement
housing to skilled care…
- Assisted living
centers:
Offer medical attention, assistance with eating,
bathing and other activities of daily living...
- Nursing facilities/skilled
nursing facilities:
Provide intensive nursing care around the clock...
- Acute care:
Surgical or hospital with lengths of stays limited
by diagnosis-related group caps...
Primary Long Term Care Providers
The three largest provider types in long term care
are nursing homes, assisted living facilities, and
home health care providers. Nursing homes remain
the dominant and most recognizable component of
the long-term care continuum. While long-term care
continues to diversify and evolve, the nursing home
sector has traditionally been first among equals.
However, recent industry outgrowth into assisted
living, community-based, and other ancillary services
(including therapies, durable medical equipment,
laboratory, and pharmacy services) has given these
emerging services a growing role in the overall
marketplace.
Nursing Homes
A nursing home is an entity that provides skilled
nursing care and rehabilitation services to people
with illnesses, injuries, or functional disabilities.
Most facilities serve the elderly. However, some
facilities provide services to younger individuals
with special needs, such as the developmentally
disabled, mentally ill, and those requiring drug
and alcohol rehabilitation. Nursing homes are generally
stand-alone facilities, but some are operated within
a hospital or retirement community.
Nursing Home Services
The level of care provided by nursing homes has
increased significantly over the past decade.
Many homes now provide much of the nursing care
that was previously provided in a hospital setting.
As a result, most nursing homes now focus their
attention on rehabilitation, so that their clients
can return to their own homes as soon as possible.
Some of the services a nursing home may provide
include:
- Traditional nursing
- Pharmacy services
- Hospice
- Adult day care
- Home health care
- Medical lab
- Durable medical equipment
- Diagnostic services
- Respite care
- Specialty Care (Alzheimer’s treatment,
dementia care units, stroke recovery, para/quadriplegic
impairments, wound
- are, etc.)
- Management services
- Physician services
- X-ray lab
- MR/D
- Rehabilitation services (Physical, Occupational,
Speech, Respiratory)
Assisted Living Facilities
Assisted living is part of a comprehensive long
term care continuum that provides relatively independent
seniors with supervision, assistance, and limited
health care services in a home-like environment.
Assisted living services are usually offered in
state-licensed facilities.
Not all assisted living facilities are called
“assisted living.” They are known by
as many as 26 different names in the United States,
including assisted living, residential care, foster
homes, congregate care, and board care.
Assisted Living Services
Assisted living provides apartment-style accommodations
where services focus on providing assistance with
daily living activities. These facilities are
designed to bridge the gap between independent
living and nursing home care, and provide a higher
level of services for their residents including:
- 24-hour protective oversight and emergency
response system
- Three daily meals in a group dining room
- Medication assistance/ administration
- Transportation
- Provision/ coordination of social services
- Social and religious activities
- Exercise and recreational activities
- Laundry services
- Housekeeping and maintenance
- Supervision of people with cognitive disabilities
Home Health Care
Home care is a desirable option for older people
who wish to remain in their own homes, but require
some form of health services due to frailty or disability.
Home health care is provided in an individual's
home by outside providers and aims to keep the individual
functioning at the highest possible level.
The home care industry represents several aspects
of care delivered to people in their own homes.
The largest component of the industry is home health
care, usually defined as the Medicare-certified
component of home care.
Home Health Care Services
Home health care services range from basic assistance
with household chores to skilled nursing services.
This includes home health agencies that provide
nursing, skilled care, attendant care and hospice
services; medical equipment companies; and infusion
service companies. Non-medical components of the
industry include those that provide such as services
as emergency alarm device monitoring and security
surveillance, non-Medicare covered home attendant
care, homemaker services, and Meals-on-Wheels.
Other Long Term Care Providers
The range of senior care options continues to expand
to better meet the care and financial needs of individuals.
Some of the alternatives that may be available in
your area include independent living, congregate
care, continuing care retirement communities, and
hospice care.
Independent Living
Independent living is for people who can take
care of themselves and requires residing in one's
own home, apartment, retirement community, or
independent living apartment.
Congregate Care
Congregate care is similar to independent living,
but features a community environment, with one
or more meals per day prepared and served in a
community dining room. Many other services and
amenities may be provided, such as transportation,
pools, a convenience store, bank, barber/beauty
shop, resident laundry, housekeeping, and security.
Intermediate Care
Intermediate care is nursing home care for residents
needing assistance with activities of daily living,
but without significant nursing requirements.
Skilled Nursing
Skilled nursing facilities are traditional nursing
facilities that provide 24-hour medical nursing
care for people with serious illnesses or disabilities.
These facilities are state-licensed and care is
provided by registered nurses, licensed practical
nurses, and certified nurse aids.
Continuing Care Retirement
Communities (CCRC) or Life Care Communities (LCC)
These communities are planned and operated to
provide a continuum of care from independent living
through skilled nursing. The facilities allow
individuals to live within the same community
as their needs progress through the spectrum of
care.
Hospice Care
Hospice care is a combination of facility-based
and home care provided to benefit terminally ill
patients and support their families as the patient
is dying, allowing the patient to die in peace
and without pain.
Hospitals
In addition to traditional services, many hospitals
offer skilled or subacute nursing services either
in their facility or on their campus.
Respite Care
Respite care is provided on a temporary basis
to allow a primary care provider or family member
relief for a few hours or days.
Adult Day Care
Adult day care programs provide meals, social
activities, and care services in a community setting
during the day while a caregiver needs time off
or must work.
Out-patient Therapy
Many facilities offer the same therapies provided
in a nursing home on an out-patient basis. For
those choosing a home-based option, out-patient
therapy may be a necessary professional service.
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