1 Chapter 1. Long-Term Care Today: Turbulent Times Long-Term Care: Managing Across the Continuum (Second Edition)

2 Learning Objectives 1.Define the current long-term care system, including how it developed, and key strengths and weaknesses of the system. 2.Define the term "continuum of care." 3.Identify and define the consumers and providers of long-term care. 4.Define institutional and non-institutional care, and the strengths and shortcomings of each approach. 5.Identify the changes taking place in long- term care today.

3 Defining the Long-Term Care System Long-Term Care: “Care of those persons requiring health care, personal care, social, and supportive services over a sustained period of time”

4 Factors Contributing to Development of the Long-Term Care System 1.Financing: Growing role of government 2.The impact of regulations 3.The results of past successes 4.Cost-reduction efforts

5 Components of the Long-Term Care System Consumers: Elderly users of long-term care  The elderly as a political force Nonelderly long-term care users The physically handicapped The mentally ill/mentally retarded The baby boomers: future long-term care consumers

6 Components of the Long-Term Care System Providers: Nursing Facilities Assisted Living/Residential Care Subacute Care Adult Day Care Home Health Care Hospice Care

7 Institutional vs. Non- Institutional Care Institutional:Non-Institutional: Nursing Facilities Adult Day Care Assisted Living Home Health Care Subacute Care Hospice Care

8 Long-Term Care as Part of a Continuum The Continuum of care is: Client-Oriented Comprehensive Integrated

9 Strengths and Weakness of The Long-Term Care System Strengths: Response to changing needs Uniquely American nature Dedication of caregivers Focus on customer service Innovative types of care Integration efforts

10 Strengths and Weakness in The Long-Term Care System Weaknesses: Reimbursement-driven Inequitably distributed services Fragmented and uncoordinated Mix of health and social services Multiple entry points

11 Strengths and Weakness in The Long-Term Care System Weaknesses (continued): Overshadowed by the acute system Poor public image Inadequate support for informal caregivers Confusing and “user-unfriendly” system

12 Summary The long-term care system has taken years to develop, and is still evolving. It is a critical part of the overall continuum of care, and has both strengths and weaknesses