Long Term Care

Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

Karen Cumming and Patricia Milne are sisters who embarked on a daunting journey... one that many of us may go on at some point in our lives. They guided their 98 year old mother, Verna, through Ontario's long-term care system. Unfortunately, few people on the inside of that system seemed to be guiding them. The pair found themselves lost in a confusing maze of care coordinators, nurses, doctors, PSWs, therapists, paperwork, equipment purchases and rentals, and medication. It was unfamiliar territory. It was scary. They felt alone. Serious decisions had to be made about Verna's end-of-life care, but the sisters often felt ill-informed and unprepared to make them. Sound familiar? Thousands of baby boomers across Ontario are currently in the same boat. Perhaps you're helping your elderly mom or dad. Maybe you're on the journey yourself. Karen and Patricia have been where you are now. This book is the survival guide they never had. Packed with indispensable resources, tips and insights, it will help you and your family to be proactive and prepared for the decisions that lie ahead. You are not alone.

A NATIONAL BESTSELLER SHORTLISTED FOR THE BALSILLIE PRIZE FOR PUBLIC POLICY It took the coronavirus pandemic to open our eyes to the deplorable state of so many of the nation's long-term care homes: the inhumane conditions, overworked and underpaid staff, and lack of oversight. In this timely new book, esteemed health reporter André Picard reveals the full extent of the crisis in eldercare, and offers an urgently needed prescription to fix a broken system. When COVID-19 spread through seniors' residences across Canada, the impact was horrific. Along with widespread illness and a devastating death toll, the situation exposed a decades-old crisis: the shocking systemic neglect towards our elders. Called in to provide emergency care in some of the hardest-hit facilities in Ontario and Quebec, the military issued damning reports of what they encountered. And yet, the failings that were exposed--unappetizing meals, infrequent baths, overmedication, physical abuse and inadequate personal care--have persisted for years in these institutions. In Neglected No More, André Picard takes a hard look at how we came to embrace mass institutionalization, and lays out what can and must be done to improve the state of care for our elders, a highly vulnerable population with complex needs and little ability to advocate for themselves. Picard shows that the entire eldercare system--fragmented, underfunded and unsupported--is long overdue for a fundamental rethink. We need to find ways to ensure seniors can age gracefully in the community for longer, with supportive home care and respite for family caregivers, and ensure that long-term care homes are not warehouses of isolation and neglect. Our elders deserve nothing less.

Long-term care services include a broad range of services that meet the needs of frail older people and other adults with functional limitations. Long-Term care services provided by paid, regulated providers are a significant component of personal health care spending in the United States. This report presents descriptive results from the first wave of the National Study of Long-Term Care Providers (NSLTCP), which was conducted by the Centers for Disease Control and Preventions National Center for Health Statistics (NCHS). This report provides information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional composition of users of these services. Service users include residents of nursing homes and residential care communities, patients of home health agencies and hospices, and participants of adult day services centers.

This examination of long-term care in Canada seeks to bring the subject out of the shadows and into the forefront of people's thoughts. The contributors look, from a female gender point of view, at developing alternative forms of long-term residential care, which treat both residents and workers with dignity and respect.

While Being Mortal (Atul Gawande) helped us understand disease and death, and Successful Aging (Daniel J. Levitin) showed us older years can be a time of joy and resilience, Happily Ever Older reveals how the right living arrangements can create a vibrancy that defies age or ability. Reporter Moira Welsh has spent years investigating retirement homes and long-term care facilities and wants to tell the dangerous stories. Not the accounts of falls or bedsores or overmedication, but of seniors living with purpose and energy and love. Stories that could change the status quo. Welsh takes readers across North America and into Europe on a whirlwind tour of facilities with novel approaches to community living, including a day program in a fake town out of the 1950s, a residence where seniors school their student roommates in beer pong, and an aging-in-place community in a forest where everyone seems to have a pet or a garden or both. The COVID-19 pandemic cruelly showed us that social isolation is debilitating, and Welsh tells stories of elders living with friendship, new and old, in their later years. Happily Ever Older is a warm, inspiring blueprint for change, proof that instead of warehousing seniors, we can create a future with strong social connections and a reason to go on living.

"This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults."--Provided by publisher.

How can we plan, organize, distribute, and offer care in ways that treat both those who need it and those who provide it with dignity and respect? Using the example of residential services, Troubling Care: Critical Perspectives on Research and Practices investigates the fractures in our care systems and challenges how caring work is understood in social policy, in academic theory, and among health care providers. In this era defined by government cutbacks and a narrowing sense of collective responsibility, long-term residential care for the elderly and disabled is being undervalued and undermined. A result of a seven-year interdisciplinary research project-in-progress, this book draws together the work of fourteen leading health researchers, including sociologists, medical practitioners, social workers, policy researchers, cultural theorists, and historians. Using a feminist political economy lens, these scholars explore and challenge the theories, work organization, practices, and state-society relations that have come to shape long-term care. Troubling Care offers critical perspectives on the often disquieting arena of care provision and proposes alternatives for thinking about and meeting the needs of some of our most vulnerable citizens in ways that go beyond residential care. This book seeks to bridge not only the gaps between disciplines, but also those between theory and practice. Features: takes an interdisciplinary approach, making this work appropriate for courses in a variety of disciplines including sociology, medicine, social work, health policy, cultural studies, and political economy includes the work of fourteen leading health researchers, including sociologists, medical practitioners, social workers, policy researchers, cultural theorists, and historians bridges the gap between theory and practice by incorporating both theoretical research and specific case examples