Universal Coverage Of Long Term Care In The United States

As millions of baby boomers retire and age in the coming years, more American families will confront difficult choices about the long-term care of their loved ones. The swelling ranks of the disabled and elderly who need such care—including home care, adult day care, or a nursing home stay—are faced with a strained, inequitable and expensive system. How will American society and policy adapt to this demographic transition? In Universal Coverage of Long-Term Care in the United States, editors Nancy Folbre and Douglas Wolf and an expert group of care researchers assess the current U.S. long-term care policies and exercise what can be learned from other countries facing similar care demands. After the high-profile suspension of the Obama Administration’s public long-term insurance program in 2011, Robert Hudson and Howard Gleckman provide concrete suggestions for lowering the cost and improving the quality of long-term care coverage in America. In a deeply personal and empirically rigorous analysis, family care expert Carol Levine draws crucial lessons from her experience as a caregiver for her ailing husband. She sheds light on the often fraught interactions that occur between the formal care system and family caregivers and analyzes how public policy can best support long-term family care. The volume next examines recent reforms in other developed countries and finds valuable lessons for American policy-makers. Contributors David Bell and Alison Bowes discuss the provision of personal care services in Scotland, which have been publicly financed since 2002. Their analysis shows that the new program reduced costs improved efficiency and allowed more recipients to receive care. The volume assesses the political and institutional prospects for moving towards a truly universal long-term care system in the United States. Robyn Stone provides a sobering overview of the formal, paid long-term care workforce in America, which is in crisis due to increasing demand and a shortage of qualified workers. Economist Leonard Burman focuses on public finances of the long-term care system, which will come under increasing strain as more Americans rely on Medicaid to pay for their long-term care. In the volume’s concluding chapter, Folbre and Wolf summarize criticisms of existing long-term care policies and outline particular reforms that can move the United States toward a universal system of long-term care insurance. Universal Coverage of Long-Term Care in the United States provides an essential resource on how to improve the long-term care sector in America and helps advance the national debate on this pressing topic. This volume is available for free download on the Foundation’s website, as are the volume’s individual chapters.

There is a looming crisis in our nation's capacity to provide long-term care. The needs keep increasing while more and more of our aging seniors and large numbers of disabled can no longer gain access to affordable care. The markers are serious--more than one-half of Americans age 65 and older are expected to need help with activities of daily living, whether in a nursing home, assisted living facility, or at home; U. S. seniors are projected to outnumber children under 18 by 2035; dementia increases as our population ages, expected to involve almost 40 percent of people over age 85; one in four Americans has a major disability; and there is a growing shortage of caregivers. Regardless of our age and current circumstances, all of us will face the need for long-term care for a parent, another family member, or ourselves down the road. When that time comes, it is an open question whether most of us will be able to gain access to personal, affordable long-term care when we need it. This book examines the many issues involved in charting a way toward a system of universal coverage that will fix the challenge of 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.

"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.