Scrapped Long-Term Care Program Gets Scrutiny

2011 ◽  
Vol 41 (19) ◽  
pp. 49
Author(s):  
FRANCES CORREA
Author(s):  
Frank J. Elgar ◽  
Graham Worrall ◽  
John C. Knight

ABSTRACTAs the demand for home care services increases, health care agencies should be able to predict the intake capacity of community-based long-term care (CBLTC) programs. Two hundred and thirty-seven clients entering a CBLTC program were assessed for activities of daily living (ADL) and cognitive and affective functioning and were then followed to monitor attrition and reasons why clients left the program. Compromised ADL functioning at baseline increased likelihood of death and institutionalization by 2 per cent each year. Over a 10-year period, reduced cognitive functioning at baseline increased the risk of death by 9 per cent and decreased the likelihood of leaving the program due to improvement by 18 per cent. Reduced affective functioning at baseline increased the risk of institutionalization during the course of the study by 3 per cent. Routine functional assessments with the elderly may help in the management of similar home care programs.


Author(s):  
Mary Schmeida ◽  
Ramona Sue McNeal

The U.S. population is living longer, placing a demand on long-term care services. In the U.S., Medicaid is the primary player in funding costly long-term care for the aged poor. As a major health reform law, the 2010 Patient Protection and Affordable Care Act, Public Law 111-148, gives financial incentive for states to expand Medicaid, transitioning long-term care services from facilities toward community care. Facing other funding obligations and recent recessions, not all states expanded their Medicaid long-term care program using the financial incentives. Some states continue to spend more dollars on traditional nursing facility care despite legislation. This chapter explores why some states spend more revenue on nursing facility long-term care despite enhanced federal funding to reform, while others are spending more on home and community-based services. Regression analysis and 50 state-level data is used.


Author(s):  
Mary Schmeida ◽  
Ramona McNeal

U.S. longevity is placing a demand on long-term care services for the impaired and elderly. Medicaid is the primary insurance program in funding costly long-term care for the aged poor. As a major health reform law, the 2010 Patient Protection and Affordable Care Act, Public Law 111-148, gives financial incentive for states to expand Medicaid, transitioning long-term care services from costly facilities toward home and community-based care. Not all states choose to expand their Medicaid long-term care program despite the financial incentive, but instead they continue spending on nursing facility care despite the less costly option of community care. This article explores why some states have been reluctant to expand long-term care into the community. Regression analysis and 50 state-level data is used.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jillian L. Shotwell ◽  
Eve Wool ◽  
Andrzej Kozikowski ◽  
Renee Pekmezaris ◽  
Jill Slaboda ◽  
...  

Abstract Background Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides has not been explored. Methods Qualitative interviews were conducted with formal caregivers, defined as paid home health aides (HHAs) (n = 13) caring for patients in a home-based primary care program in the New York City metropolitan area. HHAs were asked about their satisfaction with the home based primary care program, their own job satisfaction, and whether HHA restrictions affect their work in any way. Interviews were audio-recorded, transcribed, and analyzed. Results Two main themes emerged: (1) Pay, benefits and hours worked and (2) Concerns about patient well-being afterhours. HHAs are working more hours than they are compensated for, experience wage stagnation and loss of benefits, and experience stress related to leaving frail clients alone after their shifts end. Conclusions HHAs experience significant job-related stress when caring for frail elderly patients at home, which may have implications for both patient care and HHA turnover. As government bodies contemplate new policy directions for long-term care programs which rely on HHAs the impact of these changes on this vulnerable workforce must be considered.


2013 ◽  
Vol 67 (1-2) ◽  
pp. 221-226
Author(s):  
Tammi Vacha-Haase

Although bereavement programs in hospice and palliative care settings are known to produce positive outcomes for family members after the death of a loved one, currently there is a clear lack of services offered through long-term care (LTC) facilities, where older adults often reside prior to their death. The purpose of the present article is to present an initial bereavement program called We Care that focused on providing additional support for family members who experience a death of a loved one while in a LTC facility. Goals for the program include: 1) providing ongoing contact with the family for 1 year, and 2) offering a bereavement group. The program's model is explained, with highlights of obstacles experienced and suggestions for future programs.


2013 ◽  
Vol 21 (3) ◽  
pp. S101-S102
Author(s):  
Kisha N. Bazelais ◽  
Rebecca L. Greenberg ◽  
Martha L. Bruce

2000 ◽  
Vol 2 (1) ◽  
pp. 23-39 ◽  
Author(s):  
EM Guagenti-Tax ◽  
TA DiLorenzo ◽  
L Tenteromano ◽  
NG LaRocca ◽  
CR Smith

Abstract The goal of this project was to evaluate a comprehensive model of long-term care in multiple sclerosis (MS). This model consisted of workshops designed to assist participants cope with caregiving demands; medical day care to provide rehabilitation and group therapy; home visits by a psychotherapist or nurse to assist with practical and psychological issues; and case management and liaison services. Thirty patient-caregiver units receiving treatment were compared with 29 control subjects, with data being collected on 3 occasions over a 2-year period. Repeated measures analysis of variance found that physical functioning declined for MS subjects as indicated by Kurtzke score, Incapacity Status Scale score, and number of hospitalizations. The experimental group reported an increase in perceived cognitive deficits and decreased anxiety. Control subjects reported a greater decline in perceived health than experimental subjects as assessed by the SF-36 general health subscale. All caregivers reported increased overcommitment. Caregivers of controls reported significant decreases in perceived health and that health problems and caregiving activities interfered with social activities. Persons with MS in both groups reported increased satisfaction with caregiver help, while control subjects reported greater satisfaction with the timeliness of help received. These results provide valuable information about effective ways to use and integrate community resources in the provision of long-term care for persons with MS.


Sign in / Sign up

Export Citation Format

Share Document