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True or False? Most Long Term Care (Ltc) Services Are Provided Informally by Family and Friends.

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Services for the elderly or those with chronic affliction or disability

Long-term care (LTC) is a variety of services which help run into both the medical and not-medical needs of people with a chronic affliction or inability who cannot care for themselves for long periods. Long term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life, and see patients' needs over a menstruation of time.[1]

It is common for long-term care to provide custodial and non-skilled care, such as assisting with activities of daily living like dressing, feeding, using the bathroom, meal grooming, functional transfers and safe restroom employ.[2] Increasingly, long-term care involves providing a level of medical care that requires the expertise of skilled practitioners to accost the multiple chronic weather condition associated with older populations. Long-term care can be provided at home, in the community, in assisted living facilities or in nursing homes. Long-term intendance may be needed past people of any historic period, although information technology is a more common need for senior citizens.[3]

Types of long-term intendance [edit]

Long-term care can exist provided formally or informally. Facilities that offer formal LTC services typically provide living accommodation for people who crave on-site commitment of effectually-the-clock supervised care, including professional health services, personal care, and services such equally meals, laundry and housekeeping.[4] These facilities may get nether various names, such every bit nursing home, personal intendance facility, residential continuing care facility, etc. and are operated by different providers.

While the Usa government has been asked by the LTC (long-term care) industry not to parcel health, personal care, and services (e.m., meal, laundry, housekeeping) into large facilities, the government continues to approve that every bit the primary use of taxpayers' funds instead (e.g., new assisted living). Greater success has been accomplished in areas such as supported housing which may however utilize older housing complexes or buildings, or may have been part of new federal-state initiatives in the 2000s.[5]

Long-term care provided formally in the home, also known every bit dwelling health care, can incorporate a wide range of clinical services (e.g. nursing, drug therapy, concrete therapy) and other activities such as physical structure (e.yard. installing hydraulic lifts, renovating bathrooms and kitchens). These services are usually ordered by a physician or other professional. Depending on the country and nature of the wellness and social care system, some of the costs of these services may be covered by wellness insurance or long-term care insurance.

Modernized forms of long term services and supports (LTSS), reimbursable by the government, are user-directed personal services, family-directed options, independent living services, benefits counseling, mental health companion services, family educational activity, and even self-advocacy and employment, amongst others. In home services can be provided by personnel other than nurses and therapists, who practice non install lifts, and belong to the long-term services and supports (LTSS) systems of the U.s..

Breezy long-term habitation care is care and support provided by family unit members, friends and other unpaid volunteers. It is estimated that 90% of all home care is provided informally by a loved 1 without compensation[6] and in 2015, families are seeking compensation from their regime for caregiving.

Long-term services and supports [edit]

"Long-term services and supports" (LTSS) is the modernized term for community services, which may obtain wellness care financing (e.grand., home and customs-based Medicaid waiver services),[7] [viii] and may or may not be operated by the traditional infirmary-medical system (e.g., physicians, nurses, nurse's aides).[9]

The Consortium of Citizens with Disabilities (CCD)[10] which works with the U. S. Congress, has indicated that while hospitals offer acute intendance, many non-astute, long-term services are provided to aid individuals to live and participate in the community. An case is the group home international emblem of community living and deinstitutionalization,[11] and the variety of supportive services (east.1000., supported housing, supported employment, supported living, supported parenting, family support), supported education.[12] [13] [14]

The term is also mutual with aging groups, such as the American Association of Retired Persons (AARP), which annually surveys the The states states on services for elders (due east.g., intermediate care facilities, assisted living, home-delivered meals).[15] The new US Back up Workforce includes the Straight Back up Professional, which is largely not-profit or for-profit, and the governmental workforces, often unionized, in the communities in U.s. states. Core competencies (Racino-Lakin, 1988) at the federal-state interface for the aides "in institutions and communities" were identified in aging and physical disabilities, intellectual and developmental disabilities, and behavioral ("mental health") wellness in 2013 (Larson, Sedlezky, Hewitt, & Blakeway, 2014).[xvi]

President Barack Obama, US House Speaker John Boehner, Minority Leader Nancy Pelosi, Bulk Leader Harry Reid, and Minority Leader Mitch McConnell received copies of the U.s.a. Senate Commission on Long Term Intendance on the "issues of service commitment, workforce and financing which have challenged policymakers for decades" (Chernof & Warshawsky, 2013).[17] The new Commission envisions a "comprehensive financing model balancing individual and public financing to insure catastrophic expenses, encourage savings and insurance for more than immediate LTSS (Long Term Services and Supports) costs, and to provide a safety net for those without resource."[17]

The direct intendance workforce envisioned by the MDs (physicians, prepared by a medical school, subsequently licensed for practice) in America (who did non develop the customs service systems, and serve different, valued roles within it) were described in 2013 as: personal care aides (20%), habitation wellness aides (23%), nursing administration (37%), and independent providers (twenty%) (p. 10).[18] [19] [twenty] The US has varying and competing wellness care systems, and hospitals have adopted a model to transfer "community funds into infirmary"; in improver, "infirmary studies" indicate M-LTSS (managed long-term care services)[21] as billable services. In addition, centrolineal health personnel preparation have formed the bulk of the preparation in specialized science and disability centers which theoretically and practically supports modernized personal assist services across population groups[22] [23] and "managed" behavioral health care "equally a subset of" mental wellness services.[24] [25]

Long-term services and supports (LTSS) legislation was developed, as were the community services and personnel, to address the needs of "individuals with disabilities" for whom the state governments were litigated against, and in many cases, required to report regularly on the development of a customs-based organization.[26] These LTSS options originally bore such categorical services as residential and vocational rehabilitation or habilitation, family unit care or foster family care, pocket-sized intermediate intendance facilities,[27] [28] "group homes",[29] and afterward supported employment,[30] clinics, family back up,[31] supportive living, and day services (Smith & Racino, 1988 for the US governments).The original country departments were Intellectual and Developmental Disabilities, Offices of Mental Health,[32] lead designations in Departments of Health in encephalon injury for communities,[33] and then, Alcohol and Substance Corruption defended land agencies.

Among the government and Executive initiatives were the development of supportive living internationally,[34] [35] new models in supportive housing (or even more sophisticated housing and health),[36] and artistic plans permeating the literature on contained living, user-directed categories (approved by US Centers for Medicaid and Medicare), expansion of abode services and family unit support, and assisted living facilities for the aging groups. These services oftentimes have undergone a revolution in payment schemes beginning with systems for payment of valued community options.[37] [38] [39] [40] so termed evidence-based practices.

Interventions for preventing delirium in older people in institutional long-term care

The current bear witness suggests that software-based interventions to identify medications that could contribute to delirium gamble and recommend a pharmacist's medication review probably reduces incidence of delirium in older adults in long-term care.[41] The benefits of hydration reminders and didactics on chance factors and care homes' solutions for reducing delirium is still uncertain.

Physical rehabilitation for older people in long-term intendance

Concrete rehabilitation can prevent deterioration in wellness and activities of daily living among intendance home residents. The electric current testify suggests benefits to concrete health from participating in different types of physical rehabilitation to better daily living, force, flexibility, residuum, mood, memory, exercise tolerance, fear of falling, injuries, and decease.[42] It may be both safe and constructive in improving physical and possibly mental state, while reducing inability with few adverse events.[42]

The current trunk of evidence suggests that concrete rehabilitation may be constructive for long-term care residents in reducing disability with few adverse events.[43] However, there is insufficient to conclude whether the beneficial effects are sustainable and toll-effective.[43] The findings are based on moderate quality evidence.

Need for long-term care [edit]

Life expectancy is going up in near countries, meaning more than people are living longer and inbound an age when they may need care. Meanwhile, birth rates are more often than not falling. Globally, 70 percent of all older people now live in low or center-income countries.[44] Countries and wellness care systems need to find innovative and sustainable means to cope with the demographic shift. As reported by John Beard, director of the Earth Health Organization's Department of Ageing and Life Course, "With the rapid ageing of populations, finding the right model for long-term care becomes more and more urgent."[iii]

The demographic shift is likewise being accompanied by changing social patterns, including smaller families, different residential patterns, and increased female labour force participation. These factors often contribute to an increased demand for paid care.[45]

In many countries, the largest percentages of older persons needing LTC services all the same rely on breezy dwelling care, or services provided past unpaid caregivers (usually nonprofessional family unit members, friends or other volunteers). Estimates from the OECD of these figures oft are in the eighty to 90 pct range; for instance, in Republic of austria, 80 percent of all older citizens.[46] The similar figure for dependent elders in Spain is 82.2 per centum.[47]

The Us Centers for Medicare and Medicaid Services estimates that about 9 one thousand thousand American men and women over the historic period of 65 needed long-term care in 2006, with the number expected to jump to 27 million by 2050.[48] It is predictable that near will be cared for at dwelling house; family and friends are the sole caregivers for seventy percent of the elderly. A report by the U.S. Section of Health and Human Services says that four out of every 10 people who reach age 65 will enter a nursing dwelling house at some signal in their lives.[49] Roughly 10 percent of the people who enter a nursing home volition stay there five years or more.[50]

Based on projections of needs in long term intendance (LTC), the US 1980s demonstrations of versions of Nursing Homes Without Walls (Senator Lombardi of New York) for elders in the The states were popular, simply limited: On LOK, PACE, Channeling, Section 222 Homemaker, Admission Medicaid-Medicare, and new Social Day Care. The major argument for the new services was cost savings based upon reduction of institutionalization.[51] The demonstrations were significant in developing and integrating personal care, transportation, homemaking/meals, nursing/medical, emotional back up, help with finances, and informal caregiving. Weasart concluded that: "Increased life satisfaction appears to be relatively consistent benefit of customs care" and that a "prospective budgeting model" of abode and customs-based long term care (LTC) used "break-even costs" to prevent institutional care.

Long-term intendance costs [edit]

A recent analysis indicates that Americans spent $219.9 billion on long-term care services for the elderly in 2012.[52] Nursing domicile spending accounts for the majority of long-term care expenditures, but the proportion of home and community based intendance expenditures has increased over the past 25 years.[53] The US federal-country-local authorities systems have supported the creation of modernized health care options, though new intergovernmental barriers continue to exist.[54] [55]

The Medicaid and Medicare health intendance systems in the US are relatively young, celebrating 50 years in 2015. According to the Wellness Care Financing Review (Fall 2000), its history includes a 1967 expansion of to ensure primary and preventive services to Medicaid-eligible children (EPSDT), the use dwelling and community-based Medicaid waivers (so HCBS services), Clinton administration wellness intendance demonstrations (under 1115 waiver authorization), the new era of SCHIP to embrace uninsured children and families, coverage for the HIV/AIDS population groups, and attention to indigenous and racial-based service commitment (east.g., beneficiaries). Subsequently, managed care plans which used "intensive residential children'south" options and "non-traditional out-patients services (school-based services, fractional hospitalization, in-home treatment and instance management) developed "behavioral health intendance plans".[56]

In 2019, the boilerplate annual cost of nursing dwelling house care in the United States was $102,200 for a private room. The average almanac cost for assisted living was $48,612. Home health care, based on a 44 average week, cost $52,654 a twelvemonth [57] Genworth 2019 Cost of Care Survey]. The boilerplate cost of a nursing habitation for 1 year is more than the typical family has saved for retirement in a 401(1000) or an IRA.[58] As of 2014, 26 states have contracts with managed care organizations (MCO) to deliver long-term care for the elderly and individuals with disabilities. Us pay a monthly capitated rate per fellow member to the MCOs that provide comprehensive care and accept the chance of managing full costs.[59]

When the percentage of elderly individuals in the population rises to nearly 14% in 2040 equally predicted, a huge strain volition be put on caregivers' finances besides every bit continuing care retirement facilities and nursing homes because demand volition increase dramatically.[threescore] New options for elders during the era of choice expansion (east.g., seniors helping seniors, home companions), which includes limitations on doctor choices, assisted living facilities, retirement communities with disability access indicators, and new "aging in place" plans (eastward.thousand., aging in a grouping home, or "transfer" to a home or support services with siblings upon parents' deaths-intellectual and developmental disabilities).

Politically, the 21st Century has shifted to the cost of unpaid family caregiving (valued by AARP in aging at $450 billion in 2009), and the governments in the The states are being asked to "pes part of the bill or costs" of caregiving for family members in abode. This movement, based in function on feminist trends in the workplace, has intersected with other infirmary to home, home health care and visiting nurses, user-directed services, and even hospice care. The government's Medicaid programs is considered the primary payer of Long Term Services and Supports (LTSS), according to the American Clan of Retired Persons, Public Policy Plant.[61] New trends in family unit back up and family caregiving likewise impact diverse inability population groups, including the very young children and young adults,[62] and are expected to be high increases in Alzheimer'southward due to longevity by age 85.

Long-term care funding [edit]

Governments around the world take responded to growing long-term care needs to unlike degrees and at different levels. These responses by governments, are based in part, upon a public policy research calendar on long term care which includes special population research, flexible models of services, and managed care models to command escalating costs and high private pay rates.[63] [64] [65] [66] [67]

Europe [edit]

About Western European countries have put in place a mechanism to fund formal care and, in a number of Northern and Continental European countries, arrangements exist to at least partially fund informal intendance every bit well. Some countries take had publicly organized funding arrangements in place for many years: holland adopted the Infrequent Medical Expenses Act (ABWZ) in 1967, and in 1988 Norway established a framework for municipal payments to informal caregivers (in certain instances making them municipal employees). Other countries have simply recently put in place comprehensive national programs: in 2004, for example, France fix a specific insurance fund for dependent older people and in 2006, Portugal created a public funded national network for long-term intendance. Some countries (Spain and Italy in Southern Europe, Poland and Hungary in Central Europe) have non yet established comprehensive national programs, relying on breezy caregivers combined with a fragmented mix of formal services that varies in quality and by location.[half dozen]

In the 1980s, some Nordic countries began making payments to informal caregivers, with Norway and Denmark allowing relatives and neighbors who were providing regular home care to become municipal employees, complete with regular pension benefits. In Finland, informal caregivers received a fixed fee from municipalities as well as pension payments. In the 1990s, a number of countries with social health insurance (Republic of austria in 1994, Federal republic of germany in 1996, Grand duchy of luxembourg in 1999) began providing a greenbacks payment to service recipients, who could then employ those funds to pay breezy caregivers.[6]

In Germany, funding for long-term intendance is covered through a mandatory insurance scheme (or Pflegeversicherung), with contributions divided every bit betwixt the insured and their employers. The scheme covers the intendance needs of people who as a upshot of affliction or disability are unable to live independently for a period of at least six months. Nigh beneficiaries stay at home (69%).[three] The country'due south LTC fund may also make pension contributions if an breezy caregiver works more than than 14 hours per week.[6]

Major reform initiatives in health care systems in Europe are based, in function on an extension of user-directed services demonstrations and approvals in the U.s.a. (eastward.chiliad., Greenbacks and counseling demonstrations and evaluations).[68] [69] Clare Ungerson, a Professor of Social Policy, together with Susan Yeandle, Professor of Sociology, reported on the Greenbacks for Care Demonstrations in Nation-States in Europe (Austria, French republic, Italia, Netherlands, England, Germany) with a comparative The states ("paradigm of home and customs care").[70] [71]

In addition, direct payment schemes were developed and implemented in the UK, including in Scotland,[72] for parents with children with disabilities and people with mental health issues. These "wellness care schemes" on the commodification of intendance were compared to individualised planning and directly funding in the US and Canada.[73]

Due north America [edit]

Canada [edit]

In Canada, facility-based long-term care is non publicly insured under the Canada Health Deed in the same way every bit hospital and physician services. Funding for LTC facilities is governed by the provinces and territories, which varies across the state in terms of the range of services offered and the toll coverage.[four] In Canada, from April ane, 2013 to March 31, 2014, there were 1,519 long-term intendance facilities housing 149,488 residents.[74]

Canada-US take a long term relationship equally border neighbors on health intendance; notwithstanding Canada, has a national wellness care organization (which coincidentally they call Medicare) in which providers (physicians and other practitioners) remain in private practice but the payer is the government, instead of being numerous commercial insurance companies (e.chiliad., The states, Bernie Sander's Proposal for Medicare for All). In the evolution of home and community-based services, individualised services and supports were popular in both Nations.[75] The Canadian citations of US projects included the greenbacks assistance programs in family support in the US, in the context of individual and family unit support services for children with significant needs. In contrast, the Usa initiatives in health care in that catamenia involved the Medicaid waiver authority and health care demonstrations, and the use of state demonstration funds dissever from the federal programs.[76] [77]

United states [edit]

Long-term care is typically funded using a combination of sources including but not limited to family members, Medicaid, long-term intendance insurance and Medicare. All of these include out-of-pocket spending, which ofttimes becomes exhausted once an individual requires more than medical attention throughout the crumbling process and might need in-domicile care or be admitted into a nursing abode. For many people, out-of-pocket spending for long-term care is a transitional country earlier somewhen being covered by Medicaid, which requires impoverishment for eligibility.[58] Personal savings can exist hard to manage and budget and oftentimes deplete apace. In addition to personal savings, individuals can besides rely on an Individual retirement account, Roth IRA, Pension, Severance package or the funds of family unit members. These are essentially retirement packages that become bachelor to the private once certain requirements take been met.

In 2008, Medicaid and Medicare accounted for approximately 71% of national long-term intendance spending in the United states of america.[78] Out-of-pocket spending deemed for 18% of national long-term care spending, private long-term care insurance accounted for seven%, and other organizations and agencies deemed for the remaining expenses. Moreover, 67% of all nursing home residents used Medicaid as their main source of payment.[79]

Private Long-Term Intendance Insurance in 2017 paid over $9.two Billion in benefits and claims for these policies keep to abound.[fourscore] The largest claim to ane person is reported to exist over $2 meg in benefits [81]

Medicaid is i of the dominant players in the nation's long-term intendance market place because there is a failure of private insurance and Medicare to pay for expensive long-term intendance services, such as nursing homes. For instance, 34% of Medicaid was spent on long-term care services in 2002.[82]

Medicaid operates every bit singled-out programs which involve home and customs-based (Medicaid) waivers designed for special population groups during deinstitutionalization then to customs, direct medical services for individuals who encounter depression income guidelines (held stable with the new Affordable Care Deed Health Care Exchanges), facility development programs (due east.1000., intermediate care facilities for intellectual and developmental disabilities populations), and additional reimbursements for specified services or beds in facilities (e.g., over 63% beds in nursing facilities). Medicaid also fund traditional home health services and is payor of adult twenty-four hour period care services. Currently, the U.s.a. Centers for Medicaid and Medicare as well accept a user-directed pick of services previously part of grayness market industry.

In the U.s.a., Medicaid is a government programme that will pay for sure wellness services and nursing home care for older people (in one case their avails are depleted). In most states, Medicaid also pays for some long-term intendance services at home and in the community. Eligibility and covered services vary from state to state. Most often, eligibility is based on income and personal resource. Individuals eligible for Medicaid are eligible for community services, such as home health, but governments have not fairly funded this option for elders who wish to remain in their homes subsequently extended illness aging in place, and Medicaid's expenses are primarily concentrated on nursing dwelling house intendance operated by the infirmary-nursing industry in the US.[83]

More often than not, Medicare does non pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home wellness care. Withal, certain conditions must be met for Medicare to pay for fifty-fifty those types of care. The services must be ordered by a dr. and tend to be rehabilatative in nature. Medicare specifically will non pay for custodial and non-skilled intendance. Medicare will typically encompass but 100 skilled nursing days following a 3-24-hour interval admission to a hospital.

A 2006 study conducted past AARP found that most Americans are unaware of the costs associated with long-term care and overestimate the amount that authorities programs such as Medicare will pay.[84] The US government plans for individuals to have care from family, similar to Depression days; however, AARP reports annually on the Long-term services and supports (LTSS) [85] for aging in the Usa including domicile-delivered meals (from senior center sites) and its advocacy for caregiving payments to family caregivers.

Long-term care insurance protects individuals from asset depletion and includes a range of benefits with varying lengths of time. This type of insurance is designed to protect policyholders from the costs of long-term care services, and policies are determined using an "experience rating" and charge higher premiums for higher-hazard individuals who have a greater chance of becoming ill.[86]

In that location are now a number of different types of long term intendance insurance plans including traditional tax-qualified, partnership plans (providing additional dollar-for-dollar asset protect offered past well-nigh states), brusk-term extended intendance policies and hybrid plans (life or annuity policies with riders to pay for long term care).[87]

Residents of LTC facilities may have certain legal rights, including a Red Cross ombudsperson, depending on the location of the facility.[88]

Unfortunately, government funded aid meant for long-term care recipients are sometimes misused. The New York Times explains how some of the businesses offer long-term care are misusing the loopholes in the newly redesigned New York Medicaid program.[89] Government resists progressive oversight which involves standing instruction requirements, community services assistants with quality of life indicators, evidence-based services, and leadership in employ of federal and state funds for the benefit of individual and their family.

For those that are poor and elderly, long term care becomes fifty-fifty more challenging. Often, these individuals are categorized as "dual eligibles" and they qualify for both Medicare and Medicaid. These individuals accounted for 319.5 billion in health intendance spending in 2011.[90]

See besides [edit]

  • Activities of daily living
  • AMDA – The Society for Post-Acute and Long-Term Care Medicine
  • Assisted living
  • Caring for people with dementia
  • Chronic condition
  • Dynamic treatment government
  • Family unit back up
  • Geriatric intendance management
  • Home care
  • Listing of companies operating nursing homes in the United States
  • Long-term care insurance
  • Options counseling
  • Transgenerational design

References [edit]

  1. ^ Shi L, Singh D (December 8, 2015). Essentials of the U.South. Health Care System (fourth ed.). Jones & Bartlett Learning. p. 232. ISBN978-1284100556.
  2. ^ Kernisan Fifty. "Activities of Daily Living: What Are ADLs and IADLs?". Caring. Retrieved 16 October 2015.
  3. ^ a b c Herbermann JD, Miranda D (January 2012). "Defusing the demographic "time-bomb" in Deutschland". Bulletin of the Earth Health Organization. ninety (1): 6–7. doi:10.2471/BLT.12.020112. PMC3260585. PMID 22271957.
  4. ^ a b "Long-Term Facilities-Based Intendance". Health Canada. 3 April 2003. Retrieved 3 January 2012.
  5. ^ O'Keefe J, Wiener J (2004). "Public funding for long term care services for older people with residential care settings.". In Pynoos J, Hollander-Feldman P, Ahers P (eds.). Linking Housing and Services for Older Adults: Obstacles, Options and Opportunities. New York, NY: The Haworth Press. pp. 51–80. ISBN978-0-7890-2779-5.
  6. ^ a b c d Saltman RB, Dubois HF, Chawla M (2006). "The affect of aging on long-term care in Europe and some potential policy responses". International Journal of Wellness Services. 36 (4): 719–46. doi:10.2190/AUL1-4LAM-4VNB-3YH0. PMID 17175843. S2CID 45396303.
  7. ^ "Habitation & Community-Based Services 1915(c)". Centers for Medicare & Medicaid Services.
  8. ^ Kane R (Apr 2012). "Thirty years of home-and community-based services: Getting closer and closer to dwelling". Generations: Journal of the American Society for Crumbling. 36 (ane): six–13.
  9. ^ Braddock DL (Nov 2002). "Public financial support for disability at the dawn of the 21st century". American Journal of Mental Retardation. 107 (6): 478–89. doi:x.1352/0895-8017(2002)107<0478:PFSFDA>2.0.CO;2. PMID 12323072.
  10. ^ "Long-Term Services and Supports Taskforce". Consortium of Citizens with Disabilities. Washington, DC. 2014.
  11. ^ Johnson K, Traustadottir R (2005). Deinstitutionalization and People with Intellectual Disabilities. London, UK: Jessica Kingsley Publishers. ISBN978-1-84310-101-7.
  12. ^ Taylor South, Bogdan R, Racino J (1991). Life in the Community: Case Studies of Organizations Supporting People with Disabilities in the Community. Baltimore, Dr.: Paul H. Brookes Publishing Company. ISBN978-1-55766-072-5.
  13. ^ Ullmer D, Webster SK, McManus M (1991). Cultivating Competence: Models of Support for Families Headed by Parents with Cognitive Limitations: A National Resource Directory. Wisconsin Council on Developmental Disabilities, Supported Parenting Project (Written report). Madison, WI.
  14. ^ Unger K, ed. (July 1993). "Special Issue on Supported Education". Psychosocial Rehabilitation Journal. Boston, MA: International Association of Psychosocial Rehabilitation Services and the Section of Rehabilitation Counseling, Boston Academy. 17 (1).
  15. ^ Racino J (2014). Public Administration and Disability: Community Services Administration in the United states of america. New York, NY: CRC Press, Francis and Taylor. ISBN978-1-4665-7982-8.
  16. ^ Larson SA, Sedlezky L, Hewitt A, Blakeway C (2014). "Chapter ten: Community support services workforce in the US.". In Racino J (ed.). Public Administration and Inability: Community Services Administration in the US. London, New York, NY, & Boca Raton, FL: CRC Press, Francis and Taylor. pp. 235–254. ISBN978-1-4665-7982-8.
  17. ^ a b Chernof B, Warshawsky M (September 2013). Commission on Long Term Intendance: Written report to US Congress (Report). Washington, DC: United states of america Senate. ISBN978-0-16-092102-5.
  18. ^ Litvak S, Kennedy J (1991). Policy Issues Affecting the Medicaid Personal Care Services Optional Benefit. Oakland, CA: World Institute on Disability.
  19. ^ Smith Chiliad (1994). Medicaid PCA Services in Massachusetts: Options and Bug. Washington, DC: National Association of Country Developmental Disabilities Services.
  20. ^ Kennedy J, Litvak South (Dec 1991). Example Studies of Six State Personal Assistance Service Programs Funded past the Medicaid Personal Intendance Option. Oakland, CA: World Institute on Disability.
  21. ^ Saucier P, Kasten J, Burwell B, Gold L (2012). The Growth of Managed Long-Term Services and Supports (MLTSS) Programs. Washington, DC: Centers for Medicaid and Medicare and Truven Health Analytics.
  22. ^ Litvak S, Racino J (1999). "Function Iii: Personal Assistance Services.". In Racino J (ed.). Policy, Programme Evaluation and Research in Disability: Community Support for All. London, New York, NY, and Binghamton, NY: Haworth Press. pp. 141–221. ISBN978-0-7890-0597-seven.
  23. ^ Flanagan SA (1994). Consumer-Directed Bellboy Services: How States Address Taxation, Legal, and Quality Issues. Cambridge, MA: MEDSTAT Group.
  24. ^ Anthony W, Cohen G, Farkas 1000, Gagne C (2002). Psychiatric Rehabilitation. Boston, MA: Boston University, Heart for Psychiatric Rehabilitation, Sargent College of Health and Rehabilitation Services. ISBN978-1-878512-11-6.
  25. ^ Raskin NJ (2004). Contributions to Customer-Centered Therapy and the Person-Centered Approach. Ross-on-the-Wye, Great britain: PCCS Books. ISBN978-1-898059-57-8.
  26. ^ Dybwad G, Bersani H (1996). New Voices: Self Advocacy for People with Disabilities. Cambridge, MA: Brookline Books.
  27. ^ Taylor SJ, McCord W, Searl Jr SJ (September 1981). "Medicaid dollars and community homes: The community ICF/MR controversy". Journal of the Clan for the Severely Handicapped. 6 (iii): 59–64. doi:10.1177/154079698100600307. S2CID 157646507.
  28. ^ Lakin KC, Colina B, Bruininks R (September 1985). An Analysis of Medicaid'south Intermediate Care Facility for the Mentally Retarded (ICF-MR) Program (Report). Minneapolis, MN: University of Minnesota, Center for Residential and Community Services.
  29. ^ Willer B, Intagliata J (May 1982). "Comparing of family-care and grouping homes equally alternatives to institutions". American Periodical of Mental Deficiency. 86 (six): 588–95. PMID 7102732.
  30. ^ Smith G, Gettings R (1991). Supported Employment and Medicaid Financing (Report). Alexandria, VA: National Association of Developmental Disabilities Services, Inc.
  31. ^ Castellani PJ, Downey NA, Tausig MB, Bird WA (April 1986). "Availability and accessibility of family support services". Mental Retardation. 24 (two): 71–9. PMID 2422520.
  32. ^ Farkas M, Anthony WA (1980). "Training rehabilitation counselors to work in state agencies, rehabilitation, and mental health facilities". Rehabilitation Counseling Bulletin. 24: 128–144.
  33. ^ Wehman P, Berth M, Stallard D, Mundy A, Sherron P, Westward Chiliad, Cifu D (September 1994). "Render to work for persons with traumatic brain injury and spinal cord injury: three example studies". International Journal of Rehabilitation Research. 17 (iii): 268–77. doi:10.1097/00004356-199409000-00008. PMID 8002134.
  34. ^ Smith GA (1990). Supportive Living: New Directions in Services for Persons with Developmental Disabilities (Report). Alexandria, VA: National Association of State Mental Retardation Plan Directors, Incorporated (NASMRPD).
  35. ^ Allard M (1996). "Supported living policies and programs in the USA.". In Mansell J, Ericsson K (eds.). Deinstitutionalization and Community Living. London: Chapman & Hall. pp. 98–16. ISBN978-0-412-57010-0.
  36. ^ Carling PJ (May 1993). "Housing and supports for persons with mental illness: emerging approaches to research and do". Hospital & Community Psychiatry. 44 (5): 439–49. doi:x.1176/ps.44.5.439. PMID 8509074.
  37. ^ Smith G, Alderman Southward (1987). Paying for Community Services (Report). Alexandria, VA: National Association of Land Mental Retardation Plan Directors.
  38. ^ Play a trick on HB, Wicks LB (1995). "Financing care coordination services under Medicaid". In Friesen BJ, Poertner J (eds.). From Case Management to Service Coordination for Children with Emotional, Behavioral, or Mental Disorders. Baltimore, Physician: Paul H. Brookes Publishing Company. pp. 95–132.
  39. ^ The State of 21st Century Long Term Services and Supports: Financing and Systems Reform for Americans with Disabilities (Report). Washington, DC: National Council on Inability. 2005.
  40. ^ Stancliffe RJ, Lakin KC (2005). Costs and Outcomes of Customs Services for People with Intellectual Disabilities. Baltimore, MD: Paul H. Brookes Publishing Visitor. ISBN978-i-55766-718-ii.
  41. ^ Woodhouse R, Burton JK, Rana N, Pang YL, Lister JE, Siddiqi N (April 2019). "Interventions for preventing delirium in older people in institutional long-term care". The Cochrane Database of Systematic Reviews. 4: CD009537. doi:10.1002/14651858.cd009537.pub3. PMC6478111. PMID 31012953.
  42. ^ a b Crocker T, Forster A, Young J, Brownish L, Ozer S, Smith J, et al. (February 2013). "Physical rehabilitation for older people in long-term care". The Cochrane Database of Systematic Reviews (2): CD004294. doi:ten.1002/14651858.cd004294.pub3. PMID 23450551.
  43. ^ a b Crocker T, Forster A, Young J, Brown L, Ozer Due south, Smith J, et al. (Cochrane Stroke Group) (Feb 2013). "Physical rehabilitation for older people in long-term care". The Cochrane Database of Systematic Reviews (2): CD004294. doi:ten.1002/14651858.CD004294.pub3. PMID 23450551.
  44. ^ "Ageing and Life Course". World Health Organization . Retrieved iii January 2012.
  45. ^ Merkur Southward, McDaid D, Maresso A (2011). "Ageing and long-term care" (PDF). Eurohealth. London School of Economics and Political Science. 17 (two–3).
  46. ^ OECD (2005). Long Term Care for Older People. Paris: OECD.
  47. ^ Costa-Font J, Patxot C (Jan 2005). "The blueprint of the long-term care organization in Spain: Policy and financial constraints". Social Policy and Club. 4 (one): 11–20. doi:10.1017/S1474746404002131. S2CID 154439579.
  48. ^ "Growing Demand for Long-Term Care in the U.Due south. (Updated)" (PDF). The Scan Foundation. Retrieved 16 Oct 2015.
  49. ^ "AHCPR Research on Long-term Care". U.S. Section of Health and Man Services. Archived from the original on 2009-07-14.
  50. ^ "Long Term Care". Colorado Gerontological Gild. Retrieved 16 October 2015.
  51. ^ Weissert WG, Cready CW, Pawelak JE (December 2005). "The Past and Futurity of Home- and Community-Based Long-Term Care: Home- and Community-Based Long-Term Care". Milbank Quarterly. 83 (iv): 10.1111/j.1468–0009.2005.00434.10. doi:10.1111/j.1468-0009.2005.00434.x. PMC2690259.
  52. ^ O'Shaughnessy CV (27 March 2014). "The Basics: National Spending for Long-Term Services and Supports" (PDF). National Wellness Policy Forum. Washington, D.C.: George Washington University. Retrieved 1 Jan 2015.
  53. ^ Rock RI, Benson WF (2012). "Financing and organizing health and long term care services.". In Prohaska TR, Anderson LA, Binstock RH (eds.). Public Health for an Aging Society. Boston: Johns Hopkins University Press. ISBN978-1-4214-0535-3.
  54. ^ Boris E, Klein J (2012). Caring for America: Domicile Health Workers in the Shadow of the Welfare State. New York, NY: Oxford Academy Printing.
  55. ^ Seekins T, Katz R, Ravesloot C (March 2008). "Nursing dwelling emancipation: Accomplishments of urban and rural centers for independent living.". Rural Disability and Rehabilitation: Research Progress Report #39. Missoula, MT: Rehabilitation Research and Training Middle on Community Living.
  56. ^ Cook JA, Fitzgibbon Chiliad, Burke-Miller J, Mulkern Five, Grey DD, Heflinger CA, et al. (2004). "Medicaid behavioral wellness intendance program satisfaction and children's service utilization". Wellness Care Financing Review. 26 (1): 43–55. PMC4194880. PMID 15776699.
  57. ^ "Price of Care Survey". Genworth Financial, Inc.
  58. ^ a b Gale WG, Iwry Chiliad, Orszag P, Ahlstrom A, Clements E, Lambrew J, Tumlinson A (September 2004). Retirement Saving and Long-Term Care Needs: An Overview. The Retirement Security Project (Study). George Washington Academy.
  59. ^ "States Turn to Managed Care To Constrain Medicaid Long-Term Care Costs". Bureau for Healthcare Research and Quality. 2014-04-09. Retrieved 2014-04-xiv .
  60. ^ Waters R (xx July 2009). "Elderly to Double to 14% of Global Population by 2040". Bloomberg News.
  61. ^ Houser A, Ujavri K, Fob-Grange West (September 2012). In Cursory #INB 198 (Report). Washington,DC: AARP Public Policy Institute.
  62. ^ Vocaliser G, Siegel D, Conway P (2012). Family unit Support and Family unit Caregiving Across Disabilities. Baltimore, MD: Paul H. Brookes Publishing Company. ISBN978-1-317-97912-viii.
  63. ^ Binstock R, Spector W (1997). "Five Priority Areas for Research on Long-Term Care". Health Services Research. Washington, DC: Bureau for Health Intendance Policy and Research. 32 (v): 715–730. PMC1070225. PMID 9402911.
  64. ^ Miller ME, Gengler DJ (1993). "Medicaid case management: Kentucky's Patient Access and Care Program". Health Care Financing Review. fifteen (i): 55–69. PMC4193407. PMID 10133709.
  65. ^ Play a trick on HB, McManus MA, Almeida RA (1998). "Managed intendance's impact on Medicaid financing for early on intervention services". Health Care Financing Review. xx (1): 59–72. PMC4194536. PMID 10387426.
  66. ^ Langman-Dorwart Northward, Peebles T (June 1988). "A comprehensive approach to managed care for mental health". Administration in Mental Health. xv (iv): 226–35. doi:x.1007/BF00818723 (inactive 31 October 2021). {{cite journal}}: CS1 maint: DOI inactive every bit of October 2021 (link)
  67. ^ Rappaport MB (2000). Remodeling Home Care: Making the Transition from Fee-for Service to Managed Care. New York, NY and London: Garland Publishing Co. ISBN978-0-8153-3440-eight.
  68. ^ Doty P, Mahoney KJ, Simon-Rusinowitz L (Feb 2007). "Designing the Cash and Counseling Sit-in and Evaluation". Wellness Services Research. 42 (1 Pt 2): 378–96. doi:ten.1111/j.1475-6773.2006.00678.x. PMC1955334. PMID 17244289.
  69. ^ Racino J (2014). "Individual and public budgeting.". Public Administration and Inability: Community Services Administration in the US. London, New York, NY and Boca Raton, FL: Francis and Taylor. pp. 209–234. ISBN978-0-429-25451-2.
  70. ^ Ungerson C, Yeandle S (2007). Greenbacks for Care in Developed Welfare States. New York, NY: Palgrave MacMillan. ISBN978-ane-4039-3552-6.
  71. ^ Keigher South (2007). "Consumer-direction in an "Ownership Social club": An Emerging Paradigm for Home and Community Care in the United States.". In Ungerson C, Yeandle South (eds.). Cash for Intendance in Adult Welfare States. New York, NY: Palgrave MacMillan. pp. 187–206. ISBN978-i-4039-3552-half dozen.
  72. ^ Pearson C (2006). "Directly payments in Scotland.". In Leece J, Bornat J (eds.). Development in Straight Payments. Bristol, UK: Polity Printing, Academy of Bristol. pp. 33–48. ISBN978-1-86134-654-4.
  73. ^ Hutchinson P, Lord J, Salisbury B (2006). "N American approaches to individualised planning and direct funding.". In Leece J, Bornat J (eds.). Developments in Direct Payments. Bristol, UK: Polity Press, University of Bristol. pp. 49–63. ISBN978-1-86134-654-4.
  74. ^ Canada, Authorities of Canada, Statistics (four May 2015). "The Daily — Long-term Care Facilities Survey, 2013". world wide web.statcan.gc.ca . Retrieved 2016-01-19 .
  75. ^ Lord J, Hutchison P (January 2003). "Individualised support and funding: edifice blocks for chapters building and inclusion". Inability & Society. 18 (1): 71–86. doi:10.1080/713662196. S2CID 55818975.
  76. ^ Taylor S, Bogdan R, Racino J (1991). Life in the Community: Case Studies of Organizations Supporting People with Disabilities in the Community. Baltimore, Dr.: Paul H. Brookes. ISBN978-one-55766-072-5.
  77. ^ Braddock D, Hemp R, Fujiura Thou, Bachelder L, Mitchell D (1990). The Land of the States in Developmental Disabilities. Baltimore, Physician: Paul H. Brookes Publishing Company. ISBN978-0996506878.
  78. ^ Lewin Group. (2010). Individuals living in the community with chronic conditions and functional limitations: A closer look. Written report prepared under contract #HHS-100-95-0046 for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.
  79. ^ Gregory SR, Gibson MJ (2002). Across u.s.a.: Profiles of Long-Term Services and Supports (5th ed.). Washington, DC: AARP Public Policy Institute.
  80. ^ Kople 50 (22 January 2018). "Long-Term Care Insurance Industry Paid Huge Benefits in 2017". LTC News.
  81. ^ "Largest Long-Term Care Insurance Merits Beingness Paid Exceeds $2 Million". www.expertclick.com.
  82. ^ O'Brien Due east, Elias R (May 2004). Kaiser commission on Medicaid and the uninsured. Medicaid and Long-Term Intendance (Report). Kaiser Commission on Medicaid and the Uninsured, Henry J. Kaiser Family unit Foundation.
  83. ^ Mulvey J, Li A (2002). "Long-term intendance financing: options for the future". Benefits Quarterly. 18 (ii): 7–14. PMID 12004582.
  84. ^ "Long-term care report". AARP Press Center. xiii December 2006. Archived from the original on 27 September 2007.
  85. ^ Hado Eastward, Komisar H (Baronial 2019). "Long-Term Services and Supports in the US" (PDF). AARP. Washington, DC.
  86. ^ Amaradio L (1998). "Financing long-term care for elderly persons: what are the options?". Journal of Health Care Finance. 25 (two): 75–84. PMID 9839257.
  87. ^ Kelly J (31 Jan 2017). "Hybrid Long-Term Care and Curt-Term Intendance". LTC News.
  88. ^ "Requirements for States and Long Term Care Facilities". ELECTRONIC Lawmaking OF FEDERAL REGULATIONS. U.S. Government Printing Office. Retrieved 15 May 2014.
  89. ^ Bernstein Due north (viii May 2014). "Medicaid Shift Fuels Blitz for Assisting Clients". The New York Times . Retrieved 15 May 2014.
  90. ^ Meyer H (June 2012). "The coming experiments in integrating and coordinating treat 'dual eligibles'". Wellness Affairs. 31 (vi): 1151–5. doi:10.1377/hlthaff.2012.0505. PMID 22665826.

External links [edit]

  • California Partnership for Long-Term Care
  • Cost of intendance calculator for Uk residents
  • American Clan for Long Term Care Insurance

carterwilyingeld.blogspot.com

Source: https://en.wikipedia.org/wiki/Long-term_care

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