Long Term Care

1. Long Term Care The Continuum of Care

2. What is Long Term Care? • Health, mental health, social and residential services provided to temporarily or chronically disabled person over extended period of time

3. Characteristics of LT Care • Physical or mental, temporary or permanent • Need based on functional disabilities • Promotes or maintains health and independence in functional abilities and quality of life • To enable us to die peacefully and with dignity • Multiple services and multiple professions spanning broad spectrum • Multifaceted • Designed around unique needs of the individual • Service can change over time

4. Who needs LT Care • Chronic – permanent or indefinite period of time • Impaired – a decrease in or loss of ability to perform • Disabled – short or long term; varies by age group • Functional ability – person’s ability to perform the basic activities of daily living

5. Understanding demand for LT Care • Patient represent “mosaic of sub-segments” of the population. Often co-morbid conditions • Services can be organized across dimensions of users • Some users of LT care have significant differences from other users

6. Organization of LT Care • Informal organization – most LT care is provided by family and friends • Each community may be different regarding availability of services • Ideal system – client oriented continuum of care.

7. What is Continuum of Care? • Matches resources to patient’s condition • Monitors the client’s condition and changes services as needs change • Coordinates care across disciplines • Integrates care in a range of settings • Enhances efficiency, reduces duplication, streamlines patient flow • Maintains comprehensive record keeping

8. Categories of Continuum of Care • Extended care • Acute inpatient care • Ambulatory care • Home care • Outreach • Wellness • Housing NOTE: Not all LT care clients get this full range of care. This is ideal that may offset or delay chronic illness.

9. Providers of LT Care • Hospitals • Nursing homes • Home health agencies • Hospices • Adult day service programs • Housing organizations

10. Types of LT Care Services(Source: http://www.medicare.gov/LongTermCare/Static/CommunityServices.asp

11. Paying for LT Care • Nursing home care represents approximately 8% of personal health care expenditures • Home health care about 2% of expenditures though this is trending higher • Since LT care is provided mostly by family and friends, these figures don’t represent full cost • Medicare, Medicaid cover much of the cost • Out of pocket costs for LT care are significant • Little private insurance currently pays for LT care though incentives have been implemented to cover that area