I work with a number of elderly adults who are wonderful examples of "successful" aging. They are active socially, physically and spiritually in a variety of different ways. I also see the other side of aging. Those who have experienced physical and cognitive decline and are left to try to care for themselves without the help or support of family and friends. The health care system has let them down as well. They need the care of a long-term facility because they cannot perform the simplest activities of daily living, they are not eating properly or taking their medications and have no daily contact with other people. Some of the elderly see no alternative as they cannot afford to stay in a long-term care facility or they are afraid to move for fear they will lose what independence they have. Many worry about mistreatment too. Since they cannot afford the nicer long-term facilities, they would rather stay in their homes. A number of agencies try to reach out and accommodate those who would like to remain in their homes but the reality is that it is a much larger problem than we have the resources to solve. The United States needs to re-examine it's priorities and health care reform, including long-term care, should be one of the top priorities. It's easy to say we need reform but much more difficult to implement. A couple of points to consider:
1. Health care has become big business. Why should CEO's of insurance companies by making millions of dollars in salaries and stock options while many elderly and disabled rely on medicare or medicaid. Think of what we could do with some of that money. We could improve or expand long-term care options, making it more affordable for those who cannot afford the nicer facilities. We could improve training of the staff, hire more professionals to inspect facilities, and staff the facilities so residents feel safe and have help when they require it. I'm not a proponent of socialized medicine but I think the health care industry has lost sight of who they are suppose to help.
2. Promote prevention and education. A number of residents who utilize long-term care have chronic conditions such as diabetes, obesity and cardiovascular conditions that have deteriorated their health over time. Community health programs and education may help to decrease the number of people who will access long-term care in the future thus decreasing the cost to society.
My employer offered us the opportunity to buy into a long-term health insurance policy a few years ago. Many signed up for the policy but most did not. It was not a good deal. Those I know who took out the policy did so out of fear because that's what the insurance company promoted. Some were inactive and many smoked. A couple of individuals had no children or immediate family nearby. In the long run it is the insurance company that reaps the benefits, not the policy holder. We know so much more now than we did when the current population of 65+ year olds were younger. Let's start taking advantage of our knowledge and not be content with the status quo.
Wednesday, April 15, 2009
Tuesday, April 14, 2009
Long-Term Care in a Group Home Setting
In the United States today, many adults with developmental disabilities are living in group home settings. These homes usually house anywhere from three to eight individuals, with varying degrees of independence. Most homes strive to increase the quality of life for these people, as well as increase their independence level in activities of daily living.
I am currently a Senior at UW-La Crosse, majoring in Therapeutic Recreation. I have worked at various group homes for about four years. Currently I am completing my internship in Minnesota, working for Dakota Communities, Inc., a company that has 32 group homes for adults with developmental disabilities all over the Twin Cities area. I have been so impressed with DCI’s level of quality and commitment to person-centered approaches. They truly do care about the individuals living in their homes.
Even though a company has high standards, and provides great services, the funding for group homes at the state and national level is negatively affecting the experiences of the people living in the homes. One example of this includes heath and wellness. Group homes are not known to advocate much for healthy lifestyles, and part of this is because they do not have the resources to do it. Money needs to be allocated for them to buy healthier foods, as well as attend programming to increase physical activity. Another example is the hourly rate at which employees get paid. Group homes have a very high turnover rate and this negatively affects the people living in the homes as they do not experience much consistency in the people working with them. More money needs to be allocated for paying individuals who are choosing to sacrifice many comforts by working in this demanding field. These employees have made a decision to put others before themselves, and strive to increase the quality of life for individuals whom our culture so often shuns. Our government should be striving to keep these employees working in this field, not encouraging them to leave by not paying them adequately.
I know that many state budgets are being cut, but advocating for people who often cannot advocate for themselves is necessary! Cuts need to be fair across the board. Most disability services are funded through Medicaid. With this system, half the money comes from the federal government and half from the state. What this means is that if lawmakers cut $1.00 from the state budget, people with disabilities lose $2.00 in services (www.arrm.org). This is simply not right. Medicaid is in need of reform. A new system must be put into place.
Long Term Care in the Eyes of a Physical Education Major
Long Term Care should not be denied to anyone. I think it is important that those who are in need of care should not have to struggle to pay the costs for care facilities, sacrifice the quality of care or not have access to care. While I’m not an expert at Long Term Care, something has to be done to improve access for those who have a hard time accessing health care. For people to have access to high quality health care, costs would need to be contained and lowered and those who still cannot afford the costs would then receive government assistance.
I am a physical education major and I am also studying health at UW-Whitewater. I can relate my studies to this by physical exercise. Starting at a young age with physical exercise will promote a healthier lifestyle in the future. This applies to Long Term Care because by promoting exercise and physical activity early on in life, chronic illnesses are less likely to occur as people age, which will help to keep them out of long-term care facilities and in the long run, cut down on health care costs. Also, those who are more physically fit and active are less likely to suffer injuries that would require them to be put into a Long Term Care facility or require assistance from families or nurses and would avoid complications that are faced during recovery.
I am a physical education major and I am also studying health at UW-Whitewater. I can relate my studies to this by physical exercise. Starting at a young age with physical exercise will promote a healthier lifestyle in the future. This applies to Long Term Care because by promoting exercise and physical activity early on in life, chronic illnesses are less likely to occur as people age, which will help to keep them out of long-term care facilities and in the long run, cut down on health care costs. Also, those who are more physically fit and active are less likely to suffer injuries that would require them to be put into a Long Term Care facility or require assistance from families or nurses and would avoid complications that are faced during recovery.
Monday, April 13, 2009
LongTerm Care & Families
One Caregivers Experience
October 9th, 2007 I found myself sitting beside my mother for what would be possibly the 20th visit to a doctor's office, Urgent Care or an emergency room since July. Symptoms seemed to allude us and no answers were ever able to conclude why she wasn't feeling well. Onset of depression, lower back pain that wrapped around to her abdominal area, nausea, and loss of weight. We both had our suspicions yet hearing a diagnosis of pancreatic cancer, cancer that had spread to her liver by this time was devastating. Our lives were drastically going to change as we battled this cancer, the silent killer, pancreatic cancer.
Physical care for my mother had began years earlier with various health issues and surgeries. The goal was always to work towards independence so she could live on her own. This typically involved her living with us for short periods of time during recovery and then returning to her home.
In December of 2007 we invited my Mom to move in with us, actually stating it as combining households. She agreed I believe primarily because she saw the toll of me caring for my family and her along with both homes was becoming difficult.
The changes that occurred over the next months in our home were dramatic. Assisting our three children still living at home ages, 10, 13, and 17 at the time to life with Grandma here, working through the emotional adjustment to dealing with a terminal illness in our faces every day, assisting my Mom in dealing with her losses of health, her home, her independence, and managing the pain that accompanies pancreatic cancer all became my life as I left my work and set my business on hold.
My mother's experience is rare with pancreatic cancer as she lived almost a year beyond her diagnosis. Typically because the diagnosis is late in pancreatic cancer, most people have much less time once they are officially diagnosed. The year was one of the most difficult experiences I've encountered in terms of managing life while being completely exhausted on a day to day basis. Truly feeling "sandwiched" between my children's needs and my Mom's meant I felt like I was not meeting any one's needs let alone even knowing what my own needs might be.
The gift in all of this was seeing my children mature, rise to the needs of their grandma, often sacrificing social plans, working as a team with my husband to care for my Mom physically as well as emotionally, mentally, and spiritually. Each night after tucking her into bed, we would meet like a staff review to see how the day went, changes that occurred and plan for the coming days needs.
The most difficult issues in the year of care were the loss of income, absence of support from siblings, and the unknown of how long this would go on. Though we may have received a cheer from my siblings here and there what we really needed was a night off, a day away, cash for groceries or a cup of coffee. With their busy lives and other priorities, visits were short and sweet, yet opinions on care plans and her finances where plentiful. This was by far my greatest challenge, to care for my Mom and not allow my disappointment towards my siblings to negatively affect the care I gave. I came to accept that each person was dealing with losing our mother differently, making the choice to assume the best and offer grace ultimately is the focus that helped me deal with the lack of support.
Through all of this my husband, my four children, and my Mom grew very close. There began a silent communication, an understanding of what might need to be done. We intentionally allowed the kids to be honest about what was difficult in having her with us and how they felt about her dying in our home. My Mom, gracious even in all her pain, encouraged us and taught us each lesson we would have missed had we not had her in our home.
Two weeks prior to her dying she agreed to use hospice. I remember crying when I came in the door and saw a home health aide sweeping my dining room floor. She thought she was doing something wrong, I cried out of relief that help was here! Using hospice was like giving up for my Mom. It was difficult because I needed help and her insurance would cover hospice, not home health aides alone. I felt like my Mom was between a rock and a hard place seeing her daughter exhausted and but not wanting to start hospice, the beginning of the end from her perspective.
In the end, the experience of having my children and husband with me as we read scriptures, sang quietly and by her request spoke the names of Jesus over and over again as she died was as miraculous as birthing my children. For those moments and all the lessons learned I can state confidently I have no regrets. This, is a powerful gift, to wake each morning with no regrets.
How Health Care Might be Improved Related to Long Term Care
After my experience of caring for my Mom in our home for over a year here are some basic improvements I believe could enhance long term care for patients and families.
Sandy Anderson, BAS Community Health Education
Parent Educator & Family Coach
Lactation Specialist
October 9th, 2007 I found myself sitting beside my mother for what would be possibly the 20th visit to a doctor's office, Urgent Care or an emergency room since July. Symptoms seemed to allude us and no answers were ever able to conclude why she wasn't feeling well. Onset of depression, lower back pain that wrapped around to her abdominal area, nausea, and loss of weight. We both had our suspicions yet hearing a diagnosis of pancreatic cancer, cancer that had spread to her liver by this time was devastating. Our lives were drastically going to change as we battled this cancer, the silent killer, pancreatic cancer.
Physical care for my mother had began years earlier with various health issues and surgeries. The goal was always to work towards independence so she could live on her own. This typically involved her living with us for short periods of time during recovery and then returning to her home.
In December of 2007 we invited my Mom to move in with us, actually stating it as combining households. She agreed I believe primarily because she saw the toll of me caring for my family and her along with both homes was becoming difficult.
The changes that occurred over the next months in our home were dramatic. Assisting our three children still living at home ages, 10, 13, and 17 at the time to life with Grandma here, working through the emotional adjustment to dealing with a terminal illness in our faces every day, assisting my Mom in dealing with her losses of health, her home, her independence, and managing the pain that accompanies pancreatic cancer all became my life as I left my work and set my business on hold.
My mother's experience is rare with pancreatic cancer as she lived almost a year beyond her diagnosis. Typically because the diagnosis is late in pancreatic cancer, most people have much less time once they are officially diagnosed. The year was one of the most difficult experiences I've encountered in terms of managing life while being completely exhausted on a day to day basis. Truly feeling "sandwiched" between my children's needs and my Mom's meant I felt like I was not meeting any one's needs let alone even knowing what my own needs might be.
The gift in all of this was seeing my children mature, rise to the needs of their grandma, often sacrificing social plans, working as a team with my husband to care for my Mom physically as well as emotionally, mentally, and spiritually. Each night after tucking her into bed, we would meet like a staff review to see how the day went, changes that occurred and plan for the coming days needs.
The most difficult issues in the year of care were the loss of income, absence of support from siblings, and the unknown of how long this would go on. Though we may have received a cheer from my siblings here and there what we really needed was a night off, a day away, cash for groceries or a cup of coffee. With their busy lives and other priorities, visits were short and sweet, yet opinions on care plans and her finances where plentiful. This was by far my greatest challenge, to care for my Mom and not allow my disappointment towards my siblings to negatively affect the care I gave. I came to accept that each person was dealing with losing our mother differently, making the choice to assume the best and offer grace ultimately is the focus that helped me deal with the lack of support.
Through all of this my husband, my four children, and my Mom grew very close. There began a silent communication, an understanding of what might need to be done. We intentionally allowed the kids to be honest about what was difficult in having her with us and how they felt about her dying in our home. My Mom, gracious even in all her pain, encouraged us and taught us each lesson we would have missed had we not had her in our home.
Two weeks prior to her dying she agreed to use hospice. I remember crying when I came in the door and saw a home health aide sweeping my dining room floor. She thought she was doing something wrong, I cried out of relief that help was here! Using hospice was like giving up for my Mom. It was difficult because I needed help and her insurance would cover hospice, not home health aides alone. I felt like my Mom was between a rock and a hard place seeing her daughter exhausted and but not wanting to start hospice, the beginning of the end from her perspective.
In the end, the experience of having my children and husband with me as we read scriptures, sang quietly and by her request spoke the names of Jesus over and over again as she died was as miraculous as birthing my children. For those moments and all the lessons learned I can state confidently I have no regrets. This, is a powerful gift, to wake each morning with no regrets.
How Health Care Might be Improved Related to Long Term Care
After my experience of caring for my Mom in our home for over a year here are some basic improvements I believe could enhance long term care for patients and families.
- Simplify the insurance coverage.
- Develop resources to enable families to offer more of the direct care.
- Educate families on caring for a loved one
Sandy Anderson, BAS Community Health Education
Parent Educator & Family Coach
Lactation Specialist
Saturday, April 4, 2009
Integrating Long Term Care into the Health Care System
Integrated health care is defined as healthcare services combining the best of conventional and complementary health care. Due to the aging population the idea of integrated health care has become a popular issue. With integrated health care already established in 8 states across the nation – New York, Minnesota, Arizona, Florida, Massachusetts, Wisconsin, Hawaii, and New Mexico – making integrated health care nationwide would be a smart idea. By the year 2020 over 12 million Americans will need long term care. These individuals account for 70% of Medicaid expenditures, but only a quarter of all of Medicaid enrollees. Integrated health care systems are trying to improve quality, coordination, and cost-effectiveness of care. An integrated health system will integrate the financing, delivery, and administration of primary, acute, long-term care, chronic and behavioral health services for adults who are dually eligible for Medicaid and Medicare, as well as those who receive services solely through Medicaid.
Today of the 7 million Americans deemed as “dual eligibles,” meaning they are covered by both Medicaid and Medicare. Integration of health care is difficult because Medicaid and Medicare are governed by their own delivery, financing, and administrative policies which misalign benefit structures. Medicare covers only medically necessary skilled nursing facility or home health care. Medicare does not cover what they call “custodial care,” which is considered activities of daily living like dressing, bathing, feeding, etc. An integrated health system will help to combine all these needs into one program that an individual who would need this type of care can have it.
In 1998 almost 20% of all Medicare beneficiaries received care in more than one setting, in turn resulting in less of a need to coordinate and integrate care for patients moving from one setting to the next. Provider competition has prevented the integration process which would provide a smoother transition from one health care setting to the next. The Balanced Budget Act of 1997 cut Medicare’s budget and forced providers to focus on financial survival, rather than trying out new ways of care. From that came Medicare’s prospective payment systems (PPS). PPS’s created separate reimbursements for where the care is provided. These incentives made providers focus only on their own site and financial survival.
In Wisconsin the integrated health care program involves all people with the decisions of receiving what kind of care. A team is usually compromised of an enrollee, enrollee’s primary care physician, a nurse practitioner, a registered nurse, and a social worker or social service coordinator. This approach has been central to eliminating system and service fragmentation, increasing comprehensive primary care, and providing support for the person in his or her home. It has also helped minimize the need for expensive hospital and nursing home care. The team conducts assessments, develops plans of care including the provision of health and psychosocial services to meet identified needs, and arranges for the delivery of the services whether they are staff-provided or purchased from subcontractors. Examples of services include primary health care, hospital care, transportation, supportive home care, personal care, and home modifications. Payments are a mix of institutional and home and community-based care costs. Rates are risk-adjusted by age, level of care, and Medicare eligibility, dual eligible or only Medicaid eligible.
Integrated care overall will improve cost savings and reduce inappropriate care and increase the quality of outcomes. For consumers, integration is assumed to produce more convenient, accessible, and clinically effective systems by reducing the degree of service and system fragmentation that characterize much of the medical and long term care financing and delivery systems. Integrated health care systems are hard to implement in rural settings because of the lack of money and experience in managed care. But training and proper investments can help to bring integrated health care to rural areas and provide the aging population with better, cost-efficient care and provide the enrollee who needs the care more choice and a feeling of independence about what they need, and allowing family’s to feel better about the care their loved ones are receiving.
1) Center for Health Care Strategies, Inc. (2005 Dec, 8). Retrieved April 4, 2009, from,
http://www.chcs.org/info-url3969/info-url_show.htm?doc_id=326796
2) Long Term Care-Confronting Today's Challenges. (2003). Academy of Health. Retrieved April 4, 2009, from
http://www.academyhealth.org/files/publications/ltcchallenges.pdf
3) Long Term Care. (2009, March 25). Centers for Medicaid and Medicare Services. Retrieved April 4, 2009, from
http://www.medicare.gov/LongTermCare/static/Home.asp.
4) Coburn, Andrew F, PhD. Models for Integrating and Managing Acute and Long Term Care Services in Rural Areas. Retrieved April 4, 2009, from http://muskie.usm.maine.edu/Publications/rural/ExecSums/%2320.pdf.
Today of the 7 million Americans deemed as “dual eligibles,” meaning they are covered by both Medicaid and Medicare. Integration of health care is difficult because Medicaid and Medicare are governed by their own delivery, financing, and administrative policies which misalign benefit structures. Medicare covers only medically necessary skilled nursing facility or home health care. Medicare does not cover what they call “custodial care,” which is considered activities of daily living like dressing, bathing, feeding, etc. An integrated health system will help to combine all these needs into one program that an individual who would need this type of care can have it.
In 1998 almost 20% of all Medicare beneficiaries received care in more than one setting, in turn resulting in less of a need to coordinate and integrate care for patients moving from one setting to the next. Provider competition has prevented the integration process which would provide a smoother transition from one health care setting to the next. The Balanced Budget Act of 1997 cut Medicare’s budget and forced providers to focus on financial survival, rather than trying out new ways of care. From that came Medicare’s prospective payment systems (PPS). PPS’s created separate reimbursements for where the care is provided. These incentives made providers focus only on their own site and financial survival.
In Wisconsin the integrated health care program involves all people with the decisions of receiving what kind of care. A team is usually compromised of an enrollee, enrollee’s primary care physician, a nurse practitioner, a registered nurse, and a social worker or social service coordinator. This approach has been central to eliminating system and service fragmentation, increasing comprehensive primary care, and providing support for the person in his or her home. It has also helped minimize the need for expensive hospital and nursing home care. The team conducts assessments, develops plans of care including the provision of health and psychosocial services to meet identified needs, and arranges for the delivery of the services whether they are staff-provided or purchased from subcontractors. Examples of services include primary health care, hospital care, transportation, supportive home care, personal care, and home modifications. Payments are a mix of institutional and home and community-based care costs. Rates are risk-adjusted by age, level of care, and Medicare eligibility, dual eligible or only Medicaid eligible.
Integrated care overall will improve cost savings and reduce inappropriate care and increase the quality of outcomes. For consumers, integration is assumed to produce more convenient, accessible, and clinically effective systems by reducing the degree of service and system fragmentation that characterize much of the medical and long term care financing and delivery systems. Integrated health care systems are hard to implement in rural settings because of the lack of money and experience in managed care. But training and proper investments can help to bring integrated health care to rural areas and provide the aging population with better, cost-efficient care and provide the enrollee who needs the care more choice and a feeling of independence about what they need, and allowing family’s to feel better about the care their loved ones are receiving.
1) Center for Health Care Strategies, Inc. (2005 Dec, 8). Retrieved April 4, 2009, from,
http://www.chcs.org/info-url3969/info-url_show.htm?doc_id=326796
2) Long Term Care-Confronting Today's Challenges. (2003). Academy of Health. Retrieved April 4, 2009, from
http://www.academyhealth.org/files/publications/ltcchallenges.pdf
3) Long Term Care. (2009, March 25). Centers for Medicaid and Medicare Services. Retrieved April 4, 2009, from
http://www.medicare.gov/LongTermCare/static/Home.asp.
4) Coburn, Andrew F, PhD. Models for Integrating and Managing Acute and Long Term Care Services in Rural Areas. Retrieved April 4, 2009, from http://muskie.usm.maine.edu/Publications/rural/ExecSums/%2320.pdf.
Saturday, March 28, 2009
The Need For More Workers
Did you know that 91 percent of nursing homes lack the adequate number of staff for basic care? The workforce shortage in long term care facilities is an increasing problem and going to escalade if we do not start to change policy. I am asking that every long term care facility be required to house enough staff to care for each resident 24 hours a day.
This change would automatically cause an increase in cost for long term care facilities, but what if we collaborated with other businesses and the government to prevent the drastic increase. Over 8 billion dollars are annually spent by the federal government to prepare primarily low-income and unemployed individuals for new and better jobs. If the government and long term care facilities started to work together we could help these people get jobs and trained for the workforce while increasing the number of workers in the long term care field.
The access for jobs will dramatically increase for those who are willing to go into the long term care field. Genworth Financial states that “The U.S. will need to recruit 200,000 new direct-care workers each year to meet future demand among our aging population.” In the state of this economy and the need for jobs in long term care, I see this looking like a place that the government should invest its money. This would help supply more jobs for the people and benefit long term care.
When there is enough staff to supply the needs of each resident the quality of that facility will flourish. This is a serious problem when residents have to wait 30 plus minutes to use the toilet, to get dressed, or to receive medications. If there were enough staff this would not be problem.
This is an important issue that is a part of our lives and is only going to increase in time. We need to move now, and help change policy! Think of your future and how you would like to be treated. Let us do the same for our family, friends, and neighbors.
1) Critical Issues in Long-Term Care (LTC) (2008, May). Retrieved March 28, 2009, from http://www.ltcop.org/StayInfSection2.htm
2) Long Term Care-Confronting Today's Callenges . (2003). Academy of Health . Retrieved March 28, 2009, from http://www.academyhealth.org/files/publications/ltcchallenges.pdf
3) Niesz, H., Price-Livingston, S., & Diamond Arsenau, K. (2002). LONG-TERM CARE WORKER SHORTAGE. . Retrieved March 28, 2009, from http://search.cga.ct.gov/dtsearch.asp?cmd=getdoc&DocId=16173&Index=I%3A%5Czindex%5C2002&HitCount=0&hits=&hc=0&req=&Item=4
4) Looming Workforce Shortage Pressures Long Term Care Costs, According to Research (2008, April 29). Retrieved March 28, 2009, from http://www.businesswire.com/portal/site/home/news/sections/?ndmViewId=news_view&newsLang=en&newsId=20080429005958
5) Stone , R. I., & Wiener, . M. (2001, October 26). Who Will Care For Us? Addressing the Long-Term Care Workforce Crisis. Retrieved March 28, 2009, from http://www.urban.org/url.cfm?ID=310304
This change would automatically cause an increase in cost for long term care facilities, but what if we collaborated with other businesses and the government to prevent the drastic increase. Over 8 billion dollars are annually spent by the federal government to prepare primarily low-income and unemployed individuals for new and better jobs. If the government and long term care facilities started to work together we could help these people get jobs and trained for the workforce while increasing the number of workers in the long term care field.
The access for jobs will dramatically increase for those who are willing to go into the long term care field. Genworth Financial states that “The U.S. will need to recruit 200,000 new direct-care workers each year to meet future demand among our aging population.” In the state of this economy and the need for jobs in long term care, I see this looking like a place that the government should invest its money. This would help supply more jobs for the people and benefit long term care.
When there is enough staff to supply the needs of each resident the quality of that facility will flourish. This is a serious problem when residents have to wait 30 plus minutes to use the toilet, to get dressed, or to receive medications. If there were enough staff this would not be problem.
This is an important issue that is a part of our lives and is only going to increase in time. We need to move now, and help change policy! Think of your future and how you would like to be treated. Let us do the same for our family, friends, and neighbors.
1) Critical Issues in Long-Term Care (LTC) (2008, May). Retrieved March 28, 2009, from http://www.ltcop.org/StayInfSection2.htm
2) Long Term Care-Confronting Today's Callenges . (2003). Academy of Health . Retrieved March 28, 2009, from http://www.academyhealth.org/files/publications/ltcchallenges.pdf
3) Niesz, H., Price-Livingston, S., & Diamond Arsenau, K. (2002). LONG-TERM CARE WORKER SHORTAGE. . Retrieved March 28, 2009, from http://search.cga.ct.gov/dtsearch.asp?cmd=getdoc&DocId=16173&Index=I%3A%5Czindex%5C2002&HitCount=0&hits=&hc=0&req=&Item=4
4) Looming Workforce Shortage Pressures Long Term Care Costs, According to Research (2008, April 29). Retrieved March 28, 2009, from http://www.businesswire.com/portal/site/home/news/sections/?ndmViewId=news_view&newsLang=en&newsId=20080429005958
5) Stone , R. I., & Wiener, . M. (2001, October 26). Who Will Care For Us? Addressing the Long-Term Care Workforce Crisis. Retrieved March 28, 2009, from http://www.urban.org/url.cfm?ID=310304
Monday, March 16, 2009
Reform Proposal 2
Long term Care-grey group
By Cassie Fillhouer
According to the Agency for Healthcare Research and Quality, “Quality health means doing the right thing, at the right time, in the right way, for the right person and having the best possible results”. Looking at long term health care this is very important and sometimes is overlooked by some care institutions. Why is this important to us? With the baby boomer population aging the elderly population is going to grow and by 2020 the United states is expecting Americans with chronic conditions to increase to 157 million (Shi and Singh p. 381). Chances of individuals knowing of someone, or in use of long term care themselves, is high. Not every American may be touched by long term care presently, but imagine for a moment a loved one, or eventually yourself, being placed in a long term care facility. How would you want to be treated and what if you could not afford a nicer facility? Would you still expect or hope to be treated for the same quality of care as a more expensive place? These are questions our group would like to address in our second reform proposal on improving and maintaining quality of long term health care at the state level.
First, to address the idea of quality of care individuals receive in long term care facilities, we would like to see more randomized auditing. By doing this, it will help ensure that residents and patients are getting the right care and hopefully help avoid neglect situations toward residents. By having more auditing reports we may also be able to prevent the problem of having unqualified staff. By ensuring that staff are qualified and trained to work with specific individuals, facilities could also help prevent the possibility of injury to residents or medication mishaps.
Improving the quality of life for the individual is another part of our proposal. “A sense of satisfaction, fulfillment, and self-worth is regarded as a critical patient outcome in any health care delivery setting. It takes added significance in long term care because (1) a loss of self-worth often accompanies disability and (2) Patients remain in long term care settings for relatively long periods with little hope of full recovery in most instances”, this is taken from Delivering Health Care in America by Leiyu Shi and Douglas A. Sing. To help address this idea we would like to see throughout the state of Wisconsin consistency in the quality of long term care, especially public facilities. We would like to see facilities create a “homelike” environment for residents by bring in children, pets, and having more activity choices available. The overall purpose of this is to make residents feel as comfortable as possible, like they never left home. According to the AARP article, A Balancing Act: State Long-Term Care Reform, “87% of people with disabilities age 50 and older want to receive long-term care services in their own homes. People want choice and control over everyday situations”. If individuals do not have the option of staying in their homes, we want to make sure that they can still feel at home wherever they choose to be.
Finally, to address the cost to improve and maintain the quality of long-term care, there would have to be an increase in spending to afford to have the extra auditing, training, and improvement in the facility environment. According to I-1029: better training or train wreck? By Kathie Durbin, beginning in 2010 long-term care workers will be required to have 34 to 75 hours of training to work. According to the article the state of Washington would pay the almost $30 million. In the long run this could help save money by the benefits of prevention and care outweighing the costs. Possible ways to get money could be from private donations or taking another look at areas that could be cut. A way to decide this could be to look at all the different consumer satisfaction ratings done by residents to determine what they want out of their facility.
Many individuals may see long-term care as something to worry about only if they themselves or a loved one use long-term care options, but long term care is just as important as any other health care option, facility, or issue in our society. Everyone is human and should have the same rights and quality of life as the next person no matter what the age or state.
Bibliography
AARP. July 2008. 15 Mar. 2009.
Durbin, Kathie. "I-1029: better training or train wreck?." Columbian.com. 6 Oct.. 15 Mar. 2009.
"Long-Term Care Reform Plan." Policy Council Document. 28 Sep. 2006. 15 Mar. 2009.
Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America . 4th ed. Sudbury, MA: Jones and Bartlett, 2008. 380-420.
"Your guide to choosing Quality Health Care." Agency for Healthcare Research and Quality. 15 Mar. 2009.
Long term Care-grey group
By Cassie Fillhouer
According to the Agency for Healthcare Research and Quality, “Quality health means doing the right thing, at the right time, in the right way, for the right person and having the best possible results”. Looking at long term health care this is very important and sometimes is overlooked by some care institutions. Why is this important to us? With the baby boomer population aging the elderly population is going to grow and by 2020 the United states is expecting Americans with chronic conditions to increase to 157 million (Shi and Singh p. 381). Chances of individuals knowing of someone, or in use of long term care themselves, is high. Not every American may be touched by long term care presently, but imagine for a moment a loved one, or eventually yourself, being placed in a long term care facility. How would you want to be treated and what if you could not afford a nicer facility? Would you still expect or hope to be treated for the same quality of care as a more expensive place? These are questions our group would like to address in our second reform proposal on improving and maintaining quality of long term health care at the state level.
First, to address the idea of quality of care individuals receive in long term care facilities, we would like to see more randomized auditing. By doing this, it will help ensure that residents and patients are getting the right care and hopefully help avoid neglect situations toward residents. By having more auditing reports we may also be able to prevent the problem of having unqualified staff. By ensuring that staff are qualified and trained to work with specific individuals, facilities could also help prevent the possibility of injury to residents or medication mishaps.
Improving the quality of life for the individual is another part of our proposal. “A sense of satisfaction, fulfillment, and self-worth is regarded as a critical patient outcome in any health care delivery setting. It takes added significance in long term care because (1) a loss of self-worth often accompanies disability and (2) Patients remain in long term care settings for relatively long periods with little hope of full recovery in most instances”, this is taken from Delivering Health Care in America by Leiyu Shi and Douglas A. Sing. To help address this idea we would like to see throughout the state of Wisconsin consistency in the quality of long term care, especially public facilities. We would like to see facilities create a “homelike” environment for residents by bring in children, pets, and having more activity choices available. The overall purpose of this is to make residents feel as comfortable as possible, like they never left home. According to the AARP article, A Balancing Act: State Long-Term Care Reform, “87% of people with disabilities age 50 and older want to receive long-term care services in their own homes. People want choice and control over everyday situations”. If individuals do not have the option of staying in their homes, we want to make sure that they can still feel at home wherever they choose to be.
Finally, to address the cost to improve and maintain the quality of long-term care, there would have to be an increase in spending to afford to have the extra auditing, training, and improvement in the facility environment. According to I-1029: better training or train wreck? By Kathie Durbin, beginning in 2010 long-term care workers will be required to have 34 to 75 hours of training to work. According to the article the state of Washington would pay the almost $30 million. In the long run this could help save money by the benefits of prevention and care outweighing the costs. Possible ways to get money could be from private donations or taking another look at areas that could be cut. A way to decide this could be to look at all the different consumer satisfaction ratings done by residents to determine what they want out of their facility.
Many individuals may see long-term care as something to worry about only if they themselves or a loved one use long-term care options, but long term care is just as important as any other health care option, facility, or issue in our society. Everyone is human and should have the same rights and quality of life as the next person no matter what the age or state.
Bibliography
AARP. July 2008. 15 Mar. 2009
Durbin, Kathie. "I-1029: better training or train wreck?." Columbian.com. 6 Oct.. 15 Mar. 2009
"Long-Term Care Reform Plan." Policy Council Document. 28 Sep. 2006. 15 Mar. 2009
Shi, Leiyu, and Douglas A. Singh. Delivering Health Care in America . 4th ed. Sudbury, MA: Jones and Bartlett, 2008. 380-420.
"Your guide to choosing Quality Health Care." Agency for Healthcare Research and Quality. 15 Mar. 2009
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