History and Overview of Long-Term Care
Nicole Cronk

When many people hear the term long-term care, nursing homes automatically come to mind. While nursing homes are one aspect of long-term care, there are so many more long-term care settings including: home health care, adult foster care, home delivered meals, and informal care provided by family and friends. The elderly make up the largest use of long-term care services because they are more likely to have chronic conditions, although people of all ages may use long-term care.
The history of long-term care goes back to the early 1900’s when almshouses and houses were first started. In 1954, the government sets aside grants to build nursing homes. Medicare and Medicaid were created in 1965 to help cover the cost of long-term care. In 1969, Medicare starts limiting long-term services. By 1972, people with disabilities are now eligible for Medicare which enables many to get the necessary long-term care they need. The Balanced Budget Act was passed by congress in 1997 to set up a payment system for Medicare patients receiving long-term care. As you can see, many changes have been made over the years to long-term health care. We believe there are still changes that can be made for improvement.
Long-term care features services for individuals to help encourage independence. Activities of daily living (ADL’s) and instrumental activities of daily living (IADL’s) are used to evaluate limitations. Long-term care is provided over a long period of time and works to meet the needs of the patients and improve their quality of life.
Long-term care can be described as very expensive. According to Medical News Today, (3) “The average cost of one year in a private nursing home room ($76,460) is 59% more than the median household income in the United States ($48,201).” In our opinion, this is extremely high. I don’t know how people can afford this. If people want to receive good quality care, the price is much higher than if they received poor quality. This puts many families in a tough situation because they want to get quality care for their family member but many can’t afford it. According to Shi and Singh, 27.7% of the funding for nursing homes comes from out of pocket costs and Medicare covers only 13.9%. (2).
EInsurance.com said that 13 million individuals used long-term care services in 2000, and that number is expected to more than double to 27 million people by the year 2050. The increase in long-term care use is that there has been a substantial growth in the older population.
The goal of our reform proposals will be to lower the cost and improve the quality of long-term care. We believe that if Medicare and Medicaid paid a little more toward the cost of long-term care that many families would be much better off. Families wouldn’t have to decide if they should send their relative to a long-term care facility or if they should try to take care of him or her on their own even though they know that they can’t give their loved one the care that they need. We believe that it is very important that people in long-term care get proper treatment because they cannot properly take care of themselves on their own. Too many people do not get proper long-term care because they cannot afford it.
Some may disagree with allocating more funding towards long-term care because it would increase taxes, but we believe it is very important that everyone receives proper medical care at an affordable rate. We believe we should take some of the tax money from other areas and use it towards long-term care.


1. A Brief History Of Long-term care - Brief Article. BNET. Dec. 1999. Retrieved February 20, 2009 .

2. Everything you need to know about long-term Care? (n.d.). Retrieved February 19, 2009, from http://www.einsuranceadvisors.com/long-term-care-information

3. Shi, L., & Singh, D. (2008). Delivering Health Care in America (4th ed., pp. 380-421). Sudbury, MA: Jones and Bartlett Publishers.

4. U.S. Government Finds 40% Of People Currently Receiving Long Term Care Are 18-64; Numbers Continue To Rise (2009, January 24). Retrieved February 19, 2009, from http://www.medicalnewstoday.com/articles/136557.php