Long-Term Care Issues - Research Paper Example

? Long-Term Care Issues Paper College Lecturer Long-Term Care Issues Paper Introduction Long-term care (LTC) is the medical and non-medical services offered to people with chronic illnesses, and cannot adequately care for themselves (Evashwick, 2005). This care seeks to assist individuals in living normally despite their disabilities to function without assistance (CMS, 2012). Long-term care might include medical functions like treatment of a chronic disease or non-medical care like assisting aged individuals in performing various tasks like bathing, in order to improve their livelihood (CMS, 2012). This care remains fundamental in reducing the mortality of individuals above the age of 65 years (CMS, 2012. Aged individuals encounter numerous physical challenges resulting from advancement in age, which ultimately necessitate long-term care (Kane, et al., 1998). Long-term care involves various services offered by different organizations, in support of the needy populations. A comprehensive long-term care policy could become necessary in improving the integration of these services (Feder, Komisar, & Niefeld, 2000). Many individuals normally receive long-term care from their homes because of the high costs involved when seeking assistance from professional organizations (Gregory & Gibson, 2002). Many aged individuals are normally put under the custody of nursing homes for lack of persons to care for them within the home setting. Personalized long-term care remains expensive and many insurance companies fail to offer policies covering for such problems (Coburn, 2001). Long-term care, especially for aged individuals remains limited to family members, with all involved financial requirements being met by families (Kodner & Spreeuwenberg, 2002). Individuals normally visit nursing homes for professional services, but some services might not be satisfactory. The government continues to seek increased involvement in long-term care through various government departments (Kane, et al., 1998) The involvement of government departments could improve the management of the long-term care services offered to needy individuals (Evashwick, 2005). Continuum of integrated long-term care Administration Needs assessment Inter-sector planning Organization Joint managed programs Strategic alliance between stakeholders Inter-agency budgeting Common ownership of facilities Funding Prepaid capitation Pooling of funds from different levels Service delivery Joint training Care management Integrated information system throughout the state Common decision support tools Government departments involved in long term care Long-term care services within various regions continue to be affected by the inadequacy of these services among a rising population requiring the services (Feder, et al., 2000). The demand for these services, especially in rural areas, surpasses the available capacity for providing these services (Coburn, 2001). Majority of these services are rendered by private organizations with limited presence only in urban centers. Comprehensive provision of long-term care services would include availing these services within numerous locations, to enable increased access by the needy individuals (Coburn, 2001). The involvement of various government departments within the provision of long-term services remains essential in achieving increased presence of these services to the people requiring them (Kane, et al., 1998) The various government departments which could become directly involved in long-term service delivery are identified below. Department of Health and Human Services The department of health remains charged with the capacity to provide all citizens with essential human services to enhance the wellbeing of individuals (Evashwick, 2005). This department implements government policies regarding health related matters and ensures that all policies become adequately followed by organizations operating within the health services sector (CMS, 2012). In integrating long-term care services within the state, this department’s involvement remains fundamental in ensuring comprehensiveness of the integration (Feder, et al., 2000). The department can provide stakeholders with essential information to enable them reach the required individuals. This department must be involved in ensuring that introduced services meet the basic requirements provided by the government. The individuals requiring long-term care also require primary medical services, provided by this department. The need for primary medical services becomes essential because individuals requiring long-term care remain highly susceptible to numerous ailments, affecting human beings commonly. Long-term care predominantly emphasizes the integration of living and treatment (Evashwick, 2005). The nursing homes offering long-term care would become located near hospitals or have some medical professionals assigned to them, to regularly check the health of the individuals. This would significantly enhance the integration of treatment and living among the individuals. The responsibility of providing treatment entirely remains bestowed on this department and should be involved in projects requiring medical services, like the long-term care services. Department of finance The department of finance normally provides funding for government supported projects, seeking to enhance service delivery to citizens (Kodner & Spreeuwenberg, 2002). Financing remains one of the biggest challenges faced by long-term care giving institutions regarding the management of individuals seeking these services. Some individuals remain poverty stricken and the capacity to seek long-term care services becomes difficult because of financial constrains (Feder, et al., 2000). The involvement of this department could seek to ensure government financing of the project in order to reduce the costs involved, and make long term care affordable to majority of the population. This department could provide sufficient financial guidelines regarding subsidizing the services by the government, aimed at lowering the costs of long-term care services. Through partial financing from the department of finance, prices of these services would become significantly reduced; hence becoming affordable to the population. Financial constrains in implementing long-term care services also occurs for the people offering care to patients. Within the institutionalized long-term care setting, employees are faced with poor working conditions and financial constrains resulting from poor pay. Most of the workers are volunteers who remain unpaid and lack medical insurance themselves. Commercialization of employment within the sector could ensure the government regulates and stipulates salaries for these individuals. The challenges faced by these individuals would become sufficiently reduced and offering care viewed as a prospective career opportunity. Currently, individuals fail to work within care-giving institutions because of financial constrains. The department of finance can initiate policy seeking to establish a salary level for workers within these institutions. The salaries offered would be similar to those offered to workers within the healthcare sector. Education Department The education department performs the role of training and giving people essential skills to undertake various career opportunities. The education department could develop a curriculum for training people in becoming professional care-givers to individuals requiring long-term care. Having professionally trained individuals would enhance the capacity for these workers to be treated like other workers, and be accorded the benefits accorded other workers. Workers within care-giving institutions normally face financial challenges and marginalization because of the work done. Professional healthcare workers only visit these institutions on limited occasions to perform routine checks on individuals residing in these institutions. Training of workers within these institutions would empower them with skills for offering limited medical care to institutionalized individuals. The education department could be utilized in development of curriculum for training professional who would be utilized in delivering long-term care services within the state. The department can also be used in undertaking training for the volunteers working within the sector, to enhance their service delivery skills. This training of volunteers would be immediate actions because school-based training would have to take several years. The volunteers, however, would be offered basic medical skills, like administering first aid, to ensure they assist professional medical practitioners, who come to visit institutionalized individuals. The medical professional would be comfortable leaving clients under the care of individuals with medical training (Gregory & Gibson, 2002). Though limited medical training would be offered to the volunteers, this would become sufficient in ensuring proper caring for the institutionalized individuals. Process of coordinating change The various departments involved within the implementation process would coordinate with the involved stakeholders for sufficient success for the implementation. The sector remains occupied by many private organizations offering care to various persons requiring the care. In the development of curriculum for training individuals interested in offering care, the department of education would seek information from individuals involved in offering care regarding the procedures utilized. The education department would develop a curriculum based on the current operating procedures utilized by workers within the sector. The type of care offered to institutionalized individuals, heavily relies on the availability of funding from reliable source. The finance department would analyze the care offered and assess the level of financial help to offer individuals. This would create a form of medical insurance scheme for individuals requiring long-term care, within institutions. Financial constrains continue to push people away from seeking institutionalized long-term care, because it remains relatively expensive. Financing program The government health scheme would be analyzed to include offering services to individuals requiring long-term care. This scheme remains a trusted medical scheme which individuals continue to rely on, for various treatment procedures. Through inclusion of long-term care within the government provided medical health, the financial constrains experienced when seeking long-term medical assistance would become significantly reduced; making long-term care relatively affordable (Kane, et al., 1998). Affordability of these services remains the major limitation which causes individuals to stick in home-based care, which remains affordable. Home-based care, however, lacks the professional element of care available within institution setting. Seeking institutionalized care remains better compared to home-based care. Within the institutions, the individuals receive care from trained personnel who ensure certain requirements, like dietary allocation, are followed strictly. The implementation The implementation of the service integration would require sufficient cooperation between the various stakeholders, both private and public. The existing institutions offering these services could be improved through being provided with resident medical professional to attend to residents. The department of health should seek to provide government doctors and nurses to the institutions to enhance availability of proper healthcare within these institutions (Kodner & Spreeuwenberg, 2002). These professionals would offer medical services to the individuals residing within the institutions. The worker would be informed of the required training, which would be offered to workers through government funding. The workers would be offered details of the potential benefits of training in order to ensure increased participation. Worker training would be conducted by the government through government funded projects. The government would also seek to undertake sensitization programs upon the population to enhance their understanding of the scheme. This would be necessary because changes in the monthly contribution for employed individuals would be initiated to cover for long-term care. The population would become sensitized on the importance of making these contributions while working as this would serve as medical insurance in future. Conclusion Long-term care continues to receive limited attention and policy compared to other healthcare issues within the American healthcare system. These services however, matter to all individuals equally because of the burden presented by the conditions requiring long-term care (Gregory & Gibson, 2002). There exist numerous controversies, between state and national governments, regarding provision of resources required by the service. State could adopt policies, within the legal provision of national healthcare and implement long-term care policies at the state level. The state governments could mobilize various government departments, directly involved in long-term care, in both formulation and implementation of the policies. Comprehensive policy formulation could enhance the capacity of state residents to seek institutionalized long-term care. This would significantly improve the healthcare delivery for citizens through reducing mortality resulting from conditions which could be managed through these services. References CMS. (2012). Medicare.gov. Retrieved May 19, 2013, from http://www.medicare.gov/LongTermCare/Static/Home.asp Coburn, A. F. (2001). Models for Integrating and Managing Acute and Long-Term Care Services in Rural Areas. Journal of Applied Gerontology , 20(4): 386-408. Evashwick, C. (2005). The Continuum Of Long-Term Care (3rd ed.). New York: Thompson Learning . Feder, J., Komisar, H. L., & Niefeld, M. (2000). Long-term care in the United States: an overview. Health Affairs, 19 (3): 40-56. Gregory, S. R., & Gibson, M. J. (2002). Across the states: Profiles of long-term care (5th ed.). Washington, DC: AARP Public Policy Institute. Kane, R. A., Kane, R. L. & Ladd, R. C. (1998). The Heart of Long Term Care. New York: Oxford University Press. Kodner, D. L. & Spreeuwenberg, C. (2002). Integrated care: meaning, logic, applications, and implications – a discussion paper. International Journal of Integrated Care, 2: 13-14. Read More