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Long Term and Institutional Care

Long Term and Institutional Care

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Published by Ilanna
This copyright essay is part of a larger program for EBSCO on the Sociology of Medicine and Healthcare in the U.S. This particular piece is on long term and institutional care and covers a wide range of issues within this broader topic.
This copyright essay is part of a larger program for EBSCO on the Sociology of Medicine and Healthcare in the U.S. This particular piece is on long term and institutional care and covers a wide range of issues within this broader topic.

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Published by: Ilanna on Mar 07, 2009
Copyright:Traditional Copyright: All rights reserved

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01/29/2013

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Long-Term & Institutional Care
 
Table of Contents
Author Supplied Abstract…………………………………………………… .1Author Supplied Keywords………………………………………………….. 1-2Overview……………………………………………………………………… … 2Understanding Long-Term Care……………………………………………. 2-4Nursing Homes…………………………………………………………......... 4-5Hospices……………………………………………………………………… 5-6Applications…………………………………………………………………… ..6-7Standards of Care……………………………………………………………. 6-7Conclusion………………………………………………………………………..7-8Terms & Concepts……………………………………………………………… 8-9Bibliography…………………………………………………………………… 10-11Suggested Reading…………………………………………………………… 11
Author Supplied Abstract
Long term and institutional care is one of the most important yet one of the mostcontentious issues in America today. Long term care is provided to persons with chronichealth care issues. These can be as broad as a medical condition such as multiple sclerosisto a person with a serious mental health condition (example: paranoid schizophrenia).More recently, many veterans from the Afghan and Iraq wars are also in need of longterm care and some have been placed in institutional care. Institutions can vary greatly,they include nursing homes, hospices and other institutional environments. Some of theseare run by the private sector, others by the government and there are also faith-basedservices. The primary difference between the two is that long term care is often acommunity-based model whereas institutions are a closed environment.
Author Supplied Keywords
Activities of Daily LivingAlzheimer’sAmyotrophic Lateral SclerosisAssisted LivingContinuing Care Retirement CommunitiesDementiaFaith-Based ServicesHospicesLicensed Practical NurseMultiple Sclerosis Nursing HomesPalliative CareRegistered Nurse
 
Retirement Living CommunitiesSubacute Care
Long-Term & Institutional Care
Social Issues & Public Policy > Long-Term & Institutional Care
Overview
Long-term and institutionalized care is a topic which embraces a wide range of issues; thetypes of care available, standards of care available, concern for persons who arevulnerable and/or elderly (possible abuse) and the funding required keeping theseservices functioning appropriately. For some people, any mention of the words hospiceand/or palliative care create worrisome images. However, they exist to provide importantservices in our communities. Yet, not all people who require care want to go into anursing home and feel they can be taken care of more effectively in their own home.While home care is definitely a viable and important option, one has to take into accountthe level of care required and how best to provide that. This requires an assessment of thecommunity care services available so that family members do not burn out trying to carefor their loved ones.The various options for long-term care require a strict and constant review. It isabsolutely vital that the nation’s most vulnerable individuals receive professionallyappropriate care. However, there have been concerns both in the past and in the present asto whether or not the highest of professional standards are being met.
Understanding Long-Term Care
Long-term care is a complex topic because a wide range of people benefit from servicesthat range from children and young adults who require home care services due to achronic condition or disability, to people who are elderly and require at least some levelof care that may be too complicated to provide at home. “Many people with long-termcare needs use a combination of family support and formal long-term care and some willuse formal care exclusively. Formal long-term care services can include home care, adultday care, assisted living, and nursing home care” (Tumlinson, Woods, & Avalere HealthLLC, 2007, p.2).Individuals require long-term care for many reasons but it is a misconception to think thatonly persons who are elderly require these services. Children who are born with multipledisabilities, people with severe mental health issues (that is, paranoid schizophrenia),young adults who acquire a disabling condition such as multiple sclerosis and seniors allcan require some form of long-term care.
 
The broad range of assistance that constitutes long-term care results inconfusion and disagreement about what long-term care is and how it isdistinct from medical care. Other examples of long-term care canrange from skilled nursing facility care provided post hospitalization tohousing arrangements for healthy seniors and special transportationservices (Tumlinson et al., 2007, p.1).There is no doubt that most people would rather be in their own environment, butunfortunately it is not always possible. “…many older people with disabilities simply donot have the financial resources to obtain the services they need, either in the communityor in long-term care facilities. In some cases, their care options are limited, if available atall” (“From Isolation to Integration,”
 
2007, p.13).The choice to provide long-term care at home can be a difficult one. It is often driven bya combination of emotional and financial considerations. Many families cannot bear to place a loved one into a nursing home or other care facility. In addition, the qualityservices are very expensive and many families simply do not have the money. Yet, tryingto provide the care at home can often be just as costly. The level of care required is driven by an assessment of ‘Activities of Daily Living.’ The assessment must be provided by ahome care professional. “The assessment tool allows the nurse care manager to identify medical, psychological, functional, and social needs of the client. In addition,the home environment, current health care resource utilization, and support systems areevaluated” (Phillips, Smith, & Cournoyer, 2004, p.42).Home care is not always possible even if a family member prefers to stay in their ownenvironment. It is this assessment which determines whether or not a person can be caredfor in their own home, which will provide that care, the parameters of care and thestandards that must be adhered to. Although it sounds like a simpler option (and lessexpensive) the reality is that home care is often financially and emotionally difficult on afamily. An individual may lose income depending on the amount of time they need to behome (or hiring a home care provider) and the emotional toll can sometimes be extremelytaxing on a family.The professionals who work in long-term care facilities are also under a great deal of  pressure especially as America’s health care system comes under increasing scrutiny. Thetraining required to work in long-term care is highly specialized. In addition, the providers of these services must develop an infrastructure that supports quality level care.Presently, in America, there is a dire shortage of professionals capable of working inlong-term care facilities. The state of many of the country’s long-term care facilities is areason for concern.[…] many providers maintain that inadequate funding makes it difficultfor them to upgrade their infrastructures and their care practices. In particular, providers say that they lack the necessary resources to recruit,train and retain quality staff, especially those direct care workers who provide day-to-day care to long-term care consumers. These workers are

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