Essay Sample on Long-Term Care: Challenges & Trends in Home & Community Services

Introduction

Long-term care is the healthcare field designed to offer healthcare services to people who cannot perform daily activities on their own. It can be offered at home, in a nursing home, or the community in places such as adult, a daycare center. In the recent past, there has been a trend in long-term care services mostly offered in communities and homes due to the challenges faced by long-term care facilities. Such challenges have been experienced while offering services to the increased number of the elderly and people suffering from chronic illness. Patients in long-term care are mainly assisted in performing activities of daily living. Most importantly, long-term care is a healthcare field geared towards the provision o daily living services to people that have a disability or ongoing medical condition. When people get older, frail, or when their medical condition gets worse, and they cannot be able to take care of their daily needs and are referred to long-term care where they receive help in meeting their daily needs.

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Typical Services Provided In Long-Term Care

One of the services offered in long-term care is living accommodation and medical care for people that cannot take care of their daily needs. The other types of services offered in long-term care are personal care services such as assisting patients in bathing, dress, eat, use the toilet, grooming, and moving around. Patients are mostly assisted in moving around activities such as getting in and out of bed and getting into and out of chairs. Other services are transportation, medication management, personalized care plans, rehabilitative therapies, post-hospital care, and management of chronic illnesses such as diabetes.

Typical Patients Served In Long-Term Care

The typical type of patients served in long-term care are the aging population who are too frail to take care of their personal and medical needs. The other group of patients cared for in long-term care are patients that need rehabilitation services such as speech, occupational, and physical therapies after an injury or surgery. The other group of patients also served in long-term care are people who have a worsening medical condition such as diabetes and people that have suffered a stroke.

Main Healthcare Professionals that Work In Long-Term Care

Nurses are the main medical healthcare professionals that work in long-term care either as volunteers or on paid contracts. Medical healthcare professionals who are trained in geriatric nursing are the bulk of professionals that work in long-term care for the aging population. Medical healthcare professionals trained in offering rehabilitation services also work in long-term care to offer physical, speech, and occupational therapy for patients and residents in institutions of long-term care, in the community, or at home. Nutritionists are the other group of medical healthcare professionals that offer nutritional services in post-acute care, long-term care, and community-based programs (Mowen et al., 2017). Most residents in long-term care need adequate nutrition so that their immune system is boosted, and they get the strength to recover quickly, making nutritionists very important n these facilities. Physicians also make up a proportion of medical healthcare professionals that offer medical services to residents who have serious medical conditions such as diabetes. For medical management, pharmacists also assist in offering prescription medicines to nurses and other professionals in long-term care.

Changes Experienced over the Past Three Decades

In the past three decades, there have been numerous and significant changes in healthcare technology applications and healthcare delivery models. Some of the changes are the use of telehealth applications to link patients with their providers instead of healthcare professionals visiting the patient physically. The other change has been a change from using paper records to the adoption of electronic healthcare records for the storage and retrieval of information about patients in long-term care (Kahn, Yang & Kahn, 2010). The other change has been less reliance on community health workers to visit patients or link them to providers but use web-based communities to link patients with providers, the community, and peers. Instead of using medical professionals to monitor patients at home or in long-term care facilities, there have been changes for the past three decades towards the use of robotic technology to monitor and manage the activities of patients.

There have also been changes in laws affecting the long-term care field for the last three decades. Examples of such changes are legislations that have made it possible for hospice services to be offered in assisted living care programs, which are legislative changes from Medicaid policies not allowing for hospice services to be offered assisted living (Feng, Liu, Guan & Mor, 2012). The other change in legislation is the adoption of the A9034 by Assemblyman Gottfried/S7282, which makes it mandatory for long-term care facilities to report any deaths or attempted suicide cases to the department of health, something that was previously not mandated by law (Ustin, 2018). There have also been changes in Title 18 and Title 19 amendments so that Medicaid services are offered to the elderly in long-term care facilities. The Social Security Amendment created n Title 20 is also another significant change that made it possible for laws to be set in place so that states must offer preventive, transportation services, adult daycare, and other services that improve long-term care. The adoption of the ACA as legislation has increased coverage for the elderly and patients in long-term care facilities (Shaw, Asomugha, Conway & Rein, 2014).

As it relates to stakeholder communications, there have been changes in terms of the adoption of IT, such as web-based communities that link patients with providers across the virtual space (Kahn, Yang & Kahn, 2010). As it relates to patient demographics, there have been changes in the ethnicities of people that use long-term care hence expanding the demand for long-term care services. Therefore, in the past decade, more non-Hispanic black and other ethnicities have embraced the use of long-term care services, as opposed to these services being mostly used by whites.

There have also been alterations in the ethical changes that face the long-term care field. One of the changes is that the elderly have been offered more resources to prevent the ethical challenges that arise due to falls as it relates to the ethical issue of whether the elderly and people who need long-term care should live at home. There has been an increasing voluntary from several community health nurses who have made it possible for long-term care to be offered at home or in communities. This has changed the ethical challenges of long-term care facilities being held responsible for the increased mortality of patients due to overcrowding in these facilities (Mowen et al., 2017). The changes have also reduced medical malpractice lawsuits against long-term care facilities. The other ethical issue change has been seen in how the privacy and confidentially of residents in long term care have been upheld. It has improved using technologies such as EHR.

References

Feng, Z., Liu, C., Guan, X., & Mor, V. (2012). China's rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Affairs, 31(12), 2764-2773. DOI: 10.1377/hlthaff.2012.0535.

Kahn, J. G., Yang, J. S., & Kahn, J. S. (2010). 'Mobile' health needs and opportunities in developing countries. Health Affairs, 29(2), 252-258. DOI: 10.1377/hlthaff.2009.0965.

Mowen, A. J., Barrett, A. G., Graefe, A. R., Kraschnewski, J. L., & Sciamanna, C. N. (2017). "Take in two parks and call me in the morning"-Perception of parks as an essential component of our healthcare system. Preventive medicine reports, 6, 63-65. DOI: 10.1016/j.pmedr.2017.02.006

Shaw, F. E., Asomugha, C. N., Conway, P. H., & Rein, A. S. (2014). The Patient Protection and Affordable Care Act: opportunities for prevention and public health. The Lancet, 384(9937), 75-82. DOI: 10.1016/S0140-6736(14)60259-2.

Ustin, M. (2018). Legislation Affecting Long Term Care & Aging. Retrieved 7 December 2019, from http://nyhealthlawblog.com/2018/07/02/legislation-affecting-long-term-care-aging/