longterm care 2

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Karalyn

Residential care describes a variety of long-term services provided to individuals within a specific housing setting (McSweeney-Feld, 2017). The three primary segments are independent living, assisted living facilities, and skilled nursing facilities.  

Independent living typically targets residents who are 50 and older, providing communities and congregated arrangements to offer many recreational activities and increased security (McSweeney-Feld, 2017). Independent living is targeted towards seniors with limited financial resources. Usually there are no healthcare services offered inside of residential communities, however, outside healthcare services can occur. Residents can rent or purchase a unit in independent living with monthly maintenance, subsidized monthly rates are an option through federal government program guidelines (McSweeney-Feld, 2017).  

Assisted living has no uniform definition in the United States because different terminology and standards range for each state (McSweeney-Feld, 2017). Many assisted living communities are known for their hospitality model of service provision to allow for residents to remain independent, while offering an array of services and amenities to help with daily living, supervision, organized social activities, prepared meals, laundry services, healthcare, and transportation (McSweeney-Feld, 2017). Many communities are now providing more specialized services such as memory care for residents with dementia or Alzheimer’s, hospice, and end-of-life care, and offering services to younger residents with disabilities (McSweeney-Feld, 2017). The annual median cost of assisted living facilities in the United States is $43,200 with a national median monthly rate for a room is $3,600. Many residents pay for services out of pocket (McSweeney-Feld, 2017).  

Skilled nursing facilities are typically referred to as nursing home, providing custodial supervision and care, covering both short-term and long-term rehabilitation, skill nursing, and specialized post-acute and end-of-life services (McSweeney-Feld, 2017). Nursing home care usually revolves around residents who have a chronic health condition with no cure. The United States estimated 15,700 nursing homes in 2012, within those facilities there were 1,699,100 certified beds available (McSweeney-Feld, 2017).  

When my great-grandfather went into assisted living initially at the age of 94, he just need some additional assistance. He had some supervision and still received some medical care medication, etc. The facility also offered nursing home care. Eventually he was a candidate for nursing home care and was moved, where he received even more supervision and medical care. I still am unsure how I feel about the care he received in the nursing home, it was also during the start of the pandemic so we were never able to see him to ensure he was getting the proper care he deserved, which was very hard. 

Key findings on the size and demographics of residential care population: 6.5 percent of persons aged 65 or older, about 2.2 million, live in some type of residential care other than settings for special populations (Spillman & Black, 2006). This estimates that about 1.45 million individuals live in nursing homes and more than 750,000 live in alternative residential care settings (Spillman & Black, 2006). Many living in residential care facilities is those with disabilities, those suffering from Alzheimer’s or dementia. Individuals living in residential care facilities are more likely to be over 85 years of care, likely to be female, and potentially widowed (Spillman & Black, 2006). Residential care continues to grow rapidly. 

References 

McSweeney-Feld, M. H. (2017). Dimensions of Long-Term Care Management: An Introduction, Second Edition (Gateway to Healthcare Management) (Second ed.). Health Administration Press. 

NIA. (2019). Expert Meeting on the Demography of the Older Residential Care Population: Research Questions and Data Gaps. https://www.nia.nih.gov/sites/default/files/2019-12/Expert-Mtg-Demography-Older-Res-Care-Final-508.pdf  

Spillman, B., & Black, K. (2006). The Size and Characteristics of the Residential Care Population: Evidence from Three National Surveys. ASPE. https://aspe.hhs.gov/reports/size-characteristics-residential-care-population-evidence-three-national-surveys-1  

Georiga

Topic Option 1 - Long Term Care Facility-Based and Residential Settings: Types and Demographic

The 4 main types of Residential LTC Facilities we will discuss are Independent Living, Assisted Living, Skilled nursing Facility, and Life Plan Communities. 

Independent Living is defined as “a broad range of settings in which individuals, as a matter of preference and lifestyle, move into adult communities or congregate housing arrangements that impose age restrictions, offer social activities, and usually provide increased security” (McSweeney-Feld, 2017). The demographic for these types of communities is usually 50 years of age and older.  Healthcare is rarely provided in these facilities.  The objective of these communities is for adults of the same age and same stage of life, like retirement, can coexist in one community together.  The different types of independent living include naturally occurring retirement communities, planned virtual retirement communities, co-housing communities, congregate care facilities, and group homes.

 Assisted Living does not have a concrete definition and varies in meaning from state to state, however, generally speaking, assisted living facilities are intended for individuals who cannot thrive completely independently.  Assisted Living facilities serve the demographic of individuals “who have restricted functionality—due to advanced age, disability, or some other factor— while encouraging them to live with some degree of independence” (McSweeney-Feld, 2017).  The philosophy of assisted living facilities is to still have a community atmosphere while also tending to the needs of the residents on a healthcare level.

Skilled Nursing Facilities or Nursing Homes “provide custodial supervision and care, covering both short-stay rehabilitation and long-stay skilled nursing, including specialized post-acute care and end- of-life service” (McSweeney-Feld, 2017).  The main objective of a SNF is to create a comfortable living environment for individuals, tend to their medical needs, and hopefully rehabilitate them so they can return to their homes and regular lifestyle if possible.  Transitional Care Units serve as the rehabilitation side of SNF and help improve individual outcomes.

 Life Plan Communities is defined as “residential complexes that offer comprehensive nursing care and housing options for adults as they age and their needs change” (McSweeney-Feld, 2017).  This concept is intended with adults whose needs change are they age and they are offered all the services that assisted living, skilled nursing, and independent living facilities would offer.  Life Plan Communities are also referred to as Continuing Care Retirement communities. 

 References:

 Mary Helen McSweeney-Feld. (2017). Dimensions of Long-Term Care Management: An Introduction, Second Edition: Vol. Second edition. Gateway to Healthcare Management.

 Spillman, B. C. (2002, November 24). Trends in Residential Long-Term Care: Use of Nursing Homes and Assisted Living and Characteristics of Facilities and Residents. ASPE. Retrieved from https://aspe.hhs.gov/reports/trends-residential-long-term-care-use-nursing-homes-assisted-living-characteristics-facilities-0