Strengthening Long Term Care for the Postpandemic World

Introduction:

Post-pandemic concerns regarding Long Term Care (LTC) in our nation include access and adequate provisions, quality of formal home-care services, utilization of informal caregivers and financial sustainability of our nation’s healthcare systems.  There is a critical need for reform and our nation is long overdue.  Defining quality of life for this population will become increasingly sought after in the very near future.

Creating a Focus:

Advocacy groups are working with our government healthcare agencies on meaningful reform to prepare for a growing elderly population and a quality LTC system.  A few areas must be looked at to provide a system for this population to include quality of care and increasing clinical improvements to the system, frontline workers and supporting workforce improvements, system improvement to get to a resident driven mentality and upgrading the system to provide a safe and dignified environment.

In reviewing post-pandemic environments for this patient population, there needs to be a greater focus on specialty workforce to provide a safer, healthier environment by infusing an infection prevention program in each nursing home.  There will need to be proper funding to allow for effective implementation of this safety metric.  Nursing homes have faced chronic underfunding, leaving many skilled nursing facilities to provide much needed updates in their care delivery system.  There is also work being done to tie reimbursement to quality care.

As Americans age and live with multiple co-morbidities, there is also a drive to allow them to remain as independent as possible in their homes and age with dignity and to allow their preferences in care needs. This also assists in the nursing homes with overcrowding. Costs may include bringing in aide care, as well as expenses attributed to families having to provide direct care to loved ones, such as missed worked time. 

It has been found that for the cost of one person residing in a LTC facility, Medicaid can pay for 3 people to receive home and community-based services (HCBS).  This allows HCBS the potential to have people remain more independent and fulfilling their wishes to continue to live in their homes.   Innovation and forward thinking healthcare practices are offering house calls in particular areas of our nation.

Prior to the pandemic, it was revealed that 48 million Americans provide care for adults in their homes.  Family caregivers are challenged with physical, financial and psychological constraints.  They report a decline in their own health, as well as a financial burden by out-of-pocket costs, up to 20 percent of their income, to care for their elderly family.  There is ongoing support for the bipartisan Credit for Caring Act, recently reintroduced to various senators to allow a tax credit to provide some financial relief.  There is also discussion on providing respite care to these families/caregivers.

There is ongoing innovative thinking across multiple organizations/advocacy groups/government agencies on optimizing safety and increasing quality of life.  Looking at access, technology and optimization with ideas surrounding living models are being discussed, such as smaller homelike settings (“Green” houses) may lead us to better answers.

Conclusion:

Much work is necessary to educate people on various care options and payment sources. It would be beneficial for this to begin earlier in life. My hope is to broaden the awareness amongst the public to spark discussion and innovations in our society to push long-term care reform higher on the political agendas.