When people age and can no longer perform daily tasks on their own, they tend to rely on other people for support services. These services help them live as safely and independently as possible as they pay for medical and non-medical care. Long-term care, therefore, encompasses a wide range of services that have been designed to help individuals who are unable to take care of themselves. This paper will explore what long-term care entails and the current mechanisms that are used for paying for long-term care and whether they are adequate or not. The paper will explore the financial and social differences of aging in a home place, a nursing home, or any other facility. Challenges that face healthcare equity for the elderly will also be explored in this paper as well as the policy recommendations on how to best meet the long-term care needs of an aging population.
The need for long-term care services increases as the number of aging populations that are living longer also increases. Long-term care comprises a range of services aimed at people unable to perform tasks all by one’s self (Feldstein, 2019). Some of these services that can be provided at home include doing shopping, preparing and making meals, and performing house chores. Other services that could be provided in community-based facilities are adult-based daycare services (Feldstein, 2019). Those in nursing homes unable to perform everyday activities receive services such as going to the toilets, bathing and dressing up. Long-term care services are mainly provided in nursing homes to individuals with severe functioning deficiencies, those with mental disabilities such as dementia and Alzheimer’s, and my family members (Feldstein, 2019). According to Feldstein (2019), long-term care is mostly provided at home by caregivers such as family members or close relatives. However, as the individual age, providing care at home becomes difficult, hence, community-based facilities and nursing homes are opted for.
As the demand for long-term care services increases, the cost incurred in availing of those services also increases at a higher rate compared to the generalized inflation rate. The current mechanisms through which payment can be made are Medicare, Medicaid, Federal intervention, state and local means, private insurance, and out-of-pocket means (Feldstein, 2019). Despite the availability of long-term care, the average cost that was incurred for a private room in a nursing home in 2017 was approximately $95,000 and this value is anticipated to rise to double the amount by 2037 (Feldstein, 2019). Longest (2016b), asserts that Medicare is not adequate as it only pays for limited long-term care expenses such as home health care for the individuals needing part-time nursing care or therapy also under the physician’s care. Medicaid, however, plays a major role in paying for nursing home care.
Medicaid helps pay long-term care expenses to patients after their financial resources have been depleted. Due to this, Medicaid is easily opted for, however, the states restrict expenditures on Medicaid by limiting the number of nursing home beds, limiting home services, and low rates on the nursing homes paid (Longest, 2016c). Private insurance policies are adequate as it covers all long-term care services such as nursing homes, home care, and assisted living facilities (Feldstein, 2019). Private insurance also covers services that involve case management, the providence of medical equipment for use at home, and offering training to caregivers. It also offers benefits and deductibles for days admitted before the insurance policy becomes effective.
Aging in place, in nursing homes, and in assisted living facilities for the elderly has financial and social differences. Nursing homes have the highest percentage of health care expenditures followed by home care (Feldstein, 2019). While aging in place may be the best, nursing homes buildings are designed in a way they are accessible to the aging people. They also ensure that maintenance and repair services are done by professionals. Unlike home-based care and nursing homes, assisted living facilities encourage socialization and recreational activities for the residents including outings. On finances, the average cost paid monthly for the cost in assisted living facilities is approximately $3,800 while the average monthly cost paid for a private room in a nursing home is about $8,200 (Feldstein, 2019). This implies that nursing home care is more expensive compared to assisted living facilities care. Aging in place promotes physical health as it ensures bacterial and viral risks are significantly low compared to living in nursing homes and assisted living facilities. Accessing amenities such as a transport system and health care facility in the case of an emergency may prove challenging when aging in place compared to the nursing home and assisted living facilities where the residents are under constant supervision by professionals.
Caregivers in place, nursing homes, and assisted living facilities often spend most of their time providing caregiving duties to the elderly. Ensuring equity for all residents can prove challenging to the caregivers, thereby, usually, efforts to ensure equity are faced with shortcomings. Some of the challenges in ensuring healthcare equity for the elderly are as availability of different modes of payment, whereby, each mode has its pros and cons, hence, the individuals receive long-term care depending on their payment mode. Similarly, low-income earnings among some families pose a challenge in ensuring equity as the long-term care facilities cannot provide certain services in favor of the high-income earners. Hence, this disadvantages the low-income earners who must struggle to pay for the services (Longest, 2016b)). The program of all-inclusive care for the elderly is also prone to facing challenges in ensuring equity in service providence for the aging as they do not ensure maximum nursing and medical care is provided. This makes the residents disadvantaged compared to the other long-term care residents.
Policy recommendations to best meet the long-term care needs of an aging population must be put in place. To ensure the long-term care services are accessible and affordable, the government should hugely subsidize the cost incurred for the long-term care services with the targeted group being the low-income earners (Longest, 2016a). The government can also provide the aging population with certain stipulated age funds to purchase long-term care services instead of relying on payment modes such as Medicaid (Feldstein, 2019). The states can also promote the social health maintenance organization which provides monthly incentives aimed at improving and coordinating long-term care as well as minimizing the services that are not needed. Therefore, long-term care encompasses the services people pay to the facilities designed to take care of the aged who can no longer perform chores on their own. Different modes are used as payment means, however, each mode is marred by both the benefits as well as the shortcomings. Consequently, caregivers strive to provide quality services to the elderly be it in place, at the nursing home, or in assisted living facilities.
References
Feldstein, P. J. (2019). Health policy issues: An economic perspective (p. 605-619) Chicago: Health Administration Press.
Longest, B. B. (2016a). Overview of the Patient Protection and Affordable Care Act. Health policymaking in the United States (p. 337-343). Ann Arbor, MI: AUPHA Press/Health Administration Press.
Longest, B. B. (2016b). Overview of Medicare. Health policymaking in the United States (p. 345-364). Ann Arbor, MI: AUPHA Press/Health Administration Press.
Longest, B. B. (2016c). Overview of Medicaid. Health policymaking in the United States (p. 365-377). Ann Arbor, MI: AUPHA Press/Health Administration Press.