Leadership Perspective On Long Term Care

The challenge America now faces is the number of people reaching retirement will double in number by 2030, and the U.S. population will increase almost 20 percent ("Our Aging Nation," 2015). The goal is for the elderly to maintain and live with independence and dignity, as well as, provide a wide range of professional health and social service expertise, home care, and residential support and services that will be needed ("Our Aging Nation," 2015). Since the number of caregivers needed for this population will not be able to meet the demands other resolutions are considered necessary.

Current numbers show substantial growth from the eighties, and estimates suggest that the demand for long term care among the elderly will more than double in the next thirty years. (Feder, Komisar, and Niefeld) This growth will exacerbate concerns about balancing institutional and noninstitutional care, assuring quality of care, and most importantly adopting and sustaining financing mechanisms that equitably and adequately protect the elderly who need long-term care.

Experience working in the field of health care lends insight to the growing needs of the older adult population, and the barriers which impede our capacity to meet them. As the Baby Boomer age is approaching older adulthood, the rise for financial,

In the fiscal year 2010, (O’Shaughnessy, 2012) only about 5.1%, or 3 million people, out of the 57.8 million people age sixty and over, received services funded by the Act. These services included home delivered meals, home care, personal care, or case management services on a regular or intensive basis. About 14%, 8 million people, received other services, such as transportation, congregate meals, or information and assistance on a not so regular basis. A report was made by the Government Accountability Office stating that their findings were that many older people are in need of meals and other supportive services to help remain independent in their own communities, but a large portion of them are not getting the help they are in need of. Some barriers causing this lack of help are lack of funding and lack of knowledge among the older Americans that they may be eligible for benefits and services can be available for them.

Even though long-term organizations are creating new services, many individuals continue to lack the quality of care they deserve and because of that Congress is stepping in. “As Congress and the Obama administration consider broad-based health reform, efforts to restructure long-term care are taking on greater urgency and policy experts have put forward several reform plans aimed at improving access to care“(Gleckman, 2009).

We can’t purport to have a national goal to “eliminate health disparities” and continue to accept the social inequities that come from such a major gap in wealth. If we hope to solve the pressing issues of eldercare, these inequities must be addressed head on now and in the future. Otherwise, those who are caregivers now may not have access to the care they will need in the future.

When presented with the word “elderly,” a twenty-year-old might begin to think of the joys of retirement when an older person has spent their life building a comfortable bank account; they then get to reward themselves by journeying around the world with their near and most dear companion. When reality sets in, that person may realize that a lot of today’s elderly are living in nursing homes or living week-by-week not knowing if they are going to be able to leave their hospital bed just to go relax in their recliner at home. While it is true that some elderly enjoy their last twenty or thirty years on earth, a lot of the elderly in America are struggling to hang on to life while being abused every day by healthcare workers or even loved ones. While many people have been working endlessly to put a stop to elder abuse, not everyone can say the same.

Caring for the elderly and disabled has always been a relevant issue among American’s; however, not until recently has it become a significant issue within society. Change has occurred in the past couple decade as the workforce dynamics have transitioned from the family based farm living to the inner city, college educated worker who follows opportunity. Decades ago it was common place to have an aging relative live with the family in a multi-generational home; however, that is no longer a practical option in many cases. Although this transitioning of society has created a new issue and that is providing care to those elderly or disabled members of society who cannot rely on the support of family

I conducted interviews with individuals from the Department of Health and Human services that focused on the aging population, vulnerable adults and their residency in long term care facilities. The DHS has different branches that cater to the needs of older adults as well as regulations and laws aimed at protecting residents in long-term care facilities. The regulations include, the Adult protection statute, and general statutory guidelines for home and community-based services under Medicaid. Minnesota and the federal government share responsibility for enforcing the “Nursing Facility Bill of Rights” which explains the rights afforded to residents of nursing facilities.

In the article “Don’t Seniors Deserve Better?” (MacQueen, K. 2011), MacQueen writes that many elderly patients in the midst of a medical crisis go straight to the hospital and stay there, tied to machines, consuming high-tech resources to little effect, growing weaker until the dim hope of a nursing home bed is made available. He also continues by saying that elderly citizens suffer a five percent functional decline for every day in hospital. This is a great issue; the fact being that Canada does not have enough long term facilities for the elderly population to stay in nursing homes is not being fair to the seniors of Canada. In fact, (MacQueen K. 2011) remarks, that each day in Canada, 7550 hospital beds are filled with the elderly who should be in long-term care nursing homes or in rehabilitation, yet they cannot get this option. Also, outside of the hospital, many elderly people run into the financial crisis of caring for their medical needs without the help of the Canadian Government. In the article “The unexpected costs of caring for your elderly parents” (Leong, M. 2014) Peter Silin says, “People think the government will pay for home care and nursing homes which they will, but that help is really limited.” In fact, “Seven in 10 caregivers were providing some sort of financial assistance to their parents or aging relatives, a 2012 BMO survey suggested, and half of these individuals said they had to adjust their own retirement plans as a result.” (Leong, M. 2014). With that, it costs $1,000 to keep a person in a hospital bed for a day, long term care costs $130 a day, and home care costs $55 dollars a day. (Simpson, C., Caissie M., Velji, K. 2015). After looking at the negative impacts of keeping our elderly in the hospitals, as MacQueen stated earlier, “elderly citizens suffer a five

Opportunities which can be addressed though senior care includes the increasing of staff including geriatric nurses. This can be done by local long-term care facilities, partnering with community colleges in training nursing staff and staff having the ability to gain the necessary accreditation needed. Long-term care plans can become apart of the services which are provided within the community by social workers who are employed by the state. They can partner with case managers and their individuals to derive long-term care plans, and this takes some of the strain off of case managers. Advocacy groups such as non-profit organization can bring forth the issues of long-term care to local and state level governments, so programs and initiative can be set forth. This is important for people to start looking at long-term care early, and avoid future cost which can become a burden on their loved ones or an unmet need for care.

The continuously changing long term care environment requires healthcare administrators to protect the interests of residents they care for while effectively managing and leading their healthcare teams. Successful long-term care facilities incorporate varying management and leadership principles to encourage, support, empower, and coach employees. Engaged and motivated employees result in high-performance organizations. These high-performance organizations historically rate well in overall patient and employee satisfaction as well as patient safety. To explore and observe successful management practices, a case study involving two drastically varying long-term care facilities was analyzed and examined. The purpose of this paper is to

Considering this data as vast and broad it tends to generalize the lifestyle of every senior home. It portrays the disadvantages of senior homes. For example, less communication with other family members. According to Moody and Sasser, “The ideal of a continuum of care expresses the aim of keeping older people as long as possible out of nursing homes-the most expensive and service-intensive settings” (p. 158). Medicaid does not cover total cost of the senior and nursing homes. In 2000, Metlife studies showed “the average cost of year in a private nursing home was $90,520. Of those who enter a nursing home as "private-pay" patients, after only three months, nearly 70% have reached the poverty level, and within a year, 90% are impoverished” (p. 209).

Unlike Mrs. Smith and her husband who have been able to save and invest enough money for their retirement and unforeseen medical needs, many elderly are not prepared. According to the AoA (2016) statistics, more than 4.5 million elderly individuals were below the poverty level in 2014 while at the same time, an additional 2.4 million older adults were classified as "near-poor" “income between the poverty level and 125% of this level.” Moreover, when compared with other cultural groups, such as the Hispanic women who also lived alone, the Hispanic counterparts experienced the highest level of poverty as compared to other cultural or racial groups (AoA, 2016). According to Bloom, Boersch-Supan, McGee, and Seike (2011) although aging is taking

Many family members care for their senior loved ones who cannot maintain their independence and freedom without support. A recent study found that nearly a quarter of seniors over the age of 65 receive at least 20 hours a week of care. A quarter of those receiving care required over 50 hours a week. While caring for the needs of a loved one is a labor of love and brings with it many benefits, care is also taxing, exhausting, and can impact the health of the provider.