Long Term Care Case Study

Upon arriving at the long-term care facility and noticing that the toe tag on the decedent did not match the removal authorization, I would immediately inform; the decedents doctors, the decedents nurse, or whoever was in charge of the care of the decedents body at the facility. I would also call the funeral home and get instructions on what I should do next. Most likely, I would tell the facility to call the funeral home back after the body had been properly tagged. After the facility called me back, I would come back and transfer the body to the funeral home. I would follow the same procedures for transferring a body, but I would do everything I could to make sure that I was taking the correct body. It would be helpful in identifying the

Long Term Care (LTC) is an area where change is needed. According to the CDC, by 2030, older adults will account for roughly 72 million of the U.S. population. In 2030, when the last baby boomers turn 65, one in every five Americans will be over the age of 65, and will account for roughly 20% of the population. As the growing population of baby boomers continued to aged they will become more reliant on long term care services. Nurses will be at the forefront of providing care to this demographic of the population. Leadership and accountability are needed in long term care to provide efficient care to the aging population.

I selected the topic of long-term care options for my research paper, because of the importance of allowing the elderly to remain in their residence as long as possible in their final years and what options they have if they choose not to live in their own home. I will look at programs and services that provide long-term care for the elderly.

The long-term care system is aimed at providing continued care to individuals both in facilities and at home. Many people associate long-term care specifically with nursing and assisted living facilities, but long-term care is so much more. This care can be provided to an individual whether they are home or in a specialized facility (National Institute on Aging, 2017). In essence, the system of long-term care involves the coordination of facilities, providers, and case manager support to provide the best quality of care for individuals.

Rehabilitation facilities provide inpatient care while helping the patient return to the maximum functionality possible. Rehab facilities specialize in physical medicine, physical therapy, and occupational therapy, helping patients recover from the effects of accidents, severe injuries or illnesses, strokes, or serious surgery.

Growth in the number of the baby-boom generation that enters old age is the main driver of increased demand for long-term care. Women are more likely to use long-term care compared to men because they live longer and often outlive their husbands. The main goal of the long-term care is to provide a variety of services that help to meet a person's health or personal care needs. In addition, the services can be provided at home, in the community, and in facilities. Most of the long-term care services are expensive; as a result, Americans spend billions of dollars out of pocket on the services. The most expensive is the facility-based care, such as assisted living and nursing homes. For example, according to the New York Times, the

Many aging Americans often struggle to pay for home care, assisted living and other forms of long term care. When choosing the right type of care much consideration and research should be given. In determining whether one must self-fund their care can be a process which can leave the door open for many unanswered questions. Questions like, what is the expected cost, will Medicare help to cover any cost, or can one use their property to pay the cost for long term care. Since elder care and senior care can be in a variety of forms, the biggest concern is who takes on the brunt of payments. According to Benjamin (2015), “99% of our services are a private pay product with some assistance for veterans; long-term care insurance does account for part of the remaining 1%, along with some waivers provided by Medicare. “Private Pay can be funded by savings and investments, long term care insurance or annuities, social security or other retirement benefits, Veterans’ benefits, and through the conversion of a life insurance policy into a Life Care Benefit Plan or Long Term Care Benefit Plan” (Orestis, 2013, para 1). Most anyone can pay or arrange their care cost, however cost is usually determined by ones need and where they live.

With the healthcare industry becoming more competitive, healthcare organizations like Long-Term Care facilities are finding better ways to improve quality, safety, and their medical outcomes (Schulingkamp & Latham, 2015). Many LTC organizations are improving their performance of how they operate in delivering care by following the elements of a high-reliability organization, as well as the Baldrige Performance Excellence Program criteria. By LTC organizations following the Baldrige Model criteria, it inheres to a sound platform for attaining the achievement of a high-reliability organization (Griffith, Jan/Feb 2015). In addressing the Board of Directors of a LTC organization, I will outline the required elements of a high-reliability organization based on the above Matrix Chart and the criteria needed to meet for the Baldrige Performance Excellence Program.

This week I took care of a 40-year-old man who came into the hospital after having multiple seizures at his assisted living facility. The patient had a history of cerebral palsy, intellectual disability, diabetes type two, and chronic hypothermia. The patient has both a foley catheter and stoma. He has been placed on contact precautions due to Klebsiella Pneumoniae in his urine. Safety precautions, such as, wrist restraints, gloves, and side rails upright are in place.

Following this, the health care system has been attempting to adjust to the decreased funding which has attributed to the rise in health inequalities and challenges with accessing quality care (Hick, 2014). Furthermore, these reductions in the financing have emerged in many long-term care (LTC) facilities that have cut their expenses by employing lower educated staff and decreasing their staffing levels (Walter, Wodchis, Anderson, Anderson, 2007). As a result, research on the cost of implementing good quality care in long-term care facilities revealed that by having well-trained staff, they could save money by preventing risks to seniors health (Walter et al., 2007). For example, skin ulcers, use of physical restraints, incontinence and levels

The long term care homes Act, 2007 has been implied from the year July 1, 2010. The purpose developing this act was with the picture of enhancing the fundamental principles, resident rights, safety and security, plan of care and services, prevention of abuse and neglect, effective reporting and documentation of complaints, minimal use of restrains etc. The Act is segmented into ten parts where it has also shown light into admission of residents, councils, operation of homes, funding, licensing, municipal homes and first nations homes, compliance and enforcement and administration, miscellaneous and transition. Before the Long Term Care Homes Act, there was the Nursing Homes Act, Charitable Institutions Act

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.

(Heatlh Promotion by Design in Long-Term Care Settings, n.d.). For example, insomnia or disturbed sleep is common in older individuals and ensuring the environment is comfortable is a big contribution to improving sleep. There are many other environmental aspects that can be changed to achieve quality of life for residents.

For many elderly, the nursing homes are their only primary option. As Americans age with extended life expectancy, more people will become residents of nursing homes. A report cited by the "Baby Boomer generation" shows that aging will require more long-term care services in the future. The number is "expected to increase from 15 million in 2000 to 27 million in 2050" for individuals requiring these services (U.S. Department of Health and Human Services, 2003). The growth of the "Baby Boomer" population has brought concern for their well-being since they are the most at a disadvantage.

McGlade, C., Daly, E., McCarthy, J., Cornally, N., Weathers, E., O'Caoimh, R., & Molloy, D. W. (2017). Challenges in implementing an advance care planning programme in long-term care. Nursing Ethics, 24(1), 87-99. doi:10.1177/0969733016664969