Quality Of Life Of Homebound Patients Managing Multiple Chronic Conditions

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.

Although the largest profession in the health care industry is nursing, a larger number of people are getting older and living longer. This means that more people will need nursing care, whether it’s in a hospital, a long-term care facility or at home. It is projected that long-term care facilities will need 66% more RNs by 2020 (Addressing the Nursing). The increase in life expectancy has amplified the complexity of health care because more people are living with chronic conditions. The American Nurses Association reported that “a large cross-sectional study of over 1,000,000 adults revealed that 82% had one or more chronic conditions” and we are seeing an increase of those age 65 and older living with multiple chronic conditions (Mion). Now, more than ever, there is a high demand for the best delivery of medical care.

Medicare, the federal governments health insurance program, finances acute medical care for nearly all elderly Americans over the age of sixty-five. However, very few long-term care services are covered. Medicare finances long-term care only partially through it’s limited skilled nursing facility (SNF) and home health benefits. “Despite recent growth in spending on these benefits, much of the SNF and home-care paid for by Medicare remains short-term rehabilitative care, often related to a hospital stay or outpatient procedure. Medicare covers SNF care for up to 100 days following a hospital stay of at least three days. For homebound persons needing part-time skilled nursing care or therapy services, Medicare pays for home health care, including personal care services provided by home health aides.” (Feder, Komisar, and Niefeld) All that is not covered, the elderly are expected to cover with savings, private insurance policies, and financial support

Taking care of the individuals that are getting older takes many different needs. Most of these needs cannot be given from the help of a family. This causes the need of having to put your love one into a home and causing for the worry of how they will be treated. It is important for the family and also the soon to be client to feel at home in their new environment. This has been an issue with the care being provided for each individual, which has lead to the need of making sure individuals have their own health care plan.

Our elderly population is living longer than ever before and not all of them are entering into a nursing home. They are choosing to stay in their own home or their caregiver is choosing it for them. Some caregivers are choosing to move their ageing love one in the home with them. Whatever the case may be, there is an increased need for some type of home health as it applies to the elderly population. “Medicare will pay the full cost of professional help only if the physician

In these services they would usually be offered help with activities of daily life, such as eating or bathing. Some home services also give them other benefits such as residential services, personal care or case management. To give more open details on experiences of Medicaid beneficiaries who need home and communities based services Musumeci and Reaves discuss nine seniors who are disabled and who live in different states. Those include people with different kind of disabilities which can be either developmental, physical or intellectual and issues such as autism, cerebral palsy, multiple sclerosis and their functional limitations that are there because they aged (Musumeci & Reaves, 2014). Based on interview that were given from these people to the Kaiser Commission in 2013 based on Medicaid and uninsured, these peoples’ profiles clearly show us how beneficiaries funds, well-being, status of their employment are affected by the coverage of Medicaid and the role these services play in their daily lives (Musumeci & Reaves, 2014). In the last years states are trying to work on rebalancing long-term care system by dedicating more spending to home and community care rather than institutional care. The reason is this being the efforts that are driven by beneficiaries who are

This exercise point out some very important factors with regard to health care cost.  nursing homes and other health care delivery systems are faced with significant shortfalls in reimbursement for various reasons.  Medicare reimbursement often does not cover the full extent of treatment of individuals.  McPike (2008) notes that, “The insurance and hospital industries released a study today showing that underpayment by Medicare and Medicaid costs consumers and employers $88 billion more a year for health care as providers attempt to make up the difference.” Today with continue cutbacks in medicare reimbursement this number is significantly higher.  In an attempt to reclaim these losses, both self pay and privately insured patients are charge

Competition in the home health field is intense, particularly in rural areas, where the need for services is in more demand. Because services are expensive to provide, it is critical for agencies to generate a volume of visits sufficient to cover fixed expenses plus make a small profit. Competition is primarily between another company Care One, Inc., a multicounty operation that has been established in the area for well over 10 years. AHHS surpassed them in total number of visits after its second year of operation and has been progressively growing. Many of the physicians in the area, however, continue to use Care One, and Care One receives more referrals from the local hospitals than AHHS. Currently AHHS has 32 employees, including 15 registered nurses, 8 nursing aides, 1 physical therapist, I speech language therapist, and 7 administrative staff.

The main concern about long-term care is providing the money to pay for individuals and care providers. “As a result, policymakers are considering several proposals for substantial reform. These fall under three categories: Shifting the focus of Medicaid long-term benefits to home care, expanding the long-term care and geriatric workforce, and restructuring the means of finance” (Gleckman, 2009). Federal and state have agreed that many individuals should think about long-term care insurance. In fact, federal and state have discussed providing tax credits and deductions for buying long-term care insurance.

Will mom or loved one receive better care at home or in a nursing home? This is a hard choice to make, but which is the best? In this paper, it examines the efficiency of home care programs, assisted living and long-term care programs. It examines the care and cost of the different programs with respect. The decision of whether or not to place an aging parent (or a loved one) into a long-term care facility, or to try and to keep them in their own home or yours is one that many American families are facing each day. Factors in dealing with this decision are too numerous to count, but we will address a few of them in the following paper, like the

The long-term care system consists of an integrated continuum of many institutional and non-institutional providers who deliver extended care when needed. Long-term care providers distribute a variety of care to individuals with chronic, mobility and/or cognitive impairments/limitations. These providers include: nursing facilities, subacute care, assisted living, residential care, elderly housing options and community based adult services (CBAS) (Pratt, 2010). CBAS is broken down into subdivisions, which include: home health care, hospice care, adult day care and adult day health care (ADHC). ADHC’s falls under the category of non-institutional care, allowing individuals to be independent, stay within their community, live at home, and age in place, while being of high quality and low cost. The ultimate goal of ADHC’s is to keep individuals out of hospitals and nursing homes (institutional care), and allow them to live their life comfortably, independently and in their households with their loved ones (Alteras, 2007).

Professional associations, payers, policy makers, and other stakeholders have advocated for the patient-centered medical home model. Interventions to transform primary care practices into medical homes are increasingly common, but their effectiveness in improving quality and containing costs is unclear.

The reality is that senior homecare services have grown tremendously over the last 50 years and the number of seniors taking advantage of senior homecare continues to rise. Much of the increase can be attributed to Medicare agreeing to cover a number of palliative care and end of life care provisions, but many private insurances are not covering skilled nursing, senior homecare,

First of all, according to the Agency for Healthcare Research and Quality (ARHQ, n.d.) a medical home is not a home, but a concept of a primary care practice that incorporates a variety of medical services under one roof. This is where a patient will receive care from an interdisciplinary team of physicians, nurses, pharmacists for a variety of health needs, and this care will treat the patient’s health needs as a whole. This type of patient-centered care can be obtained at a community

With the aging population at an all time high and continuing to climb there had been a spike in patients with chronic illness. Due to this the way in which patients are cared for and educated must change, chronic illness follows the patient out of the healthcare setting and they must be aware of how to care for themselves and their illness at home. This is a drastic shift in what healthcare used to be about, treating the acute illness. The Center for Disease Control defines acute illnesses as, severe and sudden in onset, for example a broken bone or the common cold. A chronic condition by contrast is a long- developing syndrome like osteoporosis or diabetes (CDC.gov). Treatment and education of a patient with chronic illness is at high demand and nurses must now gear their care towards these needs.