Challenges Of Long Term Care

The Complex Challenges of Long-term Healthcare

Long-term care can be a paid or unpaid service for people who are mentally or physically disabled,or suffer from a chronic illness that places them in need of medical or personal assistance for an indefinite period of time.

The excessive cost of Healthcare in American is creating concern for aging adults in need of long-term health care services and support. Long term healthcare is a largely profit driven industry that focuses on the the after affects of an event like a heart attack, accident, or a diagnosis of a chronic disease like diabetes as a primary means of treatment. Physicians prefer the traditional means of therapy where time permits for the patient consultation. The importance of

a healthy diet, exercise and planning for long-term care should be taught to individuals a primary function of preventative measures and treatment.
The importance of healthy diet plays a huge role in the capacity of a long-term healthcare experiences. To avoid the debilitating disease like diabetes, which can be a very costly financially. The total estimated cost of diagnosed diabetes in 2012 was $245 billion dollars including $176 billion in direct medical cost and $69 billion in reduced productivity. The largest components of medical expenditures are hospital impatient care and 43% of the total medical cost is prescription medications to treat complications (American Diabetes Association). Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease, heart attack, stroke, narrowing of arteries and nephropathy nerve damage. Short term complications of having diabetes include hypoglycemia, diabetic ketoacidosis an increase of acid in the blood. Long term complications include how diabetes affect the eyes, heart (cardiovascular disease), kidneys (nephropathy), nerves and feet (nephropathy) (Mayo Clinic). Eventually diabetes complications may may be disabling or even life-threatening. Diabetes is more common in older adults, with a high prevalence in long-term care facilities and is associated with significant disease burden and higher cost. The high ratio of diabetes in older adults in due to age related physiological changes , such as increased abdominal fat, sarcopenia and chronic low grade inflammation, that lead to an increased insulin resistance in peripheral tissue and relatively impaired pancreatic islet function. Poorly executed transitional care can result in significant financial burden for the patients, payers, facilities, and the U.S healthcare system in the aggregate. These conditions are due to re-hospitalizations and inconsistent patient monitoring, duplicate test, medications errors, delay in diagnosis, and lack of follow through on referrals. In 2005, it was estimated that more than 20 million people in the United State had diabetes. Approximately 30% of these people had undiagnosed cases. Increased risk for diabetes is primary associated with age, ethnicity, family history of diabetes, smoking, obesity and physical inactivity. In 2050, the number of people in the United State with diagnosed diabetes is estimate to grow to 48.3 million. Effective interventions, at both the individual and population levels, are desperately needed to slow the diabetes epidemic and reduce diabetes related complications in the United States. Diabetes and its complications are a major cause of morbidity and mortality in the United States and contribute substantially to overall health care cost( American Physical Therapy Association).
The cost of long-term care and meeting the financial and social service burden of a growing number of elderly people has reached a critical milestone. It's a daunting task to implement necessary changes for Baby Boomers that actually need long-term care because of the economic burden associated with caring for an aging population. Social security payments will increase, medical care insurance cost will grow, the burden associated with uncovered medical expensive such as pharmaceuticals will become quite serious, and long-term cost will likely increase in time. The general well being, of future generations, of workers is worse than that of current workers due to service cost and income transfers. Every elder has to prepare for several key ”aging shocks” such as uncovered costs of prescription drugs, the cost of medical care that is not paid by medicare or private insurance, the actual cost of private insurance that partially fills in the gaps left by medicare, and the uncovered cost of long-term care (Health Research &Educational Trust). Public policy goals related to an aging society should and must balance the need to provide adequate health services and income transfers with an interest in maintaining the economic and social well being of the future generations. The average amount being paid under Skilled Nursing Care in 2015, for a shared room is $220/day with different state averages ranging from $140-771/day. A shared residence usually cost 80-90% of a private one. Even satisfied retirees with medicare coverage will spend an average of $130,000 on health care after age 65. About a third of that is for medicare premiums the rest goes to co-payments, deductibles, and drug and medical cost. The out of pocket expenses accelerate with age with those 85 and older spending more than twice of a younger beneficiary (Kaiser Family Foundation). For example if you get medicaid to pay the nursing home the state must attempt to recoup from you estate whatever benefits it paid for your care. This is called “estate recovery.”Given the rules for medicaid eligibility the only property of substantial value that a medicaid recipient is likely to own at death is his or her home. If possible, you should consult with an attorney before entering a nursing home or as soon as possible afterward, in order to discuss ways to protect your home.
All individuals regardless of age need to be cognizant of potential health issues that could present a need for long-term health care at any time in your life. You could be in an accident with traumatic injuries, which may require long-term care. Fewer than 1 in 10 of those younger than 50 is turned down for long-term care coverage, compared to nearly 25 percent of those 60-69 who are rejected and 45 percent of those ages 70-79, according to the American Association Insurance. A young female policyholder currently receiving benefits under a claim obtained coverage at age 28 and needed care within the same year. She qualified for benefits that amounted to over $135,000. A younger adult may makes a claim under a health insurance policy. Do to an accident or have been diagnosed with a serious medical condition that required long periods of care ( The New York Times). So younger people tend qualify for coverage more easily and pay lower premiums roughly $635 less annually. For a 25 year old, according to the Association of Long-Term Care 2012 price index. Over 70% of people over the age of 65 will need some long-term care, according to a study by the U.S Department of Health and Human Service. According to Genworth Financial 2016 cost of care survey families will incur a great deal of expense related to long-term care. The average nationwide cost for various types of care are Nursing Home: $92,378 per year, private room, Nursing Home semi-private room: $83,125 per year, Assisted Living: $43,539 per year, Home Health Aides: $15 to 28 per hour, and Adult Day Health Care: $68 per day. When a person is still healthy middle age is the best time to think about buying long-term care insurance because that's when a person is most likely to qualify for a policy and when premiums cost are at their lowest. Planning at a younger age for long-term care needs is a key solid retirement plan for anyone with assets that he or she wishes to pass along to the family, and not a nursing home.
Alternative measures like home care could be a viable solution to long term care facilities.

This would presumably reduce the cost to the patient and allow for more treatment services. In a study of Improving Health Status and Reduction of Institutionalization in long-term care the effects of the resident assessment instrument home care by degree of implementation were significantly less hospitalizations and fared slightly better according to activities of daily living, cognitive skills and quality of life. This is a comparison to clients who were not exposed to the resident assessment, that had worse outcomes. Home care is having a trained home health aide come into a person home to help them with activities of daily living for a few hours a day to around the clock 24/7 care. It is one on one care for a person that requires assistance, they will have someone to provide them with help with their activities of daily living. This will allow a person to reside longer and as independent as possibly in their home. According to the Genworth Living Term Care Study, which offers national data on nursing home costs, the average cost of and long-term care nursing home in Massachusetts is 6,927.00 per month. Depending on where you live in your state, how renovated the building is, and what services you are receiving, all these components can drastically change the cost. The cost for private home care range in price as well. Instead of paying for room and board in a nursing home you

can have an aide assist a senior for however many hours you choose to receive. The health aides cost on average $26/hour. Professionals can range from $20-35 per hour. The results the of study that care quality indicators were significantly different between home care and institutional care groups and were closely associated with the characteristics of individual patients' in the specific settings(Journal of Clinical Nursing).
Educating the consumer on the type of insurance products that are available under a long term care policy.

Awareness of policy benefits and how the coverage works will help to avoid confusion and a lack of coverage when there is a necessity to use coverage. Long-term care is very expensive and medicaid can cover some of the cost. But with strict financial eligibility requirements, you would have to exhaust a large portion of your life savings to become eligible for it. HMO's and medicare don't pay for long-term care expenses, you're going to need to find alternative ways to pay for long-term care. Before you buy Long-term care insurance shop around and compare policies. Read the outline of coverage portion of each policy carefully, and make sure you understand all of the benefits, exclusions, and provisions. Then check insurance company ratings from services such as A.M. Best, Moody's, and Standard & Poor to make sure that the company is financially stable (Journal of the Society on Aging). Premium cost is also based in large part on your age at the time you purchase the policy. The younger you are when you purchase a policy , the lower your premiums will be. Pay attention to these common features and

provisions.
Most important is the organizations that manage and maintain long-term care facilities focus on the patient best interest and not just the financial aspect of care provided . This behavior not only affects a patient but also the staff that work to support operations in a facility.