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Weekly Overview

Week Five

Overview

This week, you will learn about current trends and issues in long-term care. It is important to understand the needs and demands of the populations being served. The industry is changing as demands and technology change. It is essential to remain connected to the consumer and to make changes that will help the program or service provide a better environment. It is important to understand that the current long-term-care system cannot meet the needs of the growing population if everyone enters a nursing facility. Alternative choices have been developed because of the strain on the current system and the influence of changes in reimbursement (Berger, 2010). The development of additional subacute care units, assisted living facilities, and community programs has helped the attempt to meet growing demands.

Although ethics are not exclusive to health care, the implications of unethical behavior in health care are extremely important. When dealing with life and death, high ethical standards must be set and followed. Although not all long-term-care populations may be dealing with ethical concerns, such as end-of-life decisions, they must deal with other ethical considerations and are eventually affected by all decisions.

What you will cover

1. Issues and Trends in Long-Term Care

a. Analyze current trends and issues in long-term care.

1) Information systems

a) Information systems includes input from multiple disciplines.

1) Social services

2) Nursing

3) Dietary

4) Admissions

5) Business offices

6) Therapy

7) Activities

8) Physician services

b) Integrated information system includes information that is shared among the different disciplines.

1) Basic demographics

2) Assessments

a) Skin condition to include treatments needed

b) Vital signs

c) Functional mobility

d) Cognitive status

3) Physicians’ orders for care to include treatment plan

4) Payer sources: insurance information used for billing and providers of ancillary services, such as medical equipment, transportation, and contracted services

2) Privacy and security issues for integrated information systems

a) Manager’s role

1) Assign a system administrator.

2) Establish vendors to help the maintenance system and to troubleshoot as needed.

3) Establish an information committee.

a) Review data systems to keep it current with the needs of the facility.

b) Establish policies for usage and security.

3) Current trends in long-term care

a) Growing populations

1) Older adults: This is the largest growing group and will be for many years.

2) Veterans: This group will continue to grow while the United States is involved in active wars, and while those who have served age.

3) People with chronic conditions: This number continues to grow and will likely include more than half of the country’s population in 10 years.

b) Increased demands

1) Knowledge of systems and what should be provided

c) Increased competition among providers

1) Cooperation among providers to help control cost and establish a marketing presence in the community

2) Decrease in locally owned facilities because of a strain on reimbursement

3) Mergers among providers to obtain a larger market share and establish a larger continuum of care

4) Ethical issues in long-term care

a) Insurance issues

1) Access to resources is determined by payer sources.

2) Decreased choices are based on location and insurance provider.

3) Trend to use home care resources to reduce cost is not always appropriate for the client’s medical needs.

b) End-of-life issues

1) Life may be maintained longer than a client wishes.

2) Quality of life decreases as care is extended.

3) Who should make the decision? When should the decision be made?

c) Access to care

1) Not everyone can be guaranteed equal coverage.

2) Rationing may affect a client’s quality and length of life.

3) Clients may be forced to endure certain financial hardships before they are provided help.

d) Autonomy

1) Programs and services should seek to help clients remain as autonomous as possible.

2) Clients may not choose the proper care or services for themselves.

3) Client choices may also affect those living with them.

e) Life issues

1) Privacy is extremely important for a client’s self-worth.

2) Client confidentiality should be maintained.

3) Food, activities, and shared space should be provided as a means of enjoyment and socialization for clients.

Discussion prompts

1. WILL THE CURRENT HEALTH CARE SYSTEM SUPPORT THE DEMAND INCREASE OF THE GROWING POPULATION OF OLDER ADULTS? WHY?

2. How do you think community programs and services will change over the next 10 years?

3. What is the effect of technology on the delivery of health care and services?

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