Improving the Quality of Long Term Care. Summary.pdfVIP

I N S T I T U T E O F M E D I C I N E Shaping the Future for Health IMPROVING THE QUALITY OF LONG-TERM CARE erious concerns persist about the quality of long-term care among polic y- makers and the public, including the users of the services and their families. S Despite some improvements in recent years, nursing homes in particular remain the focus of continuing concern about the quality, cost, and accessibility of care and the adequacy of oversight and enforcement mechanisms. Debate also continues over the effectiveness and appropriate scope of state and national poli­ cies to regulate long-term care, reduce poor performance of providers, and im­ prove the health and well-being of those receiving care. These questions and de- bates extend beyond nursing homes to home and community-based services and residential care facilities. Who Uses Long-Term Care? Long-term care covers a diverse array of services provided over a sustained period of time to people of all ages with chronic conditions and functional limita­ tions. Their needs range from minimal personal assistance with basic activities of everyday life to virtua lly total care and are met in a variety of care settings such as nursing homes, residential care facilities, or people’s homes. Of the 190 mil- lion people aged 18 years of age and older in 1994, nearly 9 million were using long-term care. Of these, 6.5 million were over 65 years and older. Elderly peo­ ple using long-term care are more likely to be women, to be cognitively im­ paired, and to have a greater number of limitations with activities of daily living. The aging of the U.S. population and the projected growth of the oldest age bracket (85 years and older) will have a major effect on the demand for and sup- ply of long-term-care services and on the resources needed to provide those ser­ vices.