Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults.
This book explores key factors long-term care recipients have identified as impacting their quality of life and offers programmatic and policy recommendations to enhance well-being within long-term care communities. Leadership and staff who work in nursing homes and other residential care communities serve as gatekeepers to resident well-being, often without recognizing how residents’ quality of life is impacted by their decision-making. This book takes a life domain approach to build on research-based studies that document key drivers of care recipients’ quality of life, including relationships, autonomy and respect, activities and meals, environment, and care. Using a framework that enhances understanding of resident quality of life, it outlines practical, programmatic, and policy suggestions for long-term care stakeholders, such as administrators, managers, front-line staff, family members, and policy-makers, whose directives and actions impact the lived experience of long-term care residents. As such, this book serves as a roadmap for leaders and managers of long-term care communities, along with policymakers who regulate health and human services, to best structure care environments to maximize quality of life and well-being for long-term care recipients.
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
This book explores the meaning of quality of life in care for older persons and introduces the reader to their main concerns when receiving care. Based on qualitative research, it pays particular attention to the needs and requirements of older people, considering their individual family situations, social circumstances, values and lifestyles. Person-centred care is a way of providing nursing care that puts older people and their families at the core of all decisions, seeing each person as an individual, and working together to develop appropriate solutions. Following an introduction to the concept of quality of life in old age, the book reviews essential findings from worldwide research into the experiences of older people with regard to nursing care and the impact of these experiences on their quality of life. It investigates health promotion, care provided in nursing homes and assisted living facilities, and palliative care. Each chapter includes a brief introduction to the respective field of nursing care and the problems it has to deal with, concluding with a discussion of their implications for nursing practice in the respective field of care. In closing, the evidence from qualitative research is discussed in relation to current gerontological theories.
Most people fear the idea of living in a long-term care facility. Yet, there is potential for joy and meaning in these settings. This book highlights expanded roles and services that mental health professionals can provide in long-term care for older adults, offering the potential to improve the quality of care for residents. Beyond assessments and individual therapy, the authors make a case for mental health providers to help improve the long-term care environment for both residents and staff, thus having a greater impact on systems, culture, and ultimately, patient well-being. Readers who wish to add or expand their services for older adults will find helpful guidance, including detailed instruction on Medicare policies and reimbursement practices. The authors also present an innovative model of wrap-around care that involves the array of staff and family members who are present to the individual all day, every day. This comprehensive approach, called the Eldercare Method, positions the mental health professional to serve in the roles of teacher, consultant, role model, advocate, and clinician. With numerous case examples to illustrate common scenarios and ethical dilemmas, this practical resource will help readers envision new ways to apply their skills in the rapidly growing field of long-term care for older adults.
Note to Readers: Publisher does not guarantee quality or access to any included digital components if book is purchased through a third-party seller. The Health Services Executive (HSETM): Tools for Leading Long-Term Care and Senior Living Organizations serves as a contemporary and comprehensive resource that addresses each of the core professional domains of practice and leadership essentials for long-term care administration students and professionals. With sections dedicated to postacute care settings, operations, leadership and management, this textbook covers information pertinent to the spectrum of senior living service lines – from inpatient rehab facilities, long-term acute care hospitals, nursing homes, assisted living, and residential care communities to home- and community-based services. It is a practical reference for both undergraduate and graduate students preparing to enter the field of long-term care administration and leadership, as well as for professionals transitioning to another line of postacute service. The textbook begins with a thorough history of the field, including the development of senior services in the United States. Section I then describes the components of customer care, supports, and services before transitioning into Section II, which addresses operations, including the core practice domains of effectively managing human resources, finances, and the environment. Section III offers a framework for leadership, covering strategic thinking and innovation, marketing and public relations, critical thinking and operation practice, customer service, and personal development. Case problems, discussion questions, leadership roles, high-impact practices, key points, and National Association of Long Term Care Administrator Boards (NAB) domain competencies conclude each chapter. Written by two highly experienced long-term care administrators, this textbook is intended for those preparing for the examinations administered by the NAB for the HSETM qualification or licensure for individual lines of service, such as for Nursing Home Administration (NHA), Residential Care and Assisted Living (RC/AL) and Home- and Community-Based Services (HCBS). Key Features: Provides best practices for leadership and management across the continuum of long-term care and senior living services Covers all five NAB professional practice domains: Customer Care, Supports and Services; Human Resources; Finance; Environment; and Leadership and Management Includes case problems, discussion questions, and more to foster critical thinking and decision-making skills Offers coverage of the most unique differences among service lines that are part of the HSETM initiative Weaves insightful quotes from industry leaders throughout chapters for practical tips and words of wisdom
