Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-16T17:26:53.985Z Has data issue: false hasContentIssue false

Chapter 47 - Community-based long-term care for the elderly

from Section IV - Principles of care for the elderly

Published online by Cambridge University Press:  05 June 2016

Jan Busby-Whitehead
Affiliation:
University of North Carolina
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Samuel C. Durso
Affiliation:
The Johns Hopkins University School of Medicine
Daniel Swagerty
Affiliation:
University of Kansas
Laura Mosqueda
Affiliation:
University of Southern California
Maria Fiatarone Singh
Affiliation:
University of Sydney
William Reichel
Affiliation:
Georgetown University, Washington DC
Get access

Summary

Community-based long-term care encompasses a wide array of medic al and non-medical diagnostic, preventive, therapeutic, rehabilitative, personal, social, supportive, and palliative services in a variety of settings for individuals who have lost some capacity for self-care because of a chronic illness or physical, cognitive, or emotional impairment. Some support services allow the patient to remain at home, whereas other services require a change of residence. The goal of care is to build on interprofessional expertise and teamwork to promote the optimally independent level of physical, social, and psychological functioning in the least restrictive environment. Most older adults with chronic health problems prefer to remain at home or in a homelike setting. A minority of older adults live in nursing homes, and there has been a trend toward community-based services to provide support. Community-based long-term care services focus on the older adult's medic al and psychosocial needs and aim to maintain function, prevent acute exacerbations of chronic illness, and avoid unnecessary and costly emergency room visits and hospitalizations.
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 651 - 658
Publisher: Cambridge University Press
Print publication year: 2016

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Department of Health and Human Services, Administration of Aging. Health and Health Care [cited 2014 Oct 16]. Available at: www.aoa.gov/aoaroot/aging__statistics/Profile/2013/14.aspx.Google Scholar
Kirby, JB, Lau, DT. Special Committee on Aging. Development in Aging: 1997 and 1998, Volume 1, Report 106–229. Washington, DC: United States Senate, 2000.Google Scholar
Community and individual race-ethnicity and home health care use among elderly persons in the United States, Health Serv Res. 2010;45(5 pt1):1251–67.Google Scholar
Martin, DC, Marycz, RK, McDowell, BJ, et al. Community-based geriatric assessment. J Am Geriatr Soc. 1985;33(9):602–6.Google Scholar
Stuck, AE, Siu, AL, Wieland, GD, et al. Comprehensive geriatric assessment: A meta-analysis of controlled trials. Lancet. 1993;342:1032–6.CrossRefGoogle ScholarPubMed
American Medical Association, Council on Scientific Affairs. Home Care in the 1990’s. JAMA. 1990;263(9):1241–4.Google Scholar
Levine, SA, Boal, J, Boling, PA. Home Care. JAMA. 2003;290(9):1203–7.Google Scholar
Caffry, C, Sengupta, M, Moss, A, et al. Home Health Care and Hospice Care Discharged Patients: United States 2000 and 2007. National Health Statistics Report. 2011;38.Google Scholar
National Association for Home Care & Hospice. Basic Statistics about Home Care. Washington, DC. 2010 [cited 2014 Oct 16]. Available at: www.nahc.org/assets/1/7/10HC__Stats.pdf.Google Scholar
Brickner, PW, Duque, ST, Kaufman, A, et al. The homebound aged: a medically unreached group. Ann Intern Med. 1975;82(1):16.Google Scholar
Landers, SH. Bringing Home the “Medical Home” for Older Adults. Cleve Clin J Med. 2010;77(10):661–75.Google Scholar
Ramsdell, JW, Swart, JA, Jackson, JE, Renvall, M. The yield of a home visit in the assessment of Geriatric Patients. J Am Geriatr Soc. 1989;37(1):1724.Google Scholar
Holley, APH, Gorawara-Bhat, R, Dale, W, Hayley, D. Palliative access through care at home: Experiences with an urban, geriatric home palliative care program. J Am Geriatr Soc. 2009;57(10):1925–31.Google Scholar
Mims, RB, Thomas, LL, Conroy, LV. Physician housecalls: A complement to hospital based medical care. J Am Geriatr Soc. 1977;25(1):2534.Google Scholar
Pearson, S, Inglis, SC, McLennan, SN, et al. Prolonged effects of a home-based intervention in patients with chronic illness. Arch Intern Med. 2006;166(6):645–50.Google Scholar
Edes, T, Kinosian, B, Davis, D, et al. Financial savings of home based primary care for frail veterans with chronic disabling disease. Abstract presentation, American Geriatrics Society Annual Scientific Meeting, 2010.Google Scholar
Edes, T, Tompkins, H. Quality measure of reduction of inpatient days during home based primary care (HBPC). J Am Geriatr Soc. 2007;55(4, Suppl):S7.Google Scholar
Coleman, EA, Min, S, Chomiak, A, Kramer, AM. Post-hospital care transitions: Patterns, complications, and risk identification. Health Serv Res. 2004;39:1449–65.Google Scholar
Coleman, EA, Parry, C, Chalmers, S, Min, SJ. The care transitions intervention: Results of a randomized controlled trial. Arch Intern Med. 2006;166:1822–8.CrossRefGoogle ScholarPubMed
DeJonge, KE, Jamshed, N, Gilden, D, et al. Effects of home-based primary care of Medicare costs in high-risk elders. J Am Geriatr Soc. 2014; doi:10.1111/jgs.12974.Google Scholar
Independence at Home Demonstration, Section 3024 of the Affordable Care Act [cited 2014 Oct 16]. Available at: www.cms.gov/Medicare/Demonstration-Projects/DemoProjectsEvalRpts/Medicare-Demonstrations-Items/CMS1240082.html.Google Scholar
Smith, KL, Soriano, TA, Boal, J. Brief communication. National quality-of-care standards in home-based primary care. Ann Intern Med. 2007;146:188–92.Google Scholar
Mollica, RL. State Medicaid reimbursement policies and practices in assisted living. Prepared for National Center for Assisted Living, American Health Care Association. Washington, DC. 2009.Google Scholar
Caffrey, C, Sengupta, N, Park-Lee, E, et al. Residents Living in Residential Care Facilities United States 2010. NCHS Data Brief, No. 91. Hyattsville, MD: National Center for Health Statistics; 2012.Google Scholar
Park-Lee, E, Sengupta, M, Harris-Kojetin, LD. Dementia Special Care Units in Residential Care Communities: United States, 2010. NCHS Data Brief. 2013 Nov;134:18.Google Scholar
Johnson, R, Weiner, J. A profile of frail older Americans and their caregivers. The Retirement Project. Occasional Paper Number 8. Washington, DC: Urban Institute; February 2006.Google Scholar
Arno, PS, Levine, C, Memmott, MM. The economics of informal caregiving. Health Aff (Millwood). 1999;18(2):182–8.Google Scholar
US Department of Health and Human Services. The Characteristics of Long-term Care Users. Rockville: Agency for Healthcare Research and Quality, 2001, and Thompson L. Long-term care: Support for family caregivers. Washington, DC: Georgetown University, 2004. Long-Term Care Financing Project.Google Scholar
US Department of Health and Human Services [Internet]. Washington DC: Administration for Community Living [cited 2014 Oct 16]. Available at: www.aoa.gov.Google Scholar
Siebenaler, K, O’Keeffe, J, O’Keeffe, C, et al. Regulatory Review of Adult Day Services: Final Report. U.S. Department of Health and Human Services. 2005 [cited 2014 Oct 16]. Available at: http://aspe.hhs.gov/daltcp/reports/adultday.htm#acknow.Google Scholar
Zarit, SH. Effects of adult day care on daily stress of caregivers: A within-person approach. J Gerontol B Psychol Sci Soc Sci. 2011; 66(5):538–46.Google ScholarPubMed
Skarupski, KA. Use of home-based formal services by adult day care clients with Alzheimer’s disease. Home Health Care Serv Q. 2008; 27(3):217–39.Google Scholar
National Hospice Organization Medical Guidelines Task Force, Medical guidelines for determining prognosis in selected non-cancer diseases. Arlington, VA: National Hospice Organization, 1996.Google Scholar
National Hospice and Palliative Care Organization. NHPCO’s Facts and Figures: Hospice Care in America 2013 Edition [cited 2014 Oct 16] Available at: http://www.nhpco.org/sites/default/files/public/Statistics_Research/2013_Facts_Figures.pdf.Google Scholar
Kelley, AS, Deb, P, Du, Q, et al. Hospice enrollment saves money for Medicare and improves care quality across a number of different lengths-of-stay. Health Aff (Millwood). 2013 Mar;32(3):552–61. doi: 10.1377/hlthaff.2012.0851.Google Scholar
Taylor, DC, Osterman, J, VanHoutvan, CH, et al. What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program? Soc Sci Med. 2007;65(7):1466–78.Google Scholar
Wallston, K, Burger, C, Smith, R, Baugher, R. Comparing the quality of death for hospice and non-hospice patients. Med Care. 1988;26(2):177–82.CrossRefGoogle Scholar
Black, B, Herr, K, Fine, P, et al. The relationships among pain, nonpain symptoms, and quality of life measures in older adults with cancer receiving hospice care. Pain Med. 2011;12(6): 880–9.Google Scholar
Centers for Medicare and Medicaid Services. Quick Facts about Programs for All-Inclusive Care for the Elderly (PACE). CMS Publication No. 11341 2008 [cited 2014 Oct 16]. Available at: www.npaonline.org/website/download.asp?id=2378&title=Quick_Facts_about_PACE_(CMS_Publication).Google Scholar
Segelman, M, Szydlowski, J, Kinosian, B, et al. Hospitalizations in the program of all-inclusive care for the elderly. J Am Geriatr Soc. 2014;62:320–4.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×