Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-24T11:25:33.467Z Has data issue: false hasContentIssue false

Chapter 50 - Home- and Community-Based Long-Term Care

from Section IV - Principles of Care for the Elderly

Published online by Cambridge University Press:  30 June 2022

By
Rebecca Elon  and
Fatima Sheikh
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
Get access

Summary

As the population ages, the need for home and community-based care is expected to rise. This chapter discusses public and private funding sources to help older adults with dependencies in their activities of daily living stay in their homes or find alternate community residential options. It explains the basics of the Older Americans Act, Medicaid waivers, the limited Medicare support for care at home, care of special populations such as veterans, Native Americans, and Native Alaska Elders, older adults with dementia, and those with mental health challenges. Residential housing options, assisted living communities, continuing care communities, and newer models for residential support including villages and naturally occurring retirement communities are discussed. Workforce challenges in providing care to the aging population are presented as a key factor in creating successful service programs.

Keywords

home carecommunity-based carechronic care fundingOlder Americans ActMedicaid waiversresidential careactivities of daily living supportretirement communitiesaging work force challenges
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 620 - 630
Publisher: Cambridge University Press
Print publication year: 2022

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

2019 Profile of Older Americans. US Department of Health and Human Services. May 2020. Administration for Community Living. https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2019ProfileOlderAmericans508.pdf.Google Scholar
Freedman, VA and Spillman, BC. Disability and care needs among older Americans. Milbank Quarterly. 2014; 92(3):509–541. doi: 10.1111/1468–0009.12076.CrossRefGoogle ScholarPubMed
Choi, NG, Burr, JA, Mutchler, JE, Caro, FG. Formal and informal volunteer activity and spousal caregiving among older adults. Research on Aging. 2007; 29(2):99–124. doi: 10.1177/0164027506296759.Google Scholar
Committee on Family Caregiving for Older Adults. Families Caring for an Aging America. Board on Health Care Services, Health and Medicine Division, National Academies of Science, Engineering and Medicine. Washington, DC:National Academies Press, 2016. www.nap.edu/catalog/23606/families-caring-for-an-aging-america.Google Scholar
www.ncpssm.org/documents/older-americans-policy-papers/older-americans-act.Google Scholar
www.ncoa.org/public-policy-action/older-americans-act.Google Scholar
Medicare & You 2020. The Official U.S. Government Medicare Handbook. U.S. DHHS, Centers for Medicare & Medicaid Services. 7500 Security Blvd. Baltimore, MD 21144. CMS product No. 10050–56, Sep. 2019. www.medicare.gov.Google Scholar
McCall, N, Korb, J. The impact of Medicare home health policy changes on Medicare beneficiaries. Policy Brief (Cent Home Care Policy Res). 2003; 15:1–6. PMID 15000107.Google Scholar
Schade, CP, Brehm, JG. Improving the home health acute-care hospitalization quality measure. Health Serv Res. 2010 (Jun.): 45(3):712–717. doi: 10.1111/j.1475-6773.2010.01106.xGoogle Scholar
O’Connor, M, Hanlon, A, Naylor, MD, Bowles, KH. The impact of home health length of stay and number of skilled nursing visits on hospitalization among Medicare-reimbursed skilled home health beneficiaries. Res Nurs Health. 2015; 38(4):257–267. doi: 10.1002/nur.21665.CrossRefGoogle ScholarPubMed
www.medicare.gov/coverage/hospice-care.Google Scholar
www.medicaid.gov.Google Scholar
www.payingforseniorcare.com/medicaid-waivers/home-care.Google Scholar
www.ada.gov/olmstead/olmstead_about.htm.Google Scholar
Harrington, C, Ng, T, Laplante, M, Kaye, HS. Medicaid home and community-based services: Impact of the Affordable Care Act. J Aging Soc Policy. 2012; 24(2):169–187. doi: 10.1080/08959420.2012.659118.Google Scholar
www.cms.gov/About-CMS/Story-Page/Better-care-for-dual-eligibles-fact-sheet.pdf.Google Scholar
www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/PACE/PACE.Google Scholar
www.npaonline.org.Google Scholar
www.va.gov/health-care/eligibility.Google Scholar
www.va.gov/GERIATRICS.Google Scholar
https://ihs.gov.Google Scholar
www.ihs.gov/newsroom/factsheets/disparities.Google Scholar
www.alz.org.Google Scholar
www.ncoa.org/news/resources-for-reporters/get-the-facts/healthy-aging-facts.Google Scholar
www.medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/preadmission-screening-and-resident-review/index.html.Google Scholar
www.hopkinsmedicine.org/psychiatry/specialty_areas/geriatric_neuro/day_hospital.html.Google Scholar
Substance Abuse and Mental Health Services Administration. National Mental Health Services Survey (N-MHSS): 2018. Data on Mental Health Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2019. www.samhsa.gov/data/sites/default/files/cbhsq-reports/NMHSS-2018.pdf.Google Scholar
https://apstarc.acl.gov.Google Scholar
Fernald, M, ed. Housing America’s Older Adults – 2019. Cambridge, MA: Joint Center for Housing Studies of Harvard University, 2019. www.jchs.harvard.edu/sites/default/files/Harvard_JCHS_Housing_Americas_Older_Adults_2019.pdf.Google Scholar
Cubanski, J, Koma, W, Damico, A, Neuman, T. How many seniors live in poverty? Issue brief, Kaiser Family Foundation, November 19, 2018. www.kff.org/medicare/issue-brief/how-many-seniors-live-in-poverty.Google Scholar
www.hud.gov/topics/information_for_senior_citizens.Google Scholar
https://aging.ny.gov/naturally-occurring-retirement-community-norc.Google Scholar
www.beaconhillvillage.org.Google Scholar
Greenfield, EA, Scharlach, A, et al. A conceptual framework for examining the promise of the NORC program and Village models to promote aging in place. Journal of Aging Studies. 2012; 12: 273–284.CrossRefGoogle Scholar
www.aarp.org/caregiving/basics/info-2017/continuing-care-retirement-communities.html.Google Scholar
www.ahcancal.org/Assisted-Living/Facts-and-Figures/Pages/default.aspx.Google Scholar
www.aplaceformom.com/caregiver-resources/articles/assisted-living-vs-board-care-homes.Google Scholar
Kane, RL. Care of the aging patient: From evidence to action – Finding the right level of posthospital care: “We didn’t realize there was any other option for him.” JAMA. 2011; 305(3):284–293.Google Scholar
Rerucha, CM, Salinas, R, Shook, J, Duane, M. House calls. Am Fam Physician. 2020 (Aug. 15); 102(4):211–220. www.aafp.org/afp/2020/0815/p211.html.Google Scholar
www.aahcm.org.Google Scholar
www.hospitalathome.org.Google Scholar
Keller, SC, Gurses, AP, Myers, MG, Arbaje, AI. Home health services in the time of Coronavirus disease: Recommendations for safe transitions. J Am Med Direc Assoc. 2020; 21(7):998–1000.Google Scholar
Steinman, MA, Perry, L, Perissinotto, CM. Meeting the care needs of older adults isolated at home during the COVID-19 pandemic. JAMA Intern Med. 2020 (Jun. 1); 180(6):819–820. doi: 10.1001/jamainternmed.2020.1661.Google Scholar
Mahoney, KJ. Self-direction of home and community-based services in the time of COVID-19. Journal of Gerontological Social Work. 2020; 63:625–628. doi: 10.1080/01634372.2020.1774833.Google Scholar
https://aging.com/in-home-care-costs-breakdown.Google Scholar
Osterman, P. Who Will Care for Us? Long-Term Care and the Long-Term Workforce. New York: The Russell Sage Foundation, 2017.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org 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
×