Chapter 10: Long Term Care
Introduction
37% of those in need of LTC are under the age of 65
70% of older Americans will eventually need some type of LTC (though many
will never leave their own homes)
LTC associated with chronic conditions
o 77% of Americans over the age of 65 have at least two chronic
conditions
o Example- diabetes, heart disease, dementia, Alzheimer's, osteoporosis,
cancer, etc.
Estimated 9 million Americans currently need LTC and that number is
expected to rise to 12 million by 2020
Long Term Care (LTC)
Long-term care- variety of individualized, well coordinated services that
promote the maximum possible independence for people with functional
limitations and are provided over an extended period of time in accordance
with a holistic approach, while maximizing their quality of life.
o Variety of services
Necessary because individual needs vary greatly among people
who require LTC services
Should fit needs of different individuals, address their changing
needs over time, and suit their individual preferences
o Individualized services
Services tailored to the needs of individual patient
Needs determined by an assessment of the individual’s current
physical, mental, and emotional condition, and other factors
Assessment used to develop an individualized plan of care
o Well-coordinated total care
LTC providers are responsible for managing the total care needs
of an individual; therefore, LTC must interface with non-LTC
services
Total care- requires that any health care need is recognized,
evaluated, and addressed by appropriate clinical professionals
o Promotion of functional independence
Two main goals of LTC are (1) to maintain whatever ability to
function a person still has, and (2) to prevent further decline
Goals accomplished by letting the person do as much as possible
for himself
o Extended period of care
, For most LTC clients, the delivery of various services extends over
a relatively long period of time because underlying causes of
functional decline are often irreversible
o Holistic care
Connectedness with caregivers, family, friends, members of the
faith community, etc. play an important role in overcoming social
isolation and promoting well-being of the patient
Person’s beliefs, values, religious practices must be
respected/incorporated in caregiving routines
o Quality of life
o Use of technology
Can improve overall safety and quality of care
Example- PERS (personal emergency system) enables an at-risk
elderly person living alone to summon help in an emergency at
any time
Quality of Life
Quality of life- multifaceted concept that recognizes at least five factors:
lifestyle pursuits, living environments, clinical palliation, human factors, and
personal choices
o Lifestyle pursuits- personal enrichment and making one’s life
meaningful through activities one enjoys
o Living environment- comfortable, safe, clean, etc. What kind of living
environment do they want/what can they afford?
o Clinical palliation- pain management
o Human factors- refer to caregiver attitudes and practices that
emphasize caring, compassion, respect, and preservation of human
dignity for the patient
o Personal choices
Long-Term Care Services
Medical care, nursing, and rehabilitation
o Focus on three main areas: (1) post acute continuity of care (2) clinical
management of chronic illness (3) restoration or maintenance of
physical function
Mental health services and dementia care
o Mental health disorders frequently occur along with a number of
chronic illnesses in adults
o Can range from severely problematic to disabling to fatal
Social support
o LTC patients need social and emotional support to cope with changing
life events
Preventive and therapeutic long-term care
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