Expanding Long-Term Care Options

Countries such as Denmark and Sweden have effective home and community based care systems in place were their social care services have independent living options. It is not uncommon for home health aides to visit their elderly several times a day. The problem is much of the senior care focus has been on hospitals and not the community. People often focus on getting care from hospital-based services and nursing homes instead of home-based health care. It was reported that as one-fifth to one-third of all elders placed in nursing homes shouldn't be there in the first place. Adult day-care and home health care is often a much better alternative for these elders. It is important that we invent an integrated approach to elder care that involves coordination of home health aides, physical therapists, and nurses.

There are several organizations providing models for this type of integrated care. One program called the Program of All-Inclusive Care for the Elderly (PACE) has demonstrated the financial benefits of keeping the elderly at home. It takes nursing-home-eligible individuals with functional frailty and through coordination with a team of physicians, case managers, therapists, nutritionists, and home health aides, helps these elders to live at home. The program was so successful that it became a full-fledge HMO in 1998.

Social Health Maintenance organizations are other new low-cost alternatives to nursing homes. One example, SCAN Health Plan in Long Beach, California, combines case management with social support for elders. The Aging Network has been very effective in linking more than 600 government-supported Area Agencies on Aging with thousands of community organizations. Programs are being launched in nearly every community across America to support eldercare-givers. The Aging network is credited with coming up with adult day services, internet resources, and caregiver assistance information networks.

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