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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Long-term care | 2/5 | https://en.wikipedia.org/wiki/Long-term_care | reference | science, encyclopedia | 2026-05-05T07:30:24.445699+00:00 | kb-cron |
== Long-term services and supports == "Long-term services and supports" (LTSS) is the modernized term for community services, which may obtain health care financing (e.g., home and community-based Medicaid waiver services), and may or may not be operated by the traditional hospital-medical system (e.g., physicians, nurses, nurse's aides). The Consortium of Citizens with Disabilities (CCD) which works with the U. S. Congress, has indicated that while hospitals offer acute care, many non-acute, long-term services are provided to assist individuals to live and participate in the community. An example is the group home international emblem of community living and deinstitutionalization, and the variety of supportive services (e.g., supported housing, supported employment, supported living, supported parenting, family support), supported education. The term is also common with aging groups, such as the American Association of Retired Persons (AARP), which annually surveys the US states on services for elders (e.g., intermediate care facilities, assisted living, home-delivered meals). The new US Support Workforce includes the Direct Support Professional, which is largely non-profit or for-profit, and the governmental workforces, often unionized, in the communities in US states. Core competencies (Racino-Lakin, 1988) at the federal-state interface for the aides "in institutions and communities" were identified in aging and physical disabilities, intellectual and developmental disabilities, and behavioral ("mental health") health in 2013 (Larson, Sedlezky, Hewitt, & Blakeway, 2014). President Barack Obama, US House Speaker John Boehner, Minority Leader Nancy Pelosi, Majority Leader Harry Reid, and Minority Leader Mitch McConnell received copies of the US Senate Commission on Long Term Care on the "issues of service delivery, workforce and financing which have challenged policymakers for decades" (Chernof & Warshawsky, 2013). The new Commission envisions a "comprehensive financing model balancing private and public financing to insure catastrophic expenses, encourage savings and insurance for more immediate LTSS (Long Term Services and Supports) costs, and to provide a safety net for those without resources." The direct care workforce envisioned by the MDs (physicians, prepared by a medical school, subsequently licensed for practice) in America (who did not develop the community service systems, and serve different, valued roles within it) were described in 2013 as: personal care aides (20%), home health aides (23%), nursing assistants (37%), and independent providers (20%) (p. 10). The US has varying and competing health care systems, and hospitals have adopted a model to transfer "community funds into hospital"; in addition, "hospital studies" indicate M-LTSS (managed long-term care services) as billable services. In addition, allied health personnel preparation have formed the bulk of the preparation in specialized science and disability centers which theoretically and practically supports modernized personal assistance services across population groups and "managed" behavioral health care "as a subset of" mental health services. Long-term services and supports (LTSS) legislation was developed, as were the community services and personnel, to address the needs of "individuals with disabilities" for whom the state governments were litigated against, and in many cases, required to report regularly on the development of a community-based system. These LTSS options originally bore such categorical services as residential and vocational rehabilitation or habilitation, family care or foster family care, small intermediate care facilities, "group homes", and later supported employment, clinics, family support, supportive living, and day services (Smith & Racino, 1988 for the US governments).The original state departments were Intellectual and Developmental Disabilities, Offices of Mental Health, lead designations in Departments of Health in brain injury for communities, and then, Alcohol and Substance Abuse dedicated state agencies. Among the government and Executive initiatives were the development of supportive living internationally, new models in supportive housing (or even more sophisticated housing and health), and creative plans permeating the literature on independent living, user-directed categories (approved by US Centers for Medicaid and Medicare), expansion of home services and family support, and assisted living facilities for the aging groups. These services often have undergone a revolution in payment schemes beginning with systems for payment of valued community options. then termed evidence-based practices. Interventions for preventing delirium in older people in institutional long-term care The current evidence suggests that software-based interventions to identify medications that could contribute to delirium risk and recommend a pharmacist's medication review probably reduces incidence of delirium in older adults in long-term care. The benefits of hydration reminders and education on risk factors and care homes' solutions for reducing delirium is still uncertain. Physical rehabilitation for older people in long-term care Physical rehabilitation can prevent deterioration in health and activities of daily living among care home residents. The current evidence suggests benefits to physical health from participating in different types of physical rehabilitation to improve daily living, strength, flexibility, balance, mood, memory, exercise tolerance, fear of falling, injuries, and death. It may be both safe and effective in improving physical and possibly mental state, while reducing disability with few adverse events. The current body of evidence suggests that physical rehabilitation may be effective for long-term care residents in reducing disability with few adverse events. However, there is insufficient to conclude whether the beneficial effects are sustainable and cost-effective. The findings are based on moderate quality evidence.
== Demand for long-term care ==