The Heart of Long-Term Care / Edition 1

The Heart of Long-Term Care / Edition 1

by Rosalie A. Kane, Robert L. Kane, Richard C. Ladd
     
 

The authors start with the premise that long-term care is designed to assist people who lack the capacity to function fully independently. I n addition, the authors argue, no disabled person of any age should be required to forsake his/her humanity in exchange for care. The book r ejects the artificial dichotomy between social and medical care, asser ting that both

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Overview

The authors start with the premise that long-term care is designed to assist people who lack the capacity to function fully independently. I n addition, the authors argue, no disabled person of any age should be required to forsake his/her humanity in exchange for care. The book r ejects the artificial dichotomy between social and medical care, asser ting that both play important roles in the psychological and physical well-being of long-term care patients. The book considers the need for competent and compassionate medicine and discusses the methods for im proving both its coordination of care and its effectiveness. The book redefines the meaning of safety and protection in long-term care, and how this goal can be accomplished without sacrificing quality of livin g.

Product Details

ISBN-13:
9780195122381
Publisher:
Oxford University Press, USA
Publication date:
01/28/1998
Edition description:
New Edition
Pages:
344
Sales rank:
1,113,164
Product dimensions:
9.20(w) x 6.10(h) x 1.20(d)

Table of Contents

Pt. IPrinciples of Long-Term Care
1Nature and Purpose of Long-Term Care3
Who Needs Long-Term Care?6
Who Gives Long-Term Care?14
Places for Long-Term Care16
Goals of Long-Term Care17
2Spectrum of Care31
Challenges of Long-Term Care Provision31
History34
The HCBS Service Spectrum49
Spectrum of Residential Services51
Veterans Administration51
Issues in Service Provision52
3Obstacles to Balanced State Long-Term Systems61
Obstacles to Change63
Federal Policies Favoring Nursing Homes77
State Laws and Regulations80
4Progress Toward Balanced Long-Term Care Systems85
Federal Matches86
State Variations in Nursing Home Care88
State Variation in HCBS Programs94
State Variation in Total Long-Term Care99
Varying Demand for State-Supported Services104
Program Variations107
Varying Organizational Structures111
Pt. IIPractice of Long-Term Care
5Home Care and Personal Assistant Services119
Goals of Home Care and PAS120
Issues in Home Care121
Funding Programs123
PAS versus Agency Services127
Consumer-Directed Care131
Persuading Consumers to Use In-Home Services136
Model State Systems137
Case Management143
Cash and Counseling149
Family Programs151
6Combining Housing and Services159
Conceptual Background160
Nursing Homes163
Adult Foster Homes174
Assisted Living176
Blending Housing and Services178
7Quality and Accountability189
Medical versus Social Approaches190
Steps of Quality Assurance195
Approaches to Quality Assurance203
Safety versus Freedom207
Reaching a Societal Consensus208
8Acute Care for Long-Term Care Consumers215
Fragmenting Forces in Medical Care217
Care Management221
Integrating Care222
Interdisciplinary Teams223
New Primary Care Personnel225
Aggressive Chronic Care227
Information Systems228
9Managed Care and Long-Term Care235
Historical Background238
Forms of Managed Care241
Cost Containment Strategies246
Effects on Consumers247
Evidence of Effectiveness249
Managed Long-Term Care254
Issues and Challenges259
10International Perspectives on Long-Term Care267
Common Themes268
Illustrative Countries270
Lessons for the United States278
Pt. IIIThe Heart of the Matter
11Conclusions: The Heart of the Matter285
Taking Stock286
Trade-Offs289
Preferences291
Recommendations292
Principles for Change303
Glossary307
Index323

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