Date of Award

1998

Document Type

Thesis

Degree Name

Master of Health Management

First Advisor

Betty LeMasters

Second Advisor

Lynette Gerschefke

Third Advisor

Lynn Mark

Abstract

Americans today live longer than their parents did, often two to three decades after retirement. For many, modern medicine's gift of time is a blessing. But when independent living is no longer possible, few elderly people or their families are prepared for the confusing and emotionally wrenching world of long-term care. Despite reforms passed by Congress, nursing homes remain controversial. Moreover, they are too expensive for many people, and the federal Medicare and Medicaid insurance programs provide limited benefits for nursing home care. Although innovative alternatives to nursing homes have emerged in recent years, long-term care remains a costly and complex issue. And the problems are only likely to intensify when the nation's baby boomers enter old age.

We are at the turn of a new century in which the first baby boorners will be qualifying for Medicare and retirement by the year 2011. The increasing burden of caring for our nations' elderly will preclude a need for further assessment of current issues affecting the long-term care industry and consideration of futures issues.

This thesis will focus on current issues within the long term care industry and suggested future considerations. The long term care industry has changed dramatically as the elderly population has grown.

Due to the tremendous growth in the long term care industry, escalating costs and multiple issues have arisen. This thesis discusses issues of increased costs, ethical considerations, polypharmacy, utilization of case management services, nursing home administration requirements, and discussion of industry trends and concerns.

The purpose of this thesis is to give an overview of the long term care industry with future considerations with the goal of increased insight into industry trends and issues. With increased insight, the author hopes for the possibility of choices, concerns, and policies to be affected positively.

The government has been able to stave off a long-term care crisis to date largely due to the direct caregiving provided by families. However the changes in demographics during the next several decades will result in an increased strain on the current system. The current long term care system is also weakened due in part to the inadequacies of the Medicaid Program. Enacted in 1965, Medicaid was primarily a response to the needs of the poor. Though the government did not envision Medicaid as a long-term care program, it quickly has become the primary source of Government funds for long term care services.

The population needing long term care services is a diverse group with widely differing needs, including the needs of the caregiving family members who may need a variety of long term care services. No one set of services will address the individual needs of long term care consumers. Failure to reform long term care could lead to cost shifting from the acute care system to the long term care system.

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