All people, especially ones living with disabilities, benefit from long-term care and support programs. Programs that provide medical care, support services like personal home care aides, and more contribute to overall well-being.
In a study by AARP, it shows the Americans lack a national solution for adequate home and community-based long-term care services. We depend on the state governments to fulfill the need. But few of states are prepared to handle the upcoming surge of older adults.
The study driven by AARP is called Long-Term Care Services and Support Scorecard, and it’s funded by the Commonwealth Fund and the SCAN Foundation.
The LTSS Scorecard used 5 dimensions to measure each state’s long-term care services. Here’s a list of the five dimensions used in the study:
- Affordability and Access
- Choice of Setting and Provider
- Quality of Life and Quality of Care
- Support for Family Caregivers
- Effective Transitions
The dimensions added twenty-six (26) indicators to measure each state’s long-term care services:
- Percent of adults age 21+ with ADL disability at or below 250% of poverty receiving Medicaid or other government assistance health insurance.
- Percent of Medicaid and state-funded LTSS spending going to HCBS (home and community-based services) for older people and adults with physical disabilities.
- Percent of adults age 18+ with disabilities in the community usually or always getting needed support.
- Rate of employment for adults with ADL disability ages 18 to 64 relative to the rate of employment for adults without ADL disability ages 18 to 64.
- Family caregivers without much worry or stress, with enough time, and who are well-rested.
You can view all 26 indicators used in the study by visiting: Scorecard Chartpack.
What you’ll learn from the study: If healthcare costs are too high, consumers will use their savings and turn to the state programs for help, especially if one does not have insurance.
Because states have inadequate residential alternatives in local communities, they’re forced to rely on costly nursing homes for care.
This means that people with complex needs getting care at home or in nursing homes are more likely to experience inappropriate and costly hospitalizations and inadequate support in moving from a nursing home back into the community.
Nursing home costs are much higher than home care costs. Even in the most affordable states the cost averages 171 percent of income, and in the least affordable states, it averages 382 percent of income.
Home care generally is more affordable and allows consumers to stretch their dollars further.
What the study hopes to reveal are ways for increasing quality of care for seniors and others.
In those states that performed highest on the scorecard offer programs that enlist nurses to train caregivers to help delegate patient care tasks. Whereas, low performing states do not delegate training to family members.
Here’s a short list of health tasks that nurses could train family members to do:
- administer oral medications;
- administer medication on an as-needed basis;
- administer medication via pre-filled insulin or insulin pen;
- draw up insulin for dosage measurement;
- administer intramuscular injection medications;
- administer glucometer test;
- administer medication through tubes;
- insert suppository;
- administer eye/ear drops;
- gastrostomy tube feeding
The scorecard also found:
- Low performing states do not offer Medicaid users services at home, while the better performing ones do
- Better performing states transition patients, who spent more than three months in a nursing home, back to their community. The bottom states transitioned only 5 percent.
Other public policy findings:
- Shifting service delivery toward home- and community-based services is critical.
- Few home and community-based consumers have the choice to direct their own services.
- States own a key role in minimizing inappropriate use of antipsychotic medications in nursing homes.
- Since family caregivers play a critical support role, more help for family caregivers is needed.
- Give nurses permission to delegate health maintenance tasks.
How States Rank
Minnesota ranked the highest across all five dimensions, New York and Montana ranked 25 and 26, and Kentucky ranked 51. Find out how your state ranks.
Help make changes in LTSS – Connect with your local and state governing bodies.
Studies like these arms consumers with information about long-term support and services. It’s imperative that we fight for more home and community-based services to decrease costs.
You deserve quality care at home.
Carol Marak is a contributor for the senior living and health care market. She writes on tough topics that older adults and family caregivers face; chronic issues, senior care and housing. Her work is found on AssistedLivingFacilities.org and SkilledNursingFacilities.org. Learn about Carol on LinkedIn or contact her at Carebuzz@gmail.com.
