Imagine, for a moment, an effective, cutting-edge system for improving the lives of frail elderly people. Imagine that instead of our current messy, dangerous, and needlessly expensive patchwork of elderly care, the United States had a well-coordinated care model that supported and supported paid assistants, family caregivers, safe and adequate housing, and new technology.
And imagine a system that makes it possible for seniors to live where it’s best for them, connects their personal care with medical treatment, and provides financial support to pay for it.
Over the past year, a wide variety of long-term care policy experts have worked to develop such a framework. Today, they released the results of their work, which was conducted under the auspices of the Affinity Center for Policy Resolution. Full disclosure: Served as a member of the group’s steering committee.
Report called improve care for the elderly, It is more of a framework for repair than a step-by-step cookbook. While it includes some specific examples of ways to improve the quality of long-term care for older people, it often provides policy-makers and caregivers with guidance for reform. It focuses on five main themes:
- Care settingsOlder adults need adequate, safe, and supportive housing as they age. Facility-based care must be financially sustainable even if it provides the best possible quality of life for its residents. The government should encourage new models of care for those who live at home. It should also provide appropriate incentives for high-quality care in nursing homes, supported living facilities, small group homes, and other places of worship.
- Better integration for a long time–Term care in communities. The government should encourage models that better link subsidized housing with long-term care and health care. Long-term care facility operators should strive to better communicate with their neighbours.
- family caregivers.: Policy makers should know The central role of the family and friends and develop models that support and train family caregivers. Support and training should recognize and respond to cultural differences between families.
- Direct care workers: Along with family members, direct care aides and others who provide paid personal support and services are the backbone of the long-term care system, both for those in the facilities and for the many who live at home. To ensure that the United States has enough people to provide care, these workers must be adequately paid, well trained, and given opportunities for career advancement.
- FinanceNo real reform of the long-term care system can take place without adequate funding. This means that Medicaid payments to residents of low-income nursing homes and long-term residents must be sufficient to support quality care. It will also require a fully funded public catastrophe long-term care insurance program that integrates with private insurance and Medicaid. This model is similar to Convergence Project 2016 Recommended.
The main report was attached to three detailed papers focusing on Residence Medicare Five-star rating system for nursing homes, and the The effects of deaths linked to Covid-19 on a large scale For residents and workers of long-term care facilities.
The five-star paper urged the Centers for Medicare and Medicaid Services (CMS) to refocus the nursing home rating system from primarily measuring safety to including measures of quality of life as well as more transparency around hiring.
However, the main report is much more than a broad roadmap than a set of specific step-by-step policy recommendations. In this way, it is completely different from The latest report of the National Academies of Sciences, Engineering, and Medicine on nursing home reform.
The National Academies’ report was narrow and deep: more than 600 pages of specific recommendations To improve the care of residents in nursing homes. The Convergence Framework looks at the entire aged care ecosystem in only about 16 pages, along with a package of more specific recommendations.
Like the National Academies report, this convergence paper predicts that federal and state regulators and Congress will likely address the complex issues of long-term care in small portions. Complex and large-scale reform seems highly unlikely in The current political climate. But the report points to several small steps that could improve the care that older adults now receive.
The Affinity Group included 31 members: academics, researchers, advocates, representatives of immediate care workers, long-term care facility operators, and experts in housing, finance, and technology for older adults. Its members ranged from conservatives to progressives. Members bring together hundreds of years of experience in the long-term care of the group.
The most important outcome of this project, led by Stuart Butler of the Brookings Institution, is that a diverse group of policy experts can build broad consensus on many critical long-term care issues. Congress should take note.