The need for long term care (LTC) services will dramatically increase and become in demand in the next coming decades. This is partly due to the large number of baby boomers reaching the age where one normally becomes a consumer of such services. Another reason for the demand is the changing family dynamic, high divorce rates and persons without children or family support. Long term care can encompass a wide variety of services anywhere, from helping with basic needs to intensive medical care.
Types of Assistance
Types of assistance can be classified into two categories; skilled and unskilled. Skilled refers to obtaining care in which a licensed professional can only carry out such as a Licensed vocational nurse, Registered Nurses, Physical Therapist, Respiratory Therapist, and so on. Unskilled refers to care that can be carried out by unlicensed caregivers such as; Certified Nurses Aids, Home Health Aides, Bath aid, and companions.
Activities of daily living (ADLS) are what we do every day. Putting on clothes, bathing, brushing our teeth are all types of ADLS. Some people begin to have trouble performing ADLS due to a variety of reasons. Non-skilled personnel can be appropriate in helping with ADLS.
In terms of assistance, medication help can come in two forms: Skilled and non-skilled depending on the type of medication and how it is administered. All IV medications must be administered by a Licensed Nurse. Non-skilled help can help a patient take their own medication such as pills.
Extensive Medical Care
Sometimes individuals need extensive medical services and or extensive medication regimes for a long period of time. These situations call for the service of licensed personnel such as an RN or LVN. Typical long-term needs can be patients with ventilator needs or complex IV antibiotic therapy. Normally health insurance does pay for this service because it falls under medical necessity.
Both skilled and unskilled help can be found in the following locations.
Assisted Living Facility
Assisted Living Facilities (ALF) is residential care entities which help seniors live as independently as possible. ALF’s are staffed with administrators, Nurses and health aides. Some have a physician visit once weekly or more depending on the need. Some facilities have recreational and activities areas and offer physical, occupational and recreational therapy. Certain facilities allow for treatment to be rendered onsite if it is through a qualified home health agency. Regular nursing staff is normally on staff to help with simple medication assistance, blood sugar checks, help with ADL’s and ambulation. Extensive medical treatment is not usually allowed for liability reasons.
Skilled Nursing Facility
Skilled Nursing Facilities (SNF) can be used for short term skilled care or long term custodial care. Short term skilled care is usually reserved for physical therapy, occupational therapy or medical therapy such as extensive wound management, IV antibiotic therapy or complex pain control issues. Long term is considered non-skilled, but can take place in the SNF. This is usually referred to as custodial care and involves helping a patient with ADLS and basic nursing with no skilled need. This stay is funded by ether Medicaid, long term care insurance or cash pay.
Board and Care
Board and Care facilities are like ALF’s that they provide much of the same services, but usually on a smaller scale. Some are licensed and others are not.
Sub-Acute facilities can care for patients who require medical care over a long period of time. Some examples are; patients who are on a ventilator and need an extended period to wean off, long term antibiotic therapy, and complex wound management. Some skilled nursing facilities will have a sub-acute unit and can take care of patients that need ventilator support while being on custodial care status.
Long Term Acute Care Hospital (LTAC)
These facilities are designed to provide care comparable to any acute hospital. Patients with complex medical issues, Ventilator management, and complex wound care or any complex medical issue which needs to be taken care of at the level of a hospital for an extended period.
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