Dimensions of Long-Term Care Management

Long-Term Care is one of the fastest-growing segments in the healthcare field. Societal changes, including the aging of the boomers and an evolution in attitudes toward aging and retirement, will continue to propel long-term care issues to the forefront.

Mary Helen McSweeney-Feld, PhD, is an associate professor in the Office of Collaborative Programs and a research associate in the Center for Productive Aging at Towson University in Towson, Maryland. She is a member of the Education Committee of the National Association of Long Term Care Administrator Boards and a member of the Academy of Long Term Care Leadership and Development of the American College of Health Care Administrators. Her work has appeared in a variety of peer-reviewed and professional publications. Reid Oetjen, PhD, is an associate professor and program director for the University of Central Florida's graduate programs in health services administration in Orlando. He teaches long-term care administration, aging of the population, human resources management, and healthcare quality management. Dr. Oetjen has authored articles for numerous peer-reviewed publications and regularly presents his research at academic and practitioner conferences.

Preface	p. xiii
Overview of Long-Term Care	p. 1
Introduction to the Dimensions of Long-Term Care	p. 3
The Aging Tsunami: An Overview of Older Americans	p. 4
Changing Definitions of Retirement	p. 4
What Is Long-Term Care?	p. 6
The History of Long-Term Care Service Delivery	p. 7
The Aging Process and Long-Term Care Service Delivery	p. 9
Models of Long-Term Care Delivery	p. 10
Key Aspects of Long-Term Care	p. 13
A Look Ahead	p. 15
Care Settings for Long-Term Care Services	p. 17
Residential Settings for Long-Term Care Services	p. 19
Introduction	p. 20
Independent Living	p. 20
Assisted Living	p. 25
Skilled Nursing Facilities	p. 27
Continuing Care Retirement Communities	p. 30
New Developments in Residential Long-Term Care Services	p. 33
International Perspectives on Residential Long-Term Care	p. 35
A Look Ahead	p. 35
Home and Community-Based Care Services	p. 38
Introduction	p. 39
Social Policy and the Development of Community-Based Care Services	p. 39
Aging Network	p. 39
Types of Community-Based Services	p. 41
Telehealth and Home Care Services	p. 46
Innovations in HCBS: Consumer-Directed Programs	p. 46
Older Adults with Disabilities: A Special Issue in HCBS	p. 48
A Look Ahead	p. 51
Technology and Delivery of Long-Term Care Services	p. 54
Introduction	p. 55
Foundations for Information Technology Systems in Long-Term Care	p. 56
Barriers to Information Technology Systems Adoption	p. 60
Technology Applications in Long-Term Care	p. 60
A Look Ahead	p. 61
Chronic Care and Alzheimer's Disease	p. 65
Introduction	p. 66
Alzheimer's Disease and Chronic Care Services Management	p. 67
A Look Ahead	p. 78
Hospice, Palliative, and End-of-Life Care	p. 81
Introduction	p. 82
Theoretical and Conceptual Foundations	p. 82
Core Issues in Hospice and Palliative Care	p. 84
A Look Ahead	p. 98
Diversity and the Delivery of Long-Term Care Services	p. 103
Introduction	p. 104
Long-Term Health Needs of Elders by Gender, Ethnicity, and Sexual Orientation	p. 107
Disparities in Healthcare Among Diverse Elders	p. 113
A Look Ahead	p. 115
Management Issues	p. 119
Management and Leadership in Long-Term Care Settings	p. 121
What Is Management?	p. 122
Strategic Planning	p. 125
Leadership Versus Management of LTC Facilities	p. 126
Recruitment, Hiring, and Retention	p. 130
A Look Ahead	p. 139
The Design of Long-Term Care Environments	p. 145
Introduction	p. 146
Design of Long-Term Care Facilities	p. 146
Regulatory Concerns	p. 151
Management Issues of the Physical Environment	p. 154
Philosophical Evolution in Environmental Design	p. 161
Disaster Management	p. 164
A Look Ahead	p. 164
Strategic Marketing for Long-Term Care	p. 167
Introduction	p. 168
Healthcare Marketing: The Foundation	p. 168
Segmentation	p. 169
Tips for Marketing to Seniors	p. 173
A Look Ahead	p. 176
Long-Term Care Human Resources	p. 179
Introduction	p. 180
The Long-Term Care Workforce	p. 180
Description of LTC Human Resource Departments	p. 181
Goals and Functions of Human Resources	p. 182
Legal and Regulatory Compliance	p. 200
Worker Safety Law	p. 203
Current and Future Direction in LTC Human Resources	p. 204
LTC Workforce Implications	p. 207
A Look Ahead	p. 208
Legal Issues in Long-Term Care	p. 212
Introduction	p. 213
Introduction to Legal Issues	p. 214
Civil Law	p. 214
Criminal Law	p. 218
Ethical Issues	p. 219
End-of-Life Issues	p. 224
A Look Ahead	p. 228
Regulation of Long-Term Care	p. 232
Introduction	p. 233
Origins of Regulation	p. 233
Basics of Licensure, Certification, and Accreditation of LTC Services	p. 235
Assisted Living Facilities	p. 239
Continuing Care Retirement Communities	p. 241
Home and Community-Based Services	p. 242
Accountability and Quality in LTC	p. 244
A Look Ahead	p. 246
Financing Long-Term Care Services	p. 249
Introduction	p. 250
Demographic Trends and Financing	p. 250
Policy Issues: How to Pay for Long-Term Care in the Future	p. 258
Administrative Costs in Long-Term Care Insurance	p. 259
Instability of Long-Term Care Insurance Premiums	p. 259
Adverse Selection	p. 259
The Inability to Insure Against Certain Risks	p. 260
The Availability of Medicaid	p. 260
Public Long-Term Care Insurance: Germany, Japan, and the CLASS Act	p. 261
A Look Ahead	p. 262
Epilogue	p. 265
Globalization of Healthcare	p. 265
Innovative Payment Systems for LTC Needs	p. 266
Technological Innovation	p. 266
Chronic Health Conditions	p. 267
Increased Diversity	p. 267
Quality-of-Care Concerns	p. 267
Sustainability	p. 268
Glossary	p. 269
References	p. 286
Index	p. 322
About the Contributors	p. 332
About the Editors	p. 336
Table of Contents provided by Ingram. All Rights Reserved.

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Dimensions of Long-Term Care Management

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