The odds are, at some point in a person’s life he or she will have to grapple with issues around long-term care. It may be a parent, child or spouse; it may be you. According to The Family Caregiver Alliance, 52 million Americans are informal or family caregivers who provide care for a family member age 20 or older, and one in five family households provide long term care to a person age 18 or older.
Long-term care often involves the most intimate aspects of people’s lives. When a person suffers a chronic condition, illness or trauma that limits his or her ability to carry out basic self-care tasks or home care tasks, they must rely on others to fill the gap. Because long-term care needs and services are wide-ranging and complex, there are many myths that surround these services. Here are some of the most frequently mentioned.
Myth 1: There isn’t really a difference between hospitals.
Answer: Not true. Just like cars, restaurants or hotels, hospitals differ in quality, the level and type of services provided, and the number of people they can serve. For example, the primary goal of a general hospital is to stabilize patients as a step toward recovery, and then discharge them. On the other hand, medically complex patients — those with severe, chronic health care needs, or multiple conditions who need extended recovery time and are too medically fragile to go home— are likely transferred to a long-term acute care (LTAC) hospital. Patients come to an LTAC hospital for several weeks until they are well enough to move on to the next level of their recovery. Transitional care centers (TCCs), skilled nursing and rehabilitation facilities, assisted living communities, home care and hospice are all examples of post-acute care available to patients beyond a general (acute care) hospital setting. Each one offers the targeted care a patient needs to improve his or her condition.
Myth 2: There is no difference between an LTAC hospital and a nursing home.
Answer: False. An LTAC hospital differs greatly from a skilled nursing facility or nursing home. LTAC patients are typically much sicker and have more complex medical needs than nursing home patients. They usually require 24-hour care and many depend on ventilators. The nurses, therapists and physicians at an LTAC hospital have exceptional expertise in weaning people off of ventilators and treating complex wounds. Most patients at LTACs receive care for about 25 days or more.
According to the Acute Long Term Hospital Association, LTAC patients are usually extremely ill and suffer from severe and complex conditions and diseases. Common conditions treated at LTACs include respiratory failure, head and brain trauma, serious wounds, bone infections, stroke, severe fractures and broken bones, and other conditions that require intensive care.
Myth 3: My wife’s doctor says she needs long-term care. Does the doctor mean a nursing home?
Answer: Not necessarily. Long-term care encompasses a broad spectrum of continuing health care from specialty hospitals to skilled nursing or rehabilitation centers and more. Typically long-term care means the length of care your wife needs will be a month or longer. The ultimate goal is to provide your wife with the appropriate specialized interdisciplinary care necessary to avoid re-admitting her to a traditional acute care hospital. Depending on your wife’s condition, prognosis and the severity of her illness or illnesses and how well she responds to treatment, she may or may not need additional services beyond a continued care facility to reach her fullest recovery. If additional care is needed, then the best option for her may be any one of the following -- a rehabilitation center specializing in occupational, physical or speech therapy; a skilled nursing facility or nursing home; or palliative or hospice care. Or her doctor may feel she will respond better at home with some in-home services.
Myth 4: In general, long-term care is for the elderly.
Answer: Not necessarily. The percentage of people age 65 or older with disabilities who use long term care is significantly higher (57 percent) than for younger people, according to the National Academy on Aging, but that doesn’t mean younger people don’t need long-term care. Of the 12.8 million Americans who needed long-term care in 2005, about 40 percent were younger than age 65 and 3 percent were children.
Myth 5: Over the last few decades, not much has changed in the way the U.S. delivers long-term care.
Answer: Not true. In just the last decade, medical innovation has brought about numerous advances to improve today’s healthcare. For example, the healthcare industry is always looking for, implementing and adapting better ways to care for patients so they can get well faster and resume their highest level of independence possible. Innovative facilities use best practices and continued educational programs to foster better medical collaboration between traditional acute and post-acute care facilities. This has resulted in easier transitions for patients from general hospitals to specialty care facilities, which has decreased mortality rates, lowered costs and allowed more patients to be discharged home.
Applying improved information technology to the hospital and long-term care settings allows a higher degree of communication between patients, family members and caregivers in multiple sites so everyone can work together as a team in coordinating and improving the patient’s outcome, as well as the overall health of the community.
Sources:
Long-Term Care for the Elderly with Disabilities: Current Policy, Emerging Trends, and Implications for the Twenty-First Century. Robyn I. Stone. August 2000 accessed online 9 Oct 2011 at http://www.milbank.org/0008stone/
Fact Sheet: What is long-term care? Available online at the Family Care Alliance website: accessed online 10 Oct 2011 at http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=440
What Are LTAC Hospitals. Acute Long Term Hospital Association. accessed online 3 Nov 2011 at:
http://www.altha.org/why-we-are-unique/what-are-ltac-hospitals.html
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